3.3. Retrieve MedMij Core - Patient (zib2020/R4)
3.3.1. Overview
| Id | 900000101 |
| Data service name without version (English) | Retrieve MedMij Core - Patient (zib2020/R4) |
| Data service name without version (Dutch) | Verzamelen MedMij Core - Patient (zib2020/R4) |
| Data service version | 1.0.0-beta.2 |
| System role(s) | MMC-PTR-zib2020/R4-beta.2 (PHR) MMC-PTB-zib2020/R4-beta.2 (XIS) |
| Used in Implementation Guide(s) | Dental Care |
3.3.2. Functional model
| CIM | zib Patient |
| Functional version | 3.2(2020) |
The functional model can be found on ART-DECOR.
3.3.3. Technical specification
| FHIR profile(s) | http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient |
| FHIR package | nictiz.fhir.nl.r4.nl-core version 0.12.0-beta.4 or compatible |
| FHIR version | R4 |
| Search request | GET [base]/Patient |
| Must Support |
|
| CapabilityStatement(s) | MedMij Core Patient Retrieve MedMij Core Patient Serve |
The FHIR profile is included below.
| NlcorePatient (Patient) | C | ZibPatient | |
| 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 | C | 0..* | Extension |
| nationality | C | 0..* | Extension(Complex) |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| code | C | 0..1 | Extension |
| id | 0..1 | string | |
| extension | C | 0..0 | Extension |
| url | 1..1 | uriFixed Value | |
| value[x] | 1..1 | Binding | |
| valueCodeableConcept | CodeableConcept | ||
| period | C | 0..1 | Extension |
| id | 0..1 | string | |
| extension | C | 0..0 | Extension |
| url | 1..1 | uriFixed Value | |
| value[x] | 1..1 | ||
| valuePeriod | Period | ||
| url | 1..1 | uriFixed Value | |
| value[x] | 0..0 | ||
| modifierExtension | ?! C | 0..* | Extension |
| identifier | Σ | 0..* | Identifier |
| bsn | Σ | 0..* | IdentifierPattern |
| active | Σ ?! | 0..1 | boolean |
| name | Σ | 0..* | HumanName |
| nameInformation | Σ C | 0..2 | NlcoreNameInformation |
| nameInformation-GivenName | Σ | 0..* | NlcoreNameInformationGivenName |
| telecom | Σ C | 0..* | ContactPoint |
| telephoneNumbers | Σ C | 0..* | NlcoreContactInformationTelephoneNumbers |
| emailAddresses | Σ C | 0..* | NlcoreContactInformationEmailAddresses |
| gender | Σ | 0..1 | codeBinding |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| genderCodelist | C | 0..1 | Extension(CodeableConcept) |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| url | 1..1 | uriFixed Value | |
| value[x] | 0..1 | Binding | |
| valueCodeableConcept | CodeableConcept | ||
| value | 0..1 | System.String | |
| birthDate | Σ | 0..1 | date |
| deceased[x] | Σ ?! | 0..1 | |
| deceasedBoolean | Σ ?! | 0..1 | boolean |
| deceasedDateTime | Σ ?! | 0..1 | dateTime |
| address | Σ | 0..* | NlcoreAddressInformation |
| maritalStatus | 0..1 | CodeableConceptBinding | |
| multipleBirth[x] | 0..1 | ||
| multipleBirthInteger | integer | ||
| multipleBirthBoolean | 0..1 | boolean | |
| photo | C | 0..* | Attachment |
| contact | C | 0..* | BackboneElement |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| contactPerson | C | 0..1 | Extension(Reference(RelatedPerson)) |
| id | 0..1 | string | |
| extension | C | 0..0 | Extension |
| url | 1..1 | uriFixed Value | |
| value[x] | 1..1 | ||
| valueReference | Reference(RelatedPerson | NlcoreContactPerson) | ||
| modifierExtension | Σ ?! C | 0..* | Extension |
| relationship | 0..* | CodeableConceptBinding | |
| role | 0..* | CodeableConceptBinding | |
| relationship | 0..* | CodeableConceptBinding | |
| name | C | 0..1 | NlcoreNameInformation |
| telecom | C | 0..* | ContactPoint |
| telephoneNumbers | C | 0..* | NlcoreContactInformationTelephoneNumbers |
| emailAddresses | C | 0..* | NlcoreContactInformationEmailAddresses |
| address | 0..1 | NlcoreAddressInformation | |
| gender | 0..1 | codeBinding | |
| organization | C | 0..1 | Reference(Organization) |
| period | C | 0..1 | Period |
| communication | 0..* | BackboneElement | |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| languageControl | C | 0..* | Extension(Complex) |
| id | 0..1 | string | |
| extension | C | 2..* | Extension |
| level | C | 1..1 | Extension |
| id | 0..1 | string | |
| extension | C | 0..0 | Extension |
| url | 1..1 | uriFixed Value | |
| value[x] | 1..1 | Binding | |
| valueCoding | Coding | ||
| type | C | 1..1 | Extension |
| id | 0..1 | string | |
| extension | C | 0..0 | Extension |
| url | 1..1 | uriFixed Value | |
| value[x] | 1..1 | Binding | |
| valueCoding | Coding | ||
| url | 1..1 | uriFixed Value | |
| value[x] | 0..0 | ||
| communicationDetails | C | 0..* | Extension(CodeableConcept) |
| comment | C | 0..1 | Extension(string) |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| url | 1..1 | uriFixed Value | |
| value[x] | 0..1 | ||
| valueString | string | ||
| modifierExtension | Σ ?! C | 0..* | Extension |
| language | 1..1 | CodeableConceptBinding | |
| preferred | 0..1 | boolean | |
| generalPractitioner | C | 0..* | Reference(Organization | Practitioner | PractitionerRole | NlcoreHealthProfessionalPractitionerRole) |
| managingOrganization | Σ C | 0..1 | Reference(Organization) |
| link | Σ ?! | 0..* | BackboneElement |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| other | Σ C | 1..1 | Reference(Patient | RelatedPerson) |
| type | Σ | 1..1 | codeBinding |
--- We have skipped the narrative for better readability of the resource ---
</text>
</telecom>
</contact>
<description value="A person who receives medical, psychological, paramedical or nursing care. In some care settings, the term client or participant is used instead of the term patient.\nNationality is used as an indication of the country of citizenship. \nMarital status is a person’s formal position as defined by the Dutch civil code. There is a distinction between marriage and civil union.\nLinguistic proficiency is the ability to express oneself in a certain language and understand statements made in that language. This includes both oral and written communication." />
<purpose value="A derived profile from [zib-Patient](http://nictiz.nl/fhir/StructureDefinition/zib-Patient) to provide a version better suited for implementation purposes. This profile augments the base profile with elements found in the various use cases that have adopted the zib." />
<copyright value="Copyright and related rights waived via CC0, https://creativecommons.org/publicdomain/zero/1.0/. This does not apply to information from third parties, for example a medical terminology system. The implementer alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize third party IP in connection with the specification or otherwise." />
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
<definition value="Demographics and other administrative information about an individual or animal receiving care or other health-related services." />
</base>
<human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources" />
</constraint>
<human value="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" />
<expression value="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()" />
<xpath value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))" />
</constraint>
<human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" />
<xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))" />
</constraint>
<human value="If a resource is contained in another resource, it SHALL NOT have a security label" />
</constraint>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
<valueMarkdown value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time." />
</extension>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes." />
<comment value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation." />
</base>
</extension>
</type>
</element>
<definition value="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." />
</base>
</type>
</constraint>
</element>
<definition value="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." />
<comment value="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." />
</base>
</type>
</constraint>
<isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation" />
</element>
<comment value="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)." />
</base>
</type>
</constraint>
</extension>
</extension>
</extension>
</binding>
</element>
<definition value="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." />
<comment value="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." />
</base>
</type>
</constraint>
</mapping>
</element>
<definition value="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." />
<comment value="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." />
</base>
</type>
</mapping>
</element>
</discriminator>
</slicing>
<definition value="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." />
<comment value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</element>
<comment value="Due to the nature of the nationality core extension (which allows for a period to be placed next to the nationality and thus allows for different nationalities over time), the cardinality of the extension is left at `0..*` instead of the zib cardinality of `0..1`." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</element>
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</extension>
</type>
</mapping>
</element>
</discriminator>
</slicing>
<definition value="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." />
<comment value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</element>
</base>
</type>
</constraint>
</constraint>
</element>
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</extension>
</type>
</mapping>
</element>
</discriminator>
</slicing>
</base>
</type>
</constraint>
</constraint>
</element>
<comment value="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." />
</base>
</type>
</mapping>
</element>
</base>
</type>
</constraint>
<valueSet value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.7.6.3--20200901000000" />
</binding>
</mapping>
</mapping>
</element>
</base>
</type>
</constraint>
</constraint>
</element>
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</extension>
</type>
</mapping>
</element>
</discriminator>
</slicing>
</base>
</type>
</constraint>
</constraint>
</element>
<comment value="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." />
</base>
</type>
</mapping>
</element>
<definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/extensibility.html) for a list)." />
</base>
</type>
</constraint>
</mapping>
</element>
<comment value="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." />
</base>
</extension>
</type>
</mapping>
</element>
<definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/extensibility.html) for a list)." />
</base>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</constraint>
</mapping>
</element>
