NHSDigital-Patient
Profile uri | FHIR Module | Maturity Level |
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https://fhir.nhs.uk/StructureDefinition/NHSDigital-Patient | Administration | normative |
UK Core Patient
Patient | I | Patient | Element IdPatient Information about an individual or animal receiving health care services Alternate namesSubjectOfCare Client Resident DefinitionDemographics and other administrative information about an individual or animal receiving care or other health-related services.
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extension | I | 0..* | Extension | Element IdPatient.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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birthPlace | I | 0..1 | Extension(Address) | There are no (further) constraints on this element Element IdPatient.extension:birthPlace The registered place of birth of the patient. Alternate namesextensions, user content DefinitionThe registered place of birth of the patient. 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. http://hl7.org/fhir/StructureDefinition/patient-birthPlace Constraints
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url | 1..1 | System.StringFixed Value | There are no (further) constraints on this element Element IdPatient.extension:birthPlace.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. System.String Fixed Valuehttp://hl7.org/fhir/StructureDefinition/patient-birthPlace
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value[x] | 1..1 | There are no (further) constraints on this element Element IdPatient.extension:birthPlace.value[x] The registered place of birth of the patient. DefinitionValue of extension - must be one of a constrained set of the data types (see Extensibility for a list).
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valueAddress | Address | There are no (further) constraints on this element Data Type | ||||||||||||||||||||||||||
birthSex | I | 0..1 | Extension(code) | There are no (further) constraints on this element Element IdPatient.extension:birthSex The patient's phenotypic sex at birth. Alternate namesextensions, user content DefinitionThe patient's phenotypic sex at birth. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-BirthSex Constraints
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cadavericDonor | I | 0..1 | Extension(boolean) | There are no (further) constraints on this element Element IdPatient.extension:cadavericDonor Post-mortem donor status. Alternate namesextensions, user content DefinitionFlag indicating whether the patient authorized the donation of body parts after death. 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. http://hl7.org/fhir/StructureDefinition/patient-cadavericDonor Constraints
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url | 1..1 | System.StringFixed Value | There are no (further) constraints on this element Element IdPatient.extension:cadavericDonor.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. System.String Fixed Valuehttp://hl7.org/fhir/StructureDefinition/patient-cadavericDonor
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value[x] | 1..1 | There are no (further) constraints on this element Element IdPatient.extension:cadavericDonor.value[x] Post-mortem donor status. DefinitionFlag indicating whether the patient authorized the donation of body parts after death.
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valueBoolean | boolean | There are no (further) constraints on this element Data Type | ||||||||||||||||||||||||||
contactPreference | I | 0..1 | Extension(Complex) | There are no (further) constraints on this element Element IdPatient.extension:contactPreference The preferred method of contact, contact times and written communication format given by a Patient or Related Person. Alternate namesextensions, user content DefinitionThe preferred method of contact, contact times and written communication format given by a Patient or Related Person. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Complex) Extension URLhttps://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-ContactPreference Constraints
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deathNotificationStatus | I | 0..1 | Extension(Complex) | There are no (further) constraints on this element Element IdPatient.extension:deathNotificationStatus The patient's death notification status. Alternate namesextensions, user content DefinitionThe patient's death notification status. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Complex) Extension URLhttps://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-DeathNotificationStatus Constraints
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ethnicCategory | I | 0..1 | Extension(CodeableConcept) | There are no (further) constraints on this element Element IdPatient.extension:ethnicCategory The ethnicity of the subject Alternate namesextensions, user content DefinitionThe ethnicity of the subject. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-EthnicCategory Constraints
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residentialStatus | I | 0..1 | Extension(CodeableConcept) | There are no (further) constraints on this element Element IdPatient.extension:residentialStatus The residential status of the patient. Alternate namesextensions, user content DefinitionThe residential status of the patient. For example if this patient is a UK resident. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-ResidentialStatus Constraints
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patientInterpreterRequired | I | 0..1 | Extension(boolean) | There are no (further) constraints on this element Element IdPatient.extension:patientInterpreterRequired Whether the patient needs an interpreter Alternate namesextensions, user content DefinitionThis Patient requires an interpreter to communicate healthcare information to the practitioner. The Patient does not speak the default language of the organization, and hence requires an interpreter. If the patient has other languages in the Communications list, then that would be the type of interpreter required. http://hl7.org/fhir/StructureDefinition/patient-interpreterRequired Constraints
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url | 1..1 | System.StringFixed Value | There are no (further) constraints on this element Element IdPatient.extension:patientInterpreterRequired.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. System.String Fixed Valuehttp://hl7.org/fhir/StructureDefinition/patient-interpreterRequired
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value[x] | 1..1 | There are no (further) constraints on this element Element IdPatient.extension:patientInterpreterRequired.value[x] Indicator showing whether the patient needs an interpreter DefinitionIndicator showing if this Patient requires an interpreter to communicate healthcare information to the practitioner.