<definition value="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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="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." />
<requirements value="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](extensibility.html#modifierExtension)." />
</base>
</type>
</constraint>
</constraint>
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them" />
</mapping>
</element>
</discriminator>
</slicing>
<definition value="The patient’s identification number. In transfer situations, use of the social security number (BSN) must comply with the Use of Social Security Numbers in Healthcare Act (Wbsn-z). In other situations, other number systems can be used, such as internal hospital patient numbers for example." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
</base>
</type>
</patternIdentifier>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="Whether this patient record is in active use. \nMany 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.\n\nIt is often used to filter patient lists to exclude inactive patients\n\nDeceased patients may also be marked as inactive for the same reasons, but may be active for some time after death." />
<comment value="If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient." />
<requirements value="Need to be able to mark a patient record as not to be used because it was created in error." />
</base>
</type>
<meaningWhenMissing value="This resource is generally assumed to be active if no value is provided for the active element" />
</constraint>
<isModifierReason value="This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid" />
</mapping>
</mapping>
</mapping>
</element>
</slicing>
<comment value="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." />
<requirements value="Need to be able to track the patient by multiple names. Examples are your official name and a partner name." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
</extension>
</extension>
<definition value="This slice represents the person's official name information, including given names, last name and possibly the partner's last name." />
<comment value="This `.name` element accomodates the official parts of a Dutch name according to common international usage and optionally to the [zib NameInformation v1.1 (2020)](https://zibs.nl/wiki/NameInformation-v1.1(2020EN)). An official Dutch name is represented in FHIR as an ordinary international name, optionally augmented using extensions to specify how the last name is built up according to the Dutch rules if conformance to the zib is required. See the guidance on `.family` and on `.extension:nameUsage` for more information.\n\nSystems that need to work in a Dutch context SHOULD support the extensions as specified in `.given`, `.family` and `.extension:nameUsage`. In addition, systems SHOULD use the core elements according to the FHIR specifications to provide compatibility outside Dutch contexts. This means that:\n* If parts of the name are specified using one or more of the structured elements, the `.text` element SHOULD be populated with a rendered version of the full name.\n* If parts of the family name are specified using the extensions in `.family`, the `.family` element SHOULD be populated with the full family name.\n\n**Note 1**: The zib cannot be represented straightforward in FHIR. Especially note the guidance on `.given` on how to map the FirstNames and Initials concepts, and on `.prefix`/`.suffix` on how to map the Titles concept.\n\n**Note 2**: This element should only contain a person's _official_ names. The GivenName concept is represented in another `.name` element with `.name.use` = _usual_.\n\n**Note 3**: The examples illustrate how the zib is mapped to FHIR." />
<requirements value="Need to be able to track the patient by multiple names. Examples are your official name and a partner name." />
</base>
</type>
</constraint>
<expression value="family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-prefix').empty().not() implies family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-name').empty().not()" />
</constraint>
<human value="If the prefix for a partner family name is specified, the partner family name is expected as well" />
<expression value="family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix').empty().not() implies family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-name').empty().not()" />
</constraint>
<human value="If parts of the name are specified using one or more of the structured elements, the `.text` element SHOULD be populated with a rendered version of the full name. This ensures compatibility with common FHIR usage." />
<expression value="(family.exists() or given.extension.where(url = 'http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier').where(value != 'IN').exists()) implies text.hasValue()" />
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
</extension>
</extension>
<definition value="This slice represents the name information normally used to address the person." />
<comment value="This `.name` element represents the Dutch given name ("roepnaam") according to the [zib NameInformation v1.1 (2020)](https://zibs.nl/wiki/NameInformation-v1.1(2020EN)).\n\n**Note 1**: This element should only contain a person's _unofficial_ name. The official names are represented in one or more other `.name` elements with `.name.use` = _official_.\n\n**Note 2**: The examples illustrate how the zib is mapped to FHIR." />
<requirements value="Need to be able to track the patient by multiple names. Examples are your official name and a partner name." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
</discriminator>
</slicing>
<comment value="The cardinality mismatch between the zib (`0..1`) and FHIR (`0..*`) is explained by the containers TelephoneNumbers (`0..*`) and EmailAddresses (`0..*`) inside the ContactInformation model. The FHIR datatype ContactPoint does not have these containers." />
<requirements value="People have (primary) ways to contact them in some way such as phone, email." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
</extension>
</extension>
<definition value="Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc." />
<comment value="Implementation of the "TelephoneNumbers" concept of zib ContactInformation.\n\nPlease note that, although the zib concepts TelecomType and NumberType are functionally equivalent to the FHIR concepts `ContactPoint.system` and `ContactPoint.use` respectively, a mismatch occurs on the concept of mobile phone numbers; the zib uses the first concept and FHIR the second. For this reason, the ValueSet on `ContactPoint.system` is too narrow and the zib code will need to be communicated using the ext-CodeSpecification extension." />
<requirements value="People have (primary) ways to contact them in some way such as phone, email." />
</base>
<profile value="http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactInformation-TelephoneNumbers" />
</type>
</constraint>
<source value="http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelephoneNumbers" />
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
</extension>
</extension>
<definition value="Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc." />
<requirements value="People have (primary) ways to contact them in some way such as phone, email." />
</base>
<profile value="http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactInformation-EmailAddresses" />
</type>
</constraint>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<comment value="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." />
<requirements value="Needed for identification of the individual, in combination with (at least) name and birth date." />
</base>
</type>
</constraint>
</extension>
</extension>
<description value="Use ConceptMap GeslachtCodelijst-to-AdministrativeGender to translate terminology from the functional model to profile terminology in ValueSet AdministrativeGender." />
<valueCanonical value="http://nictiz.nl/fhir/ConceptMap/GeslachtCodelijst-to-AdministrativeGender" />
</extension>
</valueSet>
</binding>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
</base>
</extension>
</type>
</element>
</discriminator>
</slicing>
<definition value="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." />
<comment value="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." />
</base>
</type>
</constraint>
</constraint>
</element>
</extension>
</extension>
<comment value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</mapping>
</element>
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</extension>
</type>
</mapping>
</element>
</discriminator>
</slicing>
<definition value="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." />
<comment value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</element>
<comment value="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." />
</base>
</extension>
</type>
</mapping>
</element>
</base>
</type>
</constraint>
<valueSet value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.0.1.1--20200901000000" />
</binding>
</mapping>
</mapping>
</element>
</base>
</extension>
</extension>
</type>
</element>
<definition value="Patient’s date of birth. The date of birth is mandatory for a patient. A vague date (such as only the year) is permitted." />
<comment value="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)." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
</discriminator>
</slicing>
<comment value="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." />
<requirements value="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." />
</base>
</type>
</type>
</constraint>
<isModifierReason value="This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different." />
</mapping>
<map value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedTime" />
</mapping>
</mapping>
</element>
<comment value="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." />
<requirements value="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." />
</base>
</type>
</constraint>
<isModifierReason value="This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different." />
</mapping>
<map value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedTime" />
</mapping>
</mapping>
</mapping>
</element>
<definition value="The date on which the patient died. A ‘vague’ date, such as only the year, is permitted." />
<comment value="The zib recognizes both the DeathIndicator (boolean) and DateOfDeath (datetime) concepts, whereas in FHIR only one of these concepts may be present. Therefore, if deceasedDateTime is present and has a value, its value can be mapped to DateOfDeath and DeathIndicator is assumed to be true." />
<requirements value="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." />
</base>
</type>
</constraint>
<isModifierReason value="This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different." />
</mapping>
<map value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedTime" />
</mapping>
</mapping>
</mapping>
</mapping>
</element>
</extension>
</extension>
<definition value="An address expressed using postal conventions (as opposed to GPS or other location definition formats). This data type may be used to convey addresses for use in delivering mail as well as for visiting locations which might not be valid for mail delivery. There are a variety of postal address formats defined around the world." />
<comment value="This datatype defines a common basis for expressing all addresses around the world, but adds extensions to express Dutch addresses specifically, according to the [zib AddressInformation v1.1 (2020)](https://zibs.nl/wiki/AddressInformation-v1.1(2020EN)). A Dutch Address still is a proper FHIR Address, which means that systems that cannot interpret the extensions will still be able to render and work with this datatype.\n\nTo have true compatibility an implementer SHOULD use the core Address parts as intended. To have addresses work for Dutch context, the implementer SHOULD in addition use the extension elements.\n\n**Separate address parts**\n\nThe first addition is that Dutch addresses make certain address parts separately communicable. These parts are required for use in true Dutch systems when dealing with Dutch addresses, but may not have value for international systems when information gets sent abroad.\n\n**Custom address types**\n\nThe second addition is that the zib defines its own ValueSet for address types, which can only be partially expressed using the FHIR Address datatype and requires a mapping to multiple elements. The table below explains how the zib concepts are mapped to the various FHIR elements (see the ConceptMaps <http://nictiz.nl/fhir/ConceptMap/AdresSoortCodelijst-to-AddressUse> and <http://nictiz.nl/fhir/ConceptMap/AdresSoortCodelijst-to-AddressType> as well). The code from the zib should also be included using the extension on `Address.extension:addressType`.\n\n| zib | .ext:addressType | .use | .type |\n|-----------------------------------|------------------|------|----------|\n| Postal Address/Postadres | PST | | postal |\n| Primary Home/Officieel adres | HP | home | both |\n| Visit Address/Woon-/verblijfadres | PHYS | home | physical |\n| Temporary Address/Tijdelijk adres | TMP | temp | |\n| Work Place/Werkadres | WP | work | |\n| Vacation Home/Vakantie adres | HV | temp | |\n\nIf `Address.type` is _both_ then this is to be understood as a dual purpose address (postal and physical), unless a specific _postal_ type address is added. Systems that support importing it like this are encouraged to do so, otherwise they may need to import this as two separate addresses.\n\nNote: FHIR core defines the AD-use extension to further specify the postal address type. However, the ValueSet used in that extension doesn't completely match the zib ValueSet. Therefore, a custom extension has been made. This doesn't preclude the use of the AD-use extension." />
<requirements value="May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="A person’s marital status according to the terms and definition in the Dutch civil code." />
</base>
</type>
</constraint>
</extension>
</extension>
<valueSet value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.7.9.1--20200901000000" />
</binding>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
</discriminator>
</slicing>
<definition value="Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer)." />
<comment value="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)." />
<requirements value="For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs." />
</base>
</type>
</type>
</constraint>
</mapping>
<map value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber" />
</mapping>
</mapping>
</element>
<comment value="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)." />
<requirements value="For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs." />
</base>
</type>
</constraint>
</mapping>
<map value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber" />
</mapping>
</mapping>
</mapping>
</element>
<comment value="Guidelines:\n* Use id photos, not clinical photos.\n* Limit dimensions to thumbnail.\n* Keep byte count low to ease resource updates." />
<requirements value="Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</element>
</extension>
<comment value="Whereas the zib ContactPerson includes all (non-healthcare professional) persons that are involved in the care for a patient, FHIR distinguishes two use cases for these persons:\n\n* The RelatedPerson resource is used to capture information about any person that is related to the patient, using the profile <http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactPerson>.\n* Information about persons that should be _contacted_ regarding the care for the patient is captured using the `Patient.contact` resource.\n\nIf a person is both a related person and a contact person, then some data duplication is inevitable. The nl-core-ContactPerson can be referenced using the extension in `contact:contactPerson`." />
</base>
</type>
</constraint>
<expression value="name.exists() or telecom.exists() or address.exists() or organization.exists()" />
<xpath value="exists(f:name) or exists(f:telecom) or exists(f:address) or exists(f:organization)" />
</constraint>
</mapping>
</mapping>
</mapping>
</element>
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</extension>
</type>
</mapping>
</element>
</discriminator>
</slicing>
<definition value="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." />
<comment value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</element>
<definition value="In some cases a Patient.contact will also be populated as a RelatedPerson resource. This linkage permits the linkage between the 2 resources to be able to accurately indicate a representation of the same individual, and updating details between could be appropriate." />
<comment value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</element>
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</extension>
</type>
</mapping>
</element>
</discriminator>
</slicing>
</base>
</type>
</constraint>
</constraint>
</element>
<comment value="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." />
</base>
</extension>
</type>
</mapping>
</element>
<definition value="Reference to an [nl-core-ContactPerson](http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactPerson) instance containing the full details for the current contact." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</element>
<definition value="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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="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." />
<requirements value="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](extensibility.html#modifierExtension)." />
</base>
</type>
</constraint>
</constraint>
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
</mapping>
</element>
</discriminator>
</slicing>
<requirements value="Used to determine which contact person is the most relevant to approach, depending on circumstances." />
</base>
</type>
</constraint>
</extension>
<description value="The nature of the relationship between a patient and a contact person for that patient." />
</binding>
</mapping>
</mapping>
</mapping>
</element>
<requirements value="Used to determine which contact person is the most relevant to approach, depending on circumstances." />
</base>
</type>
</constraint>
</extension>
<valueSet value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.3.1.2--20200901000000" />
</binding>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<requirements value="Used to determine which contact person is the most relevant to approach, depending on circumstances." />
</base>
</type>
</constraint>
</extension>
<valueSet value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.3.1.1--20200901000000" />
</binding>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
</extension>
</extension>
<definition value="This slice represents the person's official name information, including given names, last name and possibly the partner's last name." />
<comment value="This `.name` element accomodates the official parts of a Dutch name according to common international usage and optionally to the [zib NameInformation v1.1 (2020)](https://zibs.nl/wiki/NameInformation-v1.1(2020EN)). An official Dutch name is represented in FHIR as an ordinary international name, optionally augmented using extensions to specify how the last name is built up according to the Dutch rules if conformance to the zib is required. See the guidance on `.family` and on `.extension:nameUsage` for more information.\n\nSystems that need to work in a Dutch context SHOULD support the extensions as specified in `.given`, `.family` and `.extension:nameUsage`. In addition, systems SHOULD use the core elements according to the FHIR specifications to provide compatibility outside Dutch contexts. This means that:\n* If parts of the name are specified using one or more of the structured elements, the `.text` element SHOULD be populated with a rendered version of the full name.\n* If parts of the family name are specified using the extensions in `.family`, the `.family` element SHOULD be populated with the full family name.\n\n**Note 1**: The zib cannot be represented straightforward in FHIR. Especially note the guidance on `.given` on how to map the FirstNames and Initials concepts, and on `.prefix`/`.suffix` on how to map the Titles concept.\n\n**Note 2**: This element should only contain a person's _official_ names. The GivenName concept is represented in another `.name` element with `.name.use` = _usual_.\n\n**Note 3**: The examples illustrate how the zib is mapped to FHIR." />
<requirements value="Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person." />
</base>
</type>
</constraint>
<expression value="family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-prefix').empty().not() implies family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-name').empty().not()" />
</constraint>
<human value="If the prefix for a partner family name is specified, the partner family name is expected as well" />
<expression value="family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix').empty().not() implies family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-name').empty().not()" />
</constraint>
<human value="If parts of the name are specified using one or more of the structured elements, the `.text` element SHOULD be populated with a rendered version of the full name. This ensures compatibility with common FHIR usage." />