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valueBoolean | boolean | There are no (further) constraints on this element Data Type | ||||||||||||||||||||||||||
medicalApplianceSupplier | S I | 0..1 | Extension(Reference(UK Core Organization)) | Element IdPatient.extension:medicalApplianceSupplier A patient's medical appliance supplier Alternate namesextensions, user content Definition
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Reference(UK Core Organization)) Extension URLhttps://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-MedicalApplianceSupplier Constraints
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nominatedPharmacy | S I | 0..1 | Extension(Reference(UK Core Organization)) | Element IdPatient.extension:nominatedPharmacy Individual's nominated pharmacy. Alternate namesextensions, user content DefinitionA patient can choose up to three nominated dispensers to cover different contractor types:
Each of those nominations is held in an Extension. All require a ODS/ANANA code from Organisation Data Services. This contains download CSV files for these organisations, for API access please see Organisation Data Service - FHIR API nominatedPharmacy (extension nominatedPharmacy)
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Reference(UK Core Organization)) Extension URLhttps://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NominatedPharmacy Constraints
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preferredDispenserOrganization | S I | 0..1 | Extension(Reference(UK Core Organization)) | Element IdPatient.extension:preferredDispenserOrganization A patient's preferred dispensing organisation Alternate namesextensions, user content DefinitionA patient's preferred dispensing organisation.
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Reference(UK Core Organization)) Extension URLhttps://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-PreferredDispenserOrganization Constraints
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identifier | S Σ | 0..* | Identifier | Element IdPatient.identifier The patient's NHS number. The primary identifier of a patient, unique within NHS England and Wales. Always 10 digits and must be a valid NHS number. DefinitionAt least one patient identifier, MUST be provided. Where a traced NHS number is available for a patient this MUST be included. In general an untraced NHS Number MUST not be used, if an untracted NHS Number is used the extension https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus MUST be used.
Local identifiers such as MRN MUST include a system which identifies NHS provider/assigning authority.
Patients are almost always assigned specific numerical identifiers. Unordered, Open, by system(Value) Constraints
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nhsNumber | S Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdPatient.identifier:nhsNumber The patient's NHS number DefinitionAn identifier for this patient. Patients are almost always assigned specific numerical identifiers.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.identifier:nhsNumber.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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nhsNumberVerificationStatus | I | 0..1 | Extension(CodeableConcept) | There are no (further) constraints on this element Element IdPatient.identifier:nhsNumber.extension:nhsNumberVerificationStatus NHS number verification status Alternate namesextensions, user content DefinitionThe verification/tracing status of the NHS number. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus Constraints
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.identifier:nhsNumber.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.identifier:nhsNumber.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | S Σ | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.identifier:nhsNumber.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
https://fhir.nhs.uk/Id/nhs-number
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value | Σ | 1..1 | string | There are no (further) constraints on this element Element IdPatient.identifier:nhsNumber.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.identifier:nhsNumber.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(UK Core Organization) | There are no (further) constraints on this element Element IdPatient.identifier:nhsNumber.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Reference(UK Core Organization) Constraints
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active | Σ ?! | 0..1 | boolean | There are no (further) constraints on this element Element IdPatient.active Whether this patient's record is in active use DefinitionWhether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules. It is often used to filter patient lists to exclude inactive patients Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death. Need to be able to mark a patient record as not to be used because it was created in error. If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient. This resource is generally assumed to be active if no value is provided for the active element
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name | S Σ | 0..* | HumanName | Element IdPatient.name A name associated with the patient DefinitionAt least one patient name must be provided. It is recommended a use is provided.
Need to be able to track the patient by multiple names. Examples are your official name and a partner name. A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.
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use | Σ ?! | 0..1 | codeBinding | Element IdPatient.name.use The following values are allowed: usual, temp, nickname, old, maiden DefinitionHow this name should be used.
The following use codes are included in the name-use value set, but should not be used and is not be returned as part of a retrieval.
Allows the appropriate name for a particular context of use to be selected from among a set of names. Applications can assume that a name is current unless it explicitly says that it is temporary or old. The use of a human name. NameUse (required)Constraints
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.name.text Text representation of the full name DefinitionSpecifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts. A renderable, unencoded form. Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.
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family | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.name.family Family name (often called 'Surname') Alternate namessurname DefinitionThe part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father. Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).
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given | S Σ | 0..5 | string | Element IdPatient.name.given Given names (not always 'first'). Includes middle names Alternate namesfirst name, middle name DefinitionGiven names, including any middle names. If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first.
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prefix | Σ | 0..* | string | There are no (further) constraints on this element Element IdPatient.name.prefix Parts that come before the name DefinitionPart of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name. Note that FHIR strings SHALL NOT exceed 1MB in size
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suffix | Σ | 0..* | string | There are no (further) constraints on this element Element IdPatient.name.suffix Parts that come after the name DefinitionPart of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name. Note that FHIR strings SHALL NOT exceed 1MB in size
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.name.period Time period when name was/is in use DefinitionIndicates the period of time when this name was valid for the named person. Allows names to be placed in historical context. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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telecom | S Σ I | 0..* | ContactPoint | Element IdPatient.telecom A contact detail for the individual DefinitionList of contact points for the patient; for example, phone numbers or email addresses. When a patient tagged as
People have (primary) ways to contact them in some way such as phone, email. A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).
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system | Σ I | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.telecom.system phone | fax | email | pager | url | sms | other DefinitionTelecommunications form for contact point - what communications system is required to make use of the contact. Note that FHIR strings SHALL NOT exceed 1MB in size Telecommunications form for contact point. ContactPointSystem (required)Constraints
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.telecom.system.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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otherContactSystem | I | 0..1 | Extension(Coding) | There are no (further) constraints on this element Element IdPatient.telecom.system.extension:otherContactSystem Other contact system Alternate namesextensions, user content DefinitionOther contact system value which extends the system element in the ContactPoint datatype. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-OtherContactSystem Constraints
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value | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.telecom.value The actual contact point details DefinitionThe actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address). Need to support legacy numbers that are not in a tightly controlled format. Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.telecom.use home | work | temp | old | mobile - purpose of this contact point DefinitionIdentifies the purpose for the contact point. Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose. Applications can assume that a contact is current unless it explicitly says that it is temporary or old. Use of contact point. ContactPointUse (required)Constraints
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rank | Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element IdPatient.telecom.rank Specify preferred order of use (1 = highest) DefinitionSpecifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values. Note that rank does not necessarily follow the order in which the contacts are represented in the instance.
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.telecom.period Time period when the contact point was/is in use DefinitionTime period when the contact point was/is in use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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gender | S Σ | 0..1 | codeBinding | Element IdPatient.gender male | female | other | unknown DefinitionClassification of the gender of a patient. The classification is phenotypical rather than genotypical, i.e. it does not provide codes for medical or scientific purposes. It is the administrative gender that the patient wishes to be known as. In some cases, this may not be the same as the patient’s registered birth gender, or their current clinical gender. Needed for identification of the individual, in combination with (at least) name and birth date. The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex. The gender of a person used for administrative purposes. AdministrativeGender (required)Constraints
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birthDate | S Σ | 0..1 | date | Element IdPatient.birthDate The date of birth for the individual DefinitionThe date on which the patient was born or is officially deemed to have been born. It is a date in the format When a patient tagged as Age of the individual drives many clinical processes. At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternity/infant care systems).
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.birthDate.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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birthTime | I | 0..1 | Extension(dateTime) | There are no (further) constraints on this element Element IdPatient.birthDate.extension:birthTime Time of day of birth. Alternate namesextensions, user content DefinitionThe time of day that the patient was born. This includes the date to ensure that the timezone information can be communicated effectively. 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. http://hl7.org/fhir/StructureDefinition/patient-birthTime Constraints
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url | 1..1 | System.StringFixed Value | There are no (further) constraints on this element Element IdPatient.birthDate.extension:birthTime.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. System.String Fixed Valuehttp://hl7.org/fhir/StructureDefinition/patient-birthTime
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value[x] | 1..1 | There are no (further) constraints on this element Element IdPatient.birthDate.extension:birthTime.value[x] Time of day of birth. DefinitionThe time of day that the patient was born. This includes the date to ensure that the timezone information can be communicated effectively.