<expression value="(family.exists() or given.extension.where(url = 'http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier').where(value != 'IN').exists()) implies text.hasValue()" />
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
</discriminator>
</slicing>
<comment value="The cardinality mismatch between the zib (`0..1`) and FHIR (`0..*`) is explained by the containers TelephoneNumbers (`0..*`) and EmailAddresses (`0..*`) inside the ContactInformation model. The FHIR datatype ContactPoint does not have these containers." />
<requirements value="People have (primary) ways to contact them in some way such as phone, email." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
</extension>
</extension>
<definition value="Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc." />
<comment value="Implementation of the "TelephoneNumbers" concept of zib ContactInformation.\n\nPlease note that, although the zib concepts TelecomType and NumberType are functionally equivalent to the FHIR concepts `ContactPoint.system` and `ContactPoint.use` respectively, a mismatch occurs on the concept of mobile phone numbers; the zib uses the first concept and FHIR the second. For this reason, the ValueSet on `ContactPoint.system` is too narrow and the zib code will need to be communicated using the ext-CodeSpecification extension." />
<requirements value="People have (primary) ways to contact them in some way such as phone, email." />
</base>
<profile value="http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactInformation-TelephoneNumbers" />
</type>
</constraint>
<source value="http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelephoneNumbers" />
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
</extension>
</extension>
<definition value="Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc." />
<requirements value="People have (primary) ways to contact them in some way such as phone, email." />
</base>
<profile value="http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactInformation-EmailAddresses" />
</type>
</constraint>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
</extension>
</extension>
<definition value="An address expressed using postal conventions (as opposed to GPS or other location definition formats). This data type may be used to convey addresses for use in delivering mail as well as for visiting locations which might not be valid for mail delivery. There are a variety of postal address formats defined around the world." />
<comment value="This element can and should not completely capture the AddressInformation concept from zib ContactPerson; it should just be used for the information that is needed for contacting the person in relation to care of the patient. The full address information should instead be captured using an instance of [nl-core-ContactPerson](http://nictiz.nl/fhir/StructureDefintion/nl-core-ContactPerson), which can then be referenced from this resource. See the comment on `Patient.contact` for more information." />
<requirements value="Need to keep track where the contact person can be contacted per postal mail or visited." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes." />
</base>
</type>
</constraint>
</extension>
</extension>
</binding>
</mapping>
</mapping>
</mapping>
</element>
<definition value="Organization on behalf of which the contact is acting or for which the contact is working." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</element>
<short value="The period during which this contact person or organization is valid to be contacted relating to this patient" />
<definition value="The period during which this contact person or organization is valid to be contacted relating to this patient." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</element>
<definition value="A language which may be used to communicate with the patient about his or her health." />
<comment value="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." />
<requirements value="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." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</element>
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</extension>
</type>
</mapping>
</element>
</discriminator>
</slicing>
<definition value="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." />
<comment value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</element>
<definition value="The ability to understand spoken text in the language in question.\nThe ability to express oneself in spoken language.\nThe ability to understand written text in he language in question." />
<comment value="The zib concepts LanguageControlListening, LanguageControlReading, LanguageControlSpeaking are captured using a core extension from the R4 FHIR specification. Each of these three concepts is encoded as a copy of the extension, typed using the code in the type slice according to the following mapping:\n* LanguageControlListening maps to code 'RSP' (Received spoken)\n* LanguageControlReading maps to code 'RWR' (Received written)\n* LanguageControlSpeaking maps to code 'ESP' (Expressed spoken)" />
</base>
</type>
</constraint>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</extension>
</type>
</mapping>
</element>
</discriminator>
</slicing>
<definition value="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." />
<comment value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</element>
</base>
</type>
</constraint>
</constraint>
</element>
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</extension>
</type>
</mapping>
</element>
</discriminator>
</slicing>
</base>
</type>
</constraint>
</constraint>
</element>
<comment value="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." />
</base>
</type>
</mapping>
</element>
<definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/extensibility.html) for a list)." />
<comment value="The zib ValueSets TaalvaardigheidBegrijpenCodelijst, TaalvaardigheidSprekenCodelijst and TaalvaardigheidLezenCodelijst are equal to the default FHIR ValueSet." />
</base>
</type>
</constraint>
</extension>
</binding>
</mapping>
</element>
</base>
</type>
</constraint>
</constraint>
</element>
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</extension>
</type>
</mapping>
</element>
</discriminator>
</slicing>
</base>
</type>
</constraint>
</constraint>
</element>
<comment value="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." />
</base>
</type>
</mapping>
</element>
<definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/extensibility.html) for a list)." />
</base>
</type>
</constraint>
</extension>
</binding>
</mapping>
</element>
<comment value="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." />
</base>
</extension>
</type>
</mapping>
</element>
<definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/extensibility.html) for a list)." />
</base>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</type>
</constraint>
</mapping>
</element>
</extension>
</extension>
<comment value="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." />
</base>
<profile value="http://nictiz.nl/fhir/StructureDefinition/ext-LanguageProficiency.CommunicationDetails" />
</type>
</constraint>
</constraint>
</mapping>
</mapping>
</element>
</extension>
</extension>
<comment value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</mapping>
</element>
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</extension>
</type>
</mapping>
</element>
</discriminator>
</slicing>
<definition value="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." />
<comment value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</element>
<comment value="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." />
</base>
</extension>
</type>
</mapping>
</element>
<definition value="A comment on the linguistic proficiency. When using sign language, this field can be used to clarify, for example, which sign language is used. This can be informative, as there is not always a one-to-one relationship between the spoken language and sign language." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</element>
<definition value="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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="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." />
<requirements value="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](extensibility.html#modifierExtension)." />
</base>
</type>
</constraint>
</constraint>
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
</mapping>
</element>
<comment value="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." />
<requirements value="Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect." />
</base>
</type>
</constraint>
</extension>
</extension>
</extension>
<valueSet value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.7.12.2--20200901000000" />
</binding>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="Indicates whether or not the patient prefers this language (over other languages he masters up a certain level)." />
<comment value="This language is specifically identified for communicating healthcare information." />
<requirements value="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." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</element>
<comment value="Each occurrence of the zib HealthProfessional is normally represented by _two_ FHIR resources: a PractitionerRole resource (instance of [nl-core-HealthProfessional-PractitionerRole](http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-PractitionerRole)) and a Practitioner resource (instance of [nl-core-HealthProfessional-Practitioner](http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-Practitioner)). The Practitioner resource is referenced from the PractitionerRole instance. For this reason, sending systems should fill the reference to the PractitionerRole instance here, and not the Practitioner resource. Receiving systems can then retrieve the reference to the Practitioner resource from that PractitionerRole instance.\n\nIn rare circumstances, there is only a Practitioner instance, in which case it is that instance which will be referenced here. However, since this should be the exception, the nl-core-HealthProfessional-Practitioner profile is not explicitly mentioned as a target profile." />
</base>
<targetProfile value="http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-PractitionerRole" />
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</element>
<comment value="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)." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</element>
<requirements value="There are multiple use cases: \n\n* Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and \n* Distribution of patient information across multiple servers." />
</base>
</type>
</constraint>