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valueDateTime | dateTime | There are no (further) constraints on this element Data Type | ||||||||||||||||||||||||||
deceased[x] | S Σ ?! | 0..1 | Element IdPatient.deceased[x] Indicates if the individual is deceased or not DefinitionThe date and time on which a person died or is officially deemed to have died, if applicable and known. It is a datetime in the format When a patient tagged as The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive. If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.
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deceasedBoolean | boolean | There are no (further) constraints on this element Data Type | ||||||||||||||||||||||||||
deceasedDateTime | dateTime | There are no (further) constraints on this element Data Type | ||||||||||||||||||||||||||
address | S Σ | 0..* | Address | Element IdPatient.address An address for the individual DefinitionList of addresses associated with the patient. These are fully populated on a retrieval or a successful update, only the home address is returned on a search. When a patient tagged as
May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification. Patient may have multiple addresses with different uses or applicable periods.
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extension | I | 0..* | Extension | Element IdPatient.address.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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addressKey | S I | 0..1 | Extension(Complex) | Element IdPatient.address.extension:addressKey A patient's address key and type Alternate namesextensions, user content DefinitionPostal Address File (PAF) key associated with this address formatted as a FHIR extension. Empty if no PAF key for the address is known, or an object specifying the code system of the address key and the value of the address key. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Complex) Extension URLhttps://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-AddressKey Constraints
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use | Σ ?! | 0..1 | codeBinding | Element IdPatient.address.use The following values are allowed: home, work, temp, billing DefinitionPurpose of this address:
A patient should have no more than one current temp and/or billing address. However, historically this was constrained only by the integration requirements and was not enforced so theoretically more than one can exist for a patient when retrieving. Where multiple instances already exist for the patient it is not expected that local systems should manage those, but should choose the most appropriate one to maintain (e.g. by examining period dates). A home address is the patient's main residential address and should normally be used for all clinical and demographic purposes, including clinical and appointment correspondence. However additionally, temp and billing addresses may be provided by a patient when there is a requirement to record an alternative location for the purposes of unbroken care. When sending correspondence to a patient:
Allows an appropriate address to be chosen from a list of many. Applications can assume that an address is current unless it explicitly says that it is temporary or old. The use of an address. AddressUse (required)Constraints
General home Mappings
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type | Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.address.type postal | physical | both DefinitionDistinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both. The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource). The type of an address (physical / postal). AddressType (required)Constraints
General both Mappings
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.address.text Text representation of the address DefinitionSpecifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts. A renderable, unencoded form. Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.
General 137 Nowhere Street, Erewhon 9132 Mappings
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line | Σ | 0..* | string | Element IdPatient.address.line Street name, number, direction & P.O. Box etc. DefinitionAll lines of the address except the postal code. Systems must apply the following formatting convention when adding or replacing addresses lines:
If any of the lines are blank, they are not returned due to FHIR conformance constraints. must contain at most 5 items Note that FHIR strings SHALL NOT exceed 1MB in size
General 137 Nowhere Street Mappings
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city | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.address.city Name of city, town etc. Alternate namesMunicpality DefinitionThe name of the city, town, suburb, village or other community or delivery center. Note that FHIR strings SHALL NOT exceed 1MB in size
General Erewhon Mappings
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district | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.address.district District name (aka county) Alternate namesCounty DefinitionThe name of the administrative area (county). District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.
General Madison Mappings
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state | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.address.state Sub-unit of country (abbreviations ok) Alternate namesProvince, Territory DefinitionSub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes). Note that FHIR strings SHALL NOT exceed 1MB in size
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postalCode | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.address.postalCode Postal code for area Alternate namesZip DefinitionA postal code designating a region defined by the postal service. Note that FHIR strings SHALL NOT exceed 1MB in size
General 9132 Mappings
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country | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.address.country Country (e.g. can be ISO 3166 2 or 3 letter code) DefinitionCountry - a nation as commonly understood or generally accepted. ISO 3166 3 letter codes can be used in place of a human readable country name.