<isModifierReason value="This element is labeled as a modifier because it might not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'" />
</mapping>
</mapping>
</element>
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</extension>
</type>
</mapping>
</element>
<definition value="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." />
<comment value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</element>
<definition value="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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="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." />
<requirements value="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](extensibility.html#modifierExtension)." />
</base>
</type>
</constraint>
</constraint>
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
</mapping>
</element>
<comment value="Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual." />
</base>
</extension>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</element>
</base>
</type>
</constraint>
</extension>
<description value="The type of link between this patient resource and another patient resource." />
</binding>
</mapping>
</mapping>
</element>
</snapshot>
</element>
</type>
</element>
</type>
</element>
<profile value="http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactInformation-TelephoneNumbers" />
</type>
</element>
<profile value="http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactInformation-EmailAddresses" />
</type>
</element>
</type>
</element>
<comment value="Whereas the zib ContactPerson includes all (non-healthcare professional) persons that are involved in the care for a patient, FHIR distinguishes two use cases for these persons:\n\n* The RelatedPerson resource is used to capture information about any person that is related to the patient, using the profile <http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactPerson>.\n* Information about persons that should be _contacted_ regarding the care for the patient is captured using the `Patient.contact` resource.\n\nIf a person is both a related person and a contact person, then some data duplication is inevitable. The nl-core-ContactPerson can be referenced using the extension in `contact:contactPerson`." />
</element>
</element>
<definition value="Reference to an [nl-core-ContactPerson](http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactPerson) instance containing the full details for the current contact." />
</type>
</element>
</type>
</element>
<profile value="http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactInformation-TelephoneNumbers" />
</type>
</element>
<profile value="http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactInformation-EmailAddresses" />
</type>
</element>
<comment value="This element can and should not completely capture the AddressInformation concept from zib ContactPerson; it should just be used for the information that is needed for contacting the person in relation to care of the patient. The full address information should instead be captured using an instance of [nl-core-ContactPerson](http://nictiz.nl/fhir/StructureDefintion/nl-core-ContactPerson), which can then be referenced from this resource. See the comment on `Patient.contact` for more information." />
</type>
</element>
<comment value="Each occurrence of the zib HealthProfessional is normally represented by _two_ FHIR resources: a PractitionerRole resource (instance of [nl-core-HealthProfessional-PractitionerRole](http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-PractitionerRole)) and a Practitioner resource (instance of [nl-core-HealthProfessional-Practitioner](http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-Practitioner)). The Practitioner resource is referenced from the PractitionerRole instance. For this reason, sending systems should fill the reference to the PractitionerRole instance here, and not the Practitioner resource. Receiving systems can then retrieve the reference to the Practitioner resource from that PractitionerRole instance.\n\nIn rare circumstances, there is only a Practitioner instance, in which case it is that instance which will be referenced here. However, since this should be the exception, the nl-core-HealthProfessional-Practitioner profile is not explicitly mentioned as a target profile." />
<targetProfile value="http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-PractitionerRole" />
</type>
</element>
</differential>
</StructureDefinition>
{
--- We have skipped the narrative for better readability of the resource ---
},
{
]
}
],
"description": "A person who receives medical, psychological, paramedical or nursing care. In some care settings, the term client or participant is used instead of the term patient.\nNationality is used as an indication of the country of citizenship. \nMarital status is a person’s formal position as defined by the Dutch civil code. There is a distinction between marriage and civil union.\nLinguistic proficiency is the ability to express oneself in a certain language and understand statements made in that language. This includes both oral and written communication.",
"purpose": "A derived profile from [zib-Patient](http://nictiz.nl/fhir/StructureDefinition/zib-Patient) to provide a version better suited for implementation purposes. This profile augments the base profile with elements found in the various use cases that have adopted the zib.",
"copyright": "Copyright and related rights waived via CC0, https://creativecommons.org/publicdomain/zero/1.0/. This does not apply to information from third parties, for example a medical terminology system. The implementer alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize third party IP in connection with the specification or otherwise.",
{
},
{
},
{
},
{
},
{
},
{
},
{
}
],
{
"definition": "Demographics and other administrative information about an individual or animal receiving care or other health-related services.",
"SubjectOfCare Client Resident",
"Patient",
"nl-core-Patient"
],
},
{
},
{
"human": "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",
"expression": "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()",
"xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
},
{
"human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
},
{
},
{
{
},
{
"valueMarkdown": "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
}
],
}
],
{
},
{
},
{
},
{
}
]
},
{
"definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
"comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
},
{
{
}
],
}
],
},
{
"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.",
},
],
{
}
],
},
{
"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.",
"comment": "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.",
},
],
{
}
],
"isModifierReason": "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation",
},
{
"comment": "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).",
},
],
{
}
],
{
},
{
},
{
}
],
}
},
{
"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.",
"comment": "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",
"html",
"xhtml",
"display"
],
},
],
{
}
],
]
},
{
"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.",
"comment": "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.",
"inline resources",
"anonymous resources",
"contained resources"
],
},
],
]
},
{
},
"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.",
"comment": "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.",
"extensions",
"user content"
],
},
],
{
},
{
}
],
]
},
{
"comment": "Due to the nature of the nationality core extension (which allows for a period to be placed next to the nationality and thus allows for different nationalities over time), the cardinality of the extension is left at `0..*` instead of the zib cardinality of `0..1`.",
"extensions",
"user content"
],
},
{
}
],
"ele-1"
],
{
},
{
}
],
]
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
],
},
"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.",
"comment": "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.",
"extensions",
"user content"
],
},
],
{
},
{
}
],
]
},
{
},
],
{
},
{
}
],
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
],
},
},
],
{
},
{
}
],
},
{
"xmlAttr"
],
"comment": "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.",
},
],
]
},
{
"Nationaliteit"
],
},
],
{
}
],
"valueSet": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.7.6.3--20200901000000"
},
{
},
{
}
]
},
{
},
],
{
},
{
}
],
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
],
},
},
],
{
},
{
}
],
},
{
"xmlAttr"
],
"comment": "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.",
},
],
]
},
{
"definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/extensibility.html) for a list).",
},
],
{
}
],
]
},
{
"xmlAttr"
],
"comment": "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.",
},
{
{
}
],
}
],
]
},
{
"definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/extensibility.html) for a list).",
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
}
],
{
}
],
]
},
{
"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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "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.",
"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](extensibility.html#modifierExtension).",
"extensions",
"user content"
],
},
],
{
},
{
}
],
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
]
},
{
},
"definition": "The patient’s identification number. In transfer situations, use of the social security number (BSN) must comply with the Use of Social Security Numbers in Healthcare Act (Wbsn-z). In other situations, other number systems can be used, such as internal hospital patient numbers for example.",
"Identificatienummer"
],
},
],
{
}
],
{
},
{
},
{
},
{
},
{
}
]
},
{
},
],
},
{
}
],
{
},
{
},
{
},
{
}
]
},
{
"definition": "Whether this patient record is in active use. \nMany 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.\n\nIt is often used to filter patient lists to exclude inactive patients\n\nDeceased patients may also be marked as inactive for the same reasons, but may be active for some time after death.",
"comment": "If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient.",
"requirements": "Need to be able to mark a patient record as not to be used because it was created in error.",
},
],
"meaningWhenMissing": "This resource is generally assumed to be active if no value is provided for the active element",
{
}
],
"isModifierReason": "This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid",
{
},
{
},
{
}
]
},
{
},
"comment": "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.",
"requirements": "Need to be able to track the patient by multiple names. Examples are your official name and a partner name.",
"Naamgegevens",
"BetalerNaam"
],
},
],
{
}
],
{
},
{
},
{
},
{
},
{
}
]
},
{
{
},
{
}
],
"definition": "This slice represents the person's official name information, including given names, last name and possibly the partner's last name.",
"comment": "This `.name` element accomodates the official parts of a Dutch name according to common international usage and optionally to the [zib NameInformation v1.1 (2020)](https://zibs.nl/wiki/NameInformation-v1.1(2020EN)). An official Dutch name is represented in FHIR as an ordinary international name, optionally augmented using extensions to specify how the last name is built up according to the Dutch rules if conformance to the zib is required. See the guidance on `.family` and on `.extension:nameUsage` for more information.\n\nSystems that need to work in a Dutch context SHOULD support the extensions as specified in `.given`, `.family` and `.extension:nameUsage`. In addition, systems SHOULD use the core elements according to the FHIR specifications to provide compatibility outside Dutch contexts. This means that:\n* If parts of the name are specified using one or more of the structured elements, the `.text` element SHOULD be populated with a rendered version of the full name.\n* If parts of the family name are specified using the extensions in `.family`, the `.family` element SHOULD be populated with the full family name.\n\n**Note 1**: The zib cannot be represented straightforward in FHIR. Especially note the guidance on `.given` on how to map the FirstNames and Initials concepts, and on `.prefix`/`.suffix` on how to map the Titles concept.\n\n**Note 2**: This element should only contain a person's _official_ names. The GivenName concept is represented in another `.name` element with `.name.use` = _usual_.\n\n**Note 3**: The examples illustrate how the zib is mapped to FHIR.",
"requirements": "Need to be able to track the patient by multiple names. Examples are your official name and a partner name.",
"Naamgegevens",
"nl-core-NameInformation"
],
},
{
"http://nictiz.nl/fhir/StructureDefinition/nl-core-NameInformation"
]
}
],
"ele-1"
],
{
},
{
"expression": "family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-prefix').empty().not() implies family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-name').empty().not()",
},
{
"human": "If the prefix for a partner family name is specified, the partner family name is expected as well",
"expression": "family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix').empty().not() implies family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-name').empty().not()",
},
{
"human": "If parts of the name are specified using one or more of the structured elements, the `.text` element SHOULD be populated with a rendered version of the full name. This ensures compatibility with common FHIR usage.",
"expression": "(family.exists() or given.extension.where(url = 'http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier').where(value != 'IN').exists()) implies text.hasValue()",
}
],
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
}
]
},
{
{
},
{
}
],
"comment": "This `.name` element represents the Dutch given name (\"roepnaam\") according to the [zib NameInformation v1.1 (2020)](https://zibs.nl/wiki/NameInformation-v1.1(2020EN)).\n\n**Note 1**: This element should only contain a person's _unofficial_ name. The official names are represented in one or more other `.name` elements with `.name.use` = _official_.\n\n**Note 2**: The examples illustrate how the zib is mapped to FHIR.",
"requirements": "Need to be able to track the patient by multiple names. Examples are your official name and a partner name.",
"nl-core-NameInformation.GivenName"
],
},
{
"http://nictiz.nl/fhir/StructureDefinition/nl-core-NameInformation.GivenName"
]
}
],
"ele-1"
],
{
}
],
{
},
{
},
{
},
{
},
{
},
{
},
{
}
]
},
{
},
"comment": "The cardinality mismatch between the zib (`0..1`) and FHIR (`0..*`) is explained by the containers TelephoneNumbers (`0..*`) and EmailAddresses (`0..*`) inside the ContactInformation model. The FHIR datatype ContactPoint does not have these containers.",
"Contactgegevens"
],
},
],
{
}
],
{
},
{
},
{
},
{
},
{
},
{
}
]
},
{
{
},
{
}
],
"definition": "Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc.",
"comment": "Implementation of the \"TelephoneNumbers\" concept of zib ContactInformation.\n\nPlease note that, although the zib concepts TelecomType and NumberType are functionally equivalent to the FHIR concepts `ContactPoint.system` and `ContactPoint.use` respectively, a mismatch occurs on the concept of mobile phone numbers; the zib uses the first concept and FHIR the second. For this reason, the ValueSet on `ContactPoint.system` is too narrow and the zib code will need to be communicated using the ext-CodeSpecification extension.",
"Telefoonnummers",
"nl-core-ContactInformation-TelephoneNumbers"
],
},
{
"http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactInformation-TelephoneNumbers"
]
}
],
"ele-1"
],
{
},
{
}
],
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
}
]
},
{
{
},
{
}
],
"definition": "Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc.",
"EmailAdressen",
"nl-core-ContactInformation-EmailAddresses"
],
},
{
"http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactInformation-EmailAddresses"
]
}
],
"ele-1"
],
{
},
{
}
],
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
}
]
},
{
"comment": "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.",
"requirements": "Needed for identification of the individual, in combination with (at least) name and birth date.",
"Geslacht"
],
},
],
{
}
],
{
},
{
}
],
"description": "Use ConceptMap GeslachtCodelijst-to-AdministrativeGender to translate terminology from the functional model to profile terminology in ValueSet AdministrativeGender.",
{
}
]
}
},
{
},
{
},
{
},
{
}
]
},
{
"xmlAttr"
],
},
{
{
}
],
}
],
},
{
},
"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.",
"comment": "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.",
"extensions",
"user content"
],
},
],
{
},
{
}
],
},
{
{
},
{
}
],
"comment": "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.",
"extensions",
"user content"
],
},
{
"http://nictiz.nl/fhir/StructureDefinition/ext-CodeSpecification"
]
}
],
"ele-1"
],
{
},
{
}
],
]
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
],
},
"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.",
"comment": "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.",
"extensions",
"user content"
],
},
],
{
},
{
}
],
]
},
{
"xmlAttr"
],
"comment": "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.",
},
{
{
}
],
}
],
]
},
{
"Geslacht"
],
},
],
{
}
],
"valueSet": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.0.1.1--20200901000000"
},
{
},
{
}
]
},
{
"xmlAttr"
],
},
{
{
},
{
}
],
}
],
},
{
"definition": "Patient’s date of birth. The date of birth is mandatory for a patient. A vague date (such as only the year) is permitted.",
"comment": "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).",
"Geboortedatum"
],
},
],
{
}
],
{
},
{
},
{
},
{
},
{
}
]
},
{
},
"comment": "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.",
"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.",
},
],
{
}
],
"isModifierReason": "This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.",
{
},
{
"map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedTime"
},
{
}
]
},
{
"comment": "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.",
"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.",
"OverlijdensIndicator"
],
},
],
{
}
],
"isModifierReason": "This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.",
{
},
{
"map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedTime"
},
{
},
{
}
]
},
{
"definition": "The date on which the patient died. A ‘vague’ date, such as only the year, is permitted.",
"comment": "The zib recognizes both the DeathIndicator (boolean) and DateOfDeath (datetime) concepts, whereas in FHIR only one of these concepts may be present. Therefore, if deceasedDateTime is present and has a value, its value can be mapped to DateOfDeath and DeathIndicator is assumed to be 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.",
"DatumOverlijden",
"OverlijdensIndicator"
],
},
],
{
}
],
"isModifierReason": "This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.",
{
},
{
"map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedTime"
},
{
},
{
},
{
}
]
},
{
{
},
{
}
],
"definition": "An address expressed using postal conventions (as opposed to GPS or other location definition formats). This data type may be used to convey addresses for use in delivering mail as well as for visiting locations which might not be valid for mail delivery. There are a variety of postal address formats defined around the world.",
"comment": "This datatype defines a common basis for expressing all addresses around the world, but adds extensions to express Dutch addresses specifically, according to the [zib AddressInformation v1.1 (2020)](https://zibs.nl/wiki/AddressInformation-v1.1(2020EN)). A Dutch Address still is a proper FHIR Address, which means that systems that cannot interpret the extensions will still be able to render and work with this datatype.\n\nTo have true compatibility an implementer SHOULD use the core Address parts as intended. To have addresses work for Dutch context, the implementer SHOULD in addition use the extension elements.\n\n**Separate address parts**\n\nThe first addition is that Dutch addresses make certain address parts separately communicable. These parts are required for use in true Dutch systems when dealing with Dutch addresses, but may not have value for international systems when information gets sent abroad.\n\n**Custom address types**\n\nThe second addition is that the zib defines its own ValueSet for address types, which can only be partially expressed using the FHIR Address datatype and requires a mapping to multiple elements. The table below explains how the zib concepts are mapped to the various FHIR elements (see the ConceptMaps <http://nictiz.nl/fhir/ConceptMap/AdresSoortCodelijst-to-AddressUse> and <http://nictiz.nl/fhir/ConceptMap/AdresSoortCodelijst-to-AddressType> as well). The code from the zib should also be included using the extension on `Address.extension:addressType`.\n\n| zib | .ext:addressType | .use | .type |\n|-----------------------------------|------------------|------|----------|\n| Postal Address/Postadres | PST | | postal |\n| Primary Home/Officieel adres | HP | home | both |\n| Visit Address/Woon-/verblijfadres | PHYS | home | physical |\n| Temporary Address/Tijdelijk adres | TMP | temp | |\n| Work Place/Werkadres | WP | work | |\n| Vacation Home/Vakantie adres | HV | temp | |\n\nIf `Address.type` is _both_ then this is to be understood as a dual purpose address (postal and physical), unless a specific _postal_ type address is added. Systems that support importing it like this are encouraged to do so, otherwise they may need to import this as two separate addresses.\n\nNote: FHIR core defines the AD-use extension to further specify the postal address type. However, the ValueSet used in that extension doesn't completely match the zib ValueSet. Therefore, a custom extension has been made. This doesn't preclude the use of the AD-use extension.",