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.address.period Time period when address was/is in use DefinitionTime period when address was/is in use. Allows addresses to be placed in historical context. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
General { "start": "2010-03-23", "end": "2010-07-01" } Mappings
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maritalStatus | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.maritalStatus Marital (civil) status of a patient DefinitionThis field contains a patient's most recent marital (civil) status. Most, if not all systems capture it. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. An indicator to identify the legal marital status of a person UKCorePersonMaritalStatusCode (extensible)Constraints
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multipleBirth[x] | 0..1 | Element IdPatient.multipleBirth[x] Whether patient is part of a multiple birth DefinitionIndicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer). For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs. The order in which the patient was born, with 1 indicating the first or only birth in the sequence, 2 indicating the second birth in the sequence, 3 indicating the third, and so on up to 7. There are two other valid values; 8 meaning Not applicable and 9 meaning Not known. 1 ≤ value ≤ 9
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multipleBirthBoolean | boolean | There are no (further) constraints on this element Data Type | ||||||||||||||||||||||||||
multipleBirthInteger | integer | There are no (further) constraints on this element Data Type | ||||||||||||||||||||||||||
photo | I | 0..* | Attachment | There are no (further) constraints on this element Element IdPatient.photo Image of the patient DefinitionImage of the patient. Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too. Guidelines:
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contact | S I | 0..* | BackboneElement | Element IdPatient.contact A contact party (e.g. guardian, partner, friend) for the patient DefinitionA list of patient contacts. Only emergency contacts are returned and only emergency contacts should be added. Any other contacts should be added to the patients Related Person. Patients designate here any contact number they desire to be used in case of an emergency. Note, while a patient may also desire to record various related persons telecom details, these do not separately allow for a concept of emergency contact; only ranking. See RelatedPerson endpoint. When a patient tagged as restricted or very restricted is retrieved, all contacts are removed from the response. Need to track people you can contact about the patient. Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.contact.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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contactRank | I | 0..1 | Extension(positiveInt) | There are no (further) constraints on this element Element IdPatient.contact.extension:contactRank Preferred ranking or order of contact applied to a contact on a patient's contact list Alternate namesextensions, user content DefinitionThe preferred ranking or order of contact applied to a contact on a patient's contact list. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-ContactRank Constraints
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copyCorrespondenceIndicator | I | 0..1 | Extension(boolean) | There are no (further) constraints on this element Element IdPatient.contact.extension:copyCorrespondenceIndicator Indicator showing that a patient's contact or related person SHALL be copied in to patient correspondence Alternate namesextensions, user content DefinitionExtension carrying a boolean indicator showing that a patient's contact or related person SHALL be copied in to patient correspondence. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-CopyCorrespondenceIndicator Constraints
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relationship | 0..* | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.contact.relationship The kind of relationship DefinitionThe nature of the relationship between the patient and the contact person. Used to determine which contact person is the most relevant to approach, depending on circumstances. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The nature of the relationship between a patient and a contact person for that patient. UKCorePersonRelationshipType (extensible)Constraints
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name | 0..1 | HumanName | There are no (further) constraints on this element Element IdPatient.contact.name A name associated with the contact person DefinitionA name associated with the contact person. Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person. Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts might or might not be imbued with some implicit meaning; various cultures associate different importance with the name parts and the degree to which systems must care about name parts around the world varies widely.
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telecom | I | 0..* | ContactPoint | There are no (further) constraints on this element Element IdPatient.contact.telecom A contact detail for the person DefinitionA contact detail for the person, e.g. a telephone number or an email address. People have (primary) ways to contact them in some way such as phone, email. Contact may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification.
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system | Σ I | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.contact.telecom.system phone | fax | email | pager | url | sms | other DefinitionTelecommunications form for contact point - what communications system is required to make use of the contact. Note that FHIR strings SHALL NOT exceed 1MB in size Telecommunications form for contact point. ContactPointSystem (required)Constraints
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.contact.telecom.system.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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otherContactSystem | I | 0..1 | Extension(Coding) | There are no (further) constraints on this element Element IdPatient.contact.telecom.system.extension:otherContactSystem Other contact system Alternate namesextensions, user content DefinitionOther contact system value which extends the system element in the ContactPoint datatype. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-OtherContactSystem Constraints
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value | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.contact.telecom.value The actual contact point details DefinitionThe actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address). Need to support legacy numbers that are not in a tightly controlled format. Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.contact.telecom.use home | work | temp | old | mobile - purpose of this contact point DefinitionIdentifies the purpose for the contact point. Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose. Applications can assume that a contact is current unless it explicitly says that it is temporary or old. Use of contact point. ContactPointUse (required)Constraints
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rank | Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element IdPatient.contact.telecom.rank Specify preferred order of use (1 = highest) DefinitionSpecifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values. Note that rank does not necessarily follow the order in which the contacts are represented in the instance.