"requirements": "May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.",
"Adresgegevens",
"nl-core-AddressInformation"
],
},
{
"http://nictiz.nl/fhir/StructureDefinition/nl-core-AddressInformation"
]
}
],
"ele-1"
],
{
}
],
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
}
]
},
{
"definition": "A person’s marital status according to the terms and definition in the Dutch civil code.",
"BurgerlijkeStaat"
],
},
],
{
}
],
{
},
{
}
],
"valueSet": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.7.9.1--20200901000000"
},
{
},
{
},
{
},
{
}
]
},
{
},
"definition": "Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer).",
"comment": "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).",
"requirements": "For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs.",
},
],
{
}
],
{
},
{
"map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber"
},
{
}
]
},
{
"comment": "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).",
"requirements": "For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs.",
"MeerlingIndicator"
],
},
],
{
}
],
{
},
{
"map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber"
},
{
},
{
}
]
},
{
"comment": "Guidelines:\n* Use id photos, not clinical photos.\n* Limit dimensions to thumbnail.\n* Keep byte count low to ease resource updates.",
"requirements": "Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too.",
},
],
{
}
],
{
},
{
},
{
}
]
},
{
{
}
],
"comment": "Whereas the zib ContactPerson includes all (non-healthcare professional) persons that are involved in the care for a patient, FHIR distinguishes two use cases for these persons:\n\n* The RelatedPerson resource is used to capture information about any person that is related to the patient, using the profile <http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactPerson>.\n* Information about persons that should be _contacted_ regarding the care for the patient is captured using the `Patient.contact` resource.\n\nIf a person is both a related person and a contact person, then some data duplication is inevitable. The nl-core-ContactPerson can be referenced using the extension in `contact:contactPerson`.",
"Contactpersoon"
],
},
],
{
},
{
}
],
{
},
{
},
{
}
]
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
},
"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.",
"comment": "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.",
"extensions",
"user content"
],
},
],
{
},
{
}
],
]
},
{
"definition": "In some cases a Patient.contact will also be populated as a RelatedPerson resource. This linkage permits the linkage between the 2 resources to be able to accurately indicate a representation of the same individual, and updating details between could be appropriate.",
"comment": "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.",
"extensions",
"user content"
],
},
{
}
],
"ele-1"
],
{
},
{
}
],
]
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
],
},
},
],
{
},
{
}
],
},
{
"xmlAttr"
],
"comment": "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.",
},
{
{
}
],
}
],
]
},
{
"definition": "Reference to an [nl-core-ContactPerson](http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactPerson) instance containing the full details for the current contact.",
"Contactpersoon"
],
},
{
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactPerson"
]
}
],
{
}
],
{
},
{
}
]
},
{
"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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "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.",
"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](extensibility.html#modifierExtension).",
"extensions",
"user content",
"modifiers"
],
},
],
{
},
{
}
],
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
]
},
{
},
"requirements": "Used to determine which contact person is the most relevant to approach, depending on circumstances.",
},
],
{
}
],
{
}
],
"description": "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.",
"Rol"
],
},
],
{
}
],
{
}
],
"valueSet": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.3.1.2--20200901000000"
},
{
},
{
},
{
},
{
}
]
},
{
"requirements": "Used to determine which contact person is the most relevant to approach, depending on circumstances.",
"Relatie"
],
},
],
{
}
],
{
}
],
"valueSet": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.3.1.1--20200901000000"
},
{
},
{
},
{
},
{
}
]
},
{
{
},
{
}
],
"definition": "This slice represents the person's official name information, including given names, last name and possibly the partner's last name.",
"comment": "This `.name` element accomodates the official parts of a Dutch name according to common international usage and optionally to the [zib NameInformation v1.1 (2020)](https://zibs.nl/wiki/NameInformation-v1.1(2020EN)). An official Dutch name is represented in FHIR as an ordinary international name, optionally augmented using extensions to specify how the last name is built up according to the Dutch rules if conformance to the zib is required. See the guidance on `.family` and on `.extension:nameUsage` for more information.\n\nSystems that need to work in a Dutch context SHOULD support the extensions as specified in `.given`, `.family` and `.extension:nameUsage`. In addition, systems SHOULD use the core elements according to the FHIR specifications to provide compatibility outside Dutch contexts. This means that:\n* If parts of the name are specified using one or more of the structured elements, the `.text` element SHOULD be populated with a rendered version of the full name.\n* If parts of the family name are specified using the extensions in `.family`, the `.family` element SHOULD be populated with the full family name.\n\n**Note 1**: The zib cannot be represented straightforward in FHIR. Especially note the guidance on `.given` on how to map the FirstNames and Initials concepts, and on `.prefix`/`.suffix` on how to map the Titles concept.\n\n**Note 2**: This element should only contain a person's _official_ names. The GivenName concept is represented in another `.name` element with `.name.use` = _usual_.\n\n**Note 3**: The examples illustrate how the zib is mapped to FHIR.",
"requirements": "Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person.",
"Naamgegevens",
"nl-core-NameInformation"
],
},
{
"http://nictiz.nl/fhir/StructureDefinition/nl-core-NameInformation"
]
}
],
"ele-1"
],
{
},
{
"expression": "family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-prefix').empty().not() implies family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-name').empty().not()",
},
{
"human": "If the prefix for a partner family name is specified, the partner family name is expected as well",
"expression": "family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix').empty().not() implies family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-name').empty().not()",
},
{
"human": "If parts of the name are specified using one or more of the structured elements, the `.text` element SHOULD be populated with a rendered version of the full name. This ensures compatibility with common FHIR usage.",
"expression": "(family.exists() or given.extension.where(url = 'http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier').where(value != 'IN').exists()) implies text.hasValue()",
}
],
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
}
]
},
{
},
"comment": "The cardinality mismatch between the zib (`0..1`) and FHIR (`0..*`) is explained by the containers TelephoneNumbers (`0..*`) and EmailAddresses (`0..*`) inside the ContactInformation model. The FHIR datatype ContactPoint does not have these containers.",
"Contactgegevens"
],
},
],
{
}
],
{
},
{
},
{
},
{
},
{
}
]
},
{
{
},
{
}
],
"definition": "Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc.",
"comment": "Implementation of the \"TelephoneNumbers\" concept of zib ContactInformation.\n\nPlease note that, although the zib concepts TelecomType and NumberType are functionally equivalent to the FHIR concepts `ContactPoint.system` and `ContactPoint.use` respectively, a mismatch occurs on the concept of mobile phone numbers; the zib uses the first concept and FHIR the second. For this reason, the ValueSet on `ContactPoint.system` is too narrow and the zib code will need to be communicated using the ext-CodeSpecification extension.",
"Telefoonnummers",
"nl-core-ContactInformation-TelephoneNumbers"
],
},
{
"http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactInformation-TelephoneNumbers"
]
}
],
"ele-1"
],
{
},
{
}
],
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
}
]
},
{
{
},
{
}
],
"definition": "Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc.",
"EmailAdressen",
"nl-core-ContactInformation-EmailAddresses"
],
},
{
"http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactInformation-EmailAddresses"
]
}
],
"ele-1"
],
{
},
{
}
],
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
}
]
},
{
{
},
{
}
],
"definition": "An address expressed using postal conventions (as opposed to GPS or other location definition formats). This data type may be used to convey addresses for use in delivering mail as well as for visiting locations which might not be valid for mail delivery. There are a variety of postal address formats defined around the world.",
"comment": "This element can and should not completely capture the AddressInformation concept from zib ContactPerson; it should just be used for the information that is needed for contacting the person in relation to care of the patient. The full address information should instead be captured using an instance of [nl-core-ContactPerson](http://nictiz.nl/fhir/StructureDefintion/nl-core-ContactPerson), which can then be referenced from this resource. See the comment on `Patient.contact` for more information.",
"requirements": "Need to keep track where the contact person can be contacted per postal mail or visited.",
"Adresgegevens",
"nl-core-AddressInformation"
],
},
{
"http://nictiz.nl/fhir/StructureDefinition/nl-core-AddressInformation"
]
}
],
"ele-1"
],
{
}
],
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
}
]
},
{
"definition": "Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes.",
},
],
{
}
],
{
},
{
}
],
},
{
},
{
},
{
}
]
},
{
"definition": "Organization on behalf of which the contact is acting or for which the contact is working.",
},
{
}
],
"pat-1"
],
{
}
],
{
},
{
},
{
}
]
},
{
"short": "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.",
},
],
{
}
],
]
},
{
"definition": "A language which may be used to communicate with the patient about his or her health.",
"comment": "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.",
"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.",
"Taalvaardigheid"
],
},
],
{
}
],
{
},
{
},
{
}
]
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
},
"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.",
"comment": "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.",
"extensions",
"user content"
],
},
],
{
},
{
}
],
]
},
{
"definition": "The ability to understand spoken text in the language in question.\nThe ability to express oneself in spoken language.\nThe ability to understand written text in he language in question.",
"comment": "The zib concepts LanguageControlListening, LanguageControlReading, LanguageControlSpeaking are captured using a core extension from the R4 FHIR specification. Each of these three concepts is encoded as a copy of the extension, typed using the code in the type slice according to the following mapping:\n* LanguageControlListening maps to code 'RSP' (Received spoken)\n* LanguageControlReading maps to code 'RWR' (Received written)\n* LanguageControlSpeaking maps to code 'ESP' (Expressed spoken)",
"extensions",
"user content",
"TaalvaardigheidBegrijpen",
"TaalvaardigheidSpreken",
"TaalvaardigheidLezen"
],
},
{
}
],
"ele-1"
],
{
},
{
}
],
{
},
{
},
{
},
{
}
]
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
],
},
"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.",
"comment": "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.",
"extensions",
"user content"
],
},
],
{
},
{
}
],
]
},
{
},
],
{
},
{
}
],
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
],
},
},
],
{
},
{
}
],
},
{
"xmlAttr"
],
"comment": "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.",
},
],
]
},
{
"definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/extensibility.html) for a list).",
"comment": "The zib ValueSets TaalvaardigheidBegrijpenCodelijst, TaalvaardigheidSprekenCodelijst and TaalvaardigheidLezenCodelijst are equal to the default FHIR ValueSet.",
},
],
{
}
],
{
}
],
},
]
},
{
},
],
{
},
{
}
],
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
],
},
},
],
{
},
{
}
],
},
{
"xmlAttr"
],
"comment": "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.",
},
],
]
},
{
"definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/extensibility.html) for a list).",
},
],
{
}
],
{
}
],
},
]
},
{
"xmlAttr"
],
"comment": "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.",
},
{
{
}
],
}
],
]
},
{
"definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/extensibility.html) for a list).",
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
}
],
{
}
],
]
},
{
{
},
{
}
],
"comment": "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.",
"extensions",
"user content"
],
},
{
"http://nictiz.nl/fhir/StructureDefinition/ext-LanguageProficiency.CommunicationDetails"
]
}
],
"ele-1"
],
{
},
{
}
],
]
},
{
{
},
{
}
],
"comment": "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.",
"extensions",
"user content"
],
},
],
"ele-1"
],
{
},
{
}
],
]
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
],
},
"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.",
"comment": "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.",
"extensions",
"user content"
],
},
],
{
},
{
}
],
]
},
{
"xmlAttr"
],
"comment": "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.",
},
{
{
}
],
}
],
]
},
{
"definition": "A comment on the linguistic proficiency. When using sign language, this field can be used to clarify, for example, which sign language is used. This can be informative, as there is not always a one-to-one relationship between the spoken language and sign language.",
"Toelichting"
],
},
],
{
}
],
{
},
{
}
]
},
{
"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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "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.",
"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](extensibility.html#modifierExtension).",
"extensions",
"user content",
"modifiers"
],
},
],
{
},
{
}
],
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
]
},
{
"comment": "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.",
"requirements": "Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.",
"CommunicatieTaal"
],
},
],
{
}
],
{
},
{
},
{
}
],
"valueSet": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.7.12.2--20200901000000"
},
{
},
{
},
{
},
{
}
]
},
{
"definition": "Indicates whether or not the patient prefers this language (over other languages he masters up a certain level).",
"requirements": "People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method.",
},
],
{
}
],
{
},
{
},
{
}
]
},
{
"comment": "Each occurrence of the zib HealthProfessional is normally represented by _two_ FHIR resources: a PractitionerRole resource (instance of [nl-core-HealthProfessional-PractitionerRole](http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-PractitionerRole)) and a Practitioner resource (instance of [nl-core-HealthProfessional-Practitioner](http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-Practitioner)). The Practitioner resource is referenced from the PractitionerRole instance. For this reason, sending systems should fill the reference to the PractitionerRole instance here, and not the Practitioner resource. Receiving systems can then retrieve the reference to the Practitioner resource from that PractitionerRole instance.\n\nIn rare circumstances, there is only a Practitioner instance, in which case it is that instance which will be referenced here. However, since this should be the exception, the nl-core-HealthProfessional-Practitioner profile is not explicitly mentioned as a target profile.",
"careProvider"
],
},
{
"http://hl7.org/fhir/StructureDefinition/Organization",
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole",
"http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-PractitionerRole"
]
}
],
{
}
],
{
},
{
},
{
}
]
},
{
"comment": "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).",
},
{
}
],
{
}
],
]
},
{
"requirements": "There are multiple use cases: \n\n* Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and \n* Distribution of patient information across multiple servers.",
},
],
{
}
],
"isModifierReason": "This element is labeled as a modifier because it might not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'",
]
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
"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.",
"comment": "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.",
"extensions",
"user content"
],
},
],
{
},
{
}
],
]
},
{
"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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "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.",
"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](extensibility.html#modifierExtension).",
"extensions",
"user content",
"modifiers"
],
},
],
{
},
{
}
],
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
]
},
{
"comment": "Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.",
},
{
{
}
],
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson"
]
}
],
{
}
],
{
},
{
},
{
}
]
},
{
},
],
{
}
],
{
}
],
},
]
}
]
},
{
},
{
{
"http://nictiz.nl/fhir/StructureDefinition/nl-core-NameInformation"
]
}
]
},
{
{
"http://nictiz.nl/fhir/StructureDefinition/nl-core-NameInformation.GivenName"
]
}
]
},
{
{
"http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactInformation-TelephoneNumbers"
]
}
]
},
{
{
"http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactInformation-EmailAddresses"
]
}
]
},
{
{
"http://nictiz.nl/fhir/StructureDefinition/nl-core-AddressInformation"
]
}
]
},
{
"comment": "Whereas the zib ContactPerson includes all (non-healthcare professional) persons that are involved in the care for a patient, FHIR distinguishes two use cases for these persons:\n\n* The RelatedPerson resource is used to capture information about any person that is related to the patient, using the profile <http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactPerson>.\n* Information about persons that should be _contacted_ regarding the care for the patient is captured using the `Patient.contact` resource.\n\nIf a person is both a related person and a contact person, then some data duplication is inevitable. The nl-core-ContactPerson can be referenced using the extension in `contact:contactPerson`."
},
{
},
{
"definition": "Reference to an [nl-core-ContactPerson](http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactPerson) instance containing the full details for the current contact.",
{
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactPerson"
]
}
]
},
{
{
"http://nictiz.nl/fhir/StructureDefinition/nl-core-NameInformation"
]
}
]
},
{
{
"http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactInformation-TelephoneNumbers"
]
}
]
},
{
{
"http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactInformation-EmailAddresses"
]
}
]
},
{
"comment": "This element can and should not completely capture the AddressInformation concept from zib ContactPerson; it should just be used for the information that is needed for contacting the person in relation to care of the patient. The full address information should instead be captured using an instance of [nl-core-ContactPerson](http://nictiz.nl/fhir/StructureDefintion/nl-core-ContactPerson), which can then be referenced from this resource. See the comment on `Patient.contact` for more information.",
{
"http://nictiz.nl/fhir/StructureDefinition/nl-core-AddressInformation"
]
}
]
},
{
"comment": "Each occurrence of the zib HealthProfessional is normally represented by _two_ FHIR resources: a PractitionerRole resource (instance of [nl-core-HealthProfessional-PractitionerRole](http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-PractitionerRole)) and a Practitioner resource (instance of [nl-core-HealthProfessional-Practitioner](http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-Practitioner)). The Practitioner resource is referenced from the PractitionerRole instance. For this reason, sending systems should fill the reference to the PractitionerRole instance here, and not the Practitioner resource. Receiving systems can then retrieve the reference to the Practitioner resource from that PractitionerRole instance.\n\nIn rare circumstances, there is only a Practitioner instance, in which case it is that instance which will be referenced here. However, since this should be the exception, the nl-core-HealthProfessional-Practitioner profile is not explicitly mentioned as a target profile.",
{
"http://hl7.org/fhir/StructureDefinition/Organization",
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole",
"http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-PractitionerRole"
]
}
]
}
]
}
}