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.contact.telecom.period Time period when the contact point was/is in use DefinitionTime period when the contact point was/is in use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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address | 0..1 | Address | There are no (further) constraints on this element Element IdPatient.contact.address Address for the contact person DefinitionAddress for the contact person. Need to keep track where the contact person can be contacted per postal mail or visited. Note: address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource).
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gender | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.contact.gender male | female | other | unknown DefinitionAdministrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes. Needed to address the person correctly. Note that FHIR strings SHALL NOT exceed 1MB in size The gender of a person used for administrative purposes. AdministrativeGender (required)Constraints
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organization | I | 0..1 | Reference(UK Core Organization) | There are no (further) constraints on this element Element IdPatient.contact.organization Organization that is associated with the contact DefinitionOrganization on behalf of which the contact is acting or for which the contact is working. For guardians or business related contacts, the organization is relevant. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(UK Core Organization) Constraints
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reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element IdPatient.contact.organization.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdPatient.contact.organization.type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdPatient.contact.organization.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.contact.organization.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.contact.organization.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | Σ | 0..1 | uri | There are no (further) constraints on this element Element IdPatient.contact.organization.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.contact.organization.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.contact.organization.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(UK Core Organization) | There are no (further) constraints on this element Element IdPatient.contact.organization.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Reference(UK Core Organization) Constraints
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.contact.organization.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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period | I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.contact.period The period during which this contact person or organization is valid to be contacted relating to this patient DefinitionThe period during which this contact person or organization is valid to be contacted relating to this patient. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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communication | S | 0..* | BackboneElement | There are no (further) constraints on this element Element IdPatient.communication A language which may be used to communicate with the patient about his or her health DefinitionA language which may be used to communicate with the patient about his or her health. If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest. If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.communication.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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proficiency | I | 0..1 | Extension(Complex) | There are no (further) constraints on this element Element IdPatient.communication.extension:proficiency Proficiency level of the communication Alternate namesextensions, user content DefinitionProficiency level of the communication. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Complex) Extension URLhttp://hl7.org/fhir/StructureDefinition/patient-proficiency Constraints
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.communication.extension:proficiency.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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level | I | 0..1 | Extension | There are no (further) constraints on this element Element IdPatient.communication.extension:proficiency.extension:level The proficiency level of the communication Alternate namesextensions, user content DefinitionHow well the patient can communicate this communication (good, poor, etc.). 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.
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.communication.extension:proficiency.extension:level.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. level
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value[x] | 1..1 | Binding | There are no (further) constraints on this element Element IdPatient.communication.extension:proficiency.extension:level.value[x] The proficiency level for the communication DefinitionThe proficiency level for the communication. The proficiency level for the communication. v3.LanguageAbilityProficiency (preferred)Constraints
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valueCoding | Coding | There are no (further) constraints on this element Data Type | ||||||||||||||||||||||||||
type | I | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.communication.extension:proficiency.extension:type The proficiency type of the communication Alternate namesextensions, user content DefinitionWhat type of communication for the proficiency (spoken, written, etc.). 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.
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.communication.extension:proficiency.extension:type.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. type
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value[x] | 1..1 | Binding | There are no (further) constraints on this element Element IdPatient.communication.extension:proficiency.extension:type.value[x] The proficiency type for the communication DefinitionThe proficiency type for the communication. The proficiency type for the communication. v3.LanguageAbilityMode (preferred)Constraints
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valueCoding | Coding | There are no (further) constraints on this element Data Type | ||||||||||||||||||||||||||
url | 1..1 | System.StringFixed Value | There are no (further) constraints on this element Element IdPatient.communication.extension:proficiency.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. System.String Fixed Valuehttp://hl7.org/fhir/StructureDefinition/patient-proficiency
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value[x] | 0..0 | There are no (further) constraints on this element Element IdPatient.communication.extension:proficiency.value[x] Value of extension DefinitionValue of extension - must be one of a constrained set of the data types (see Extensibility for a list).
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language | 1..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.communication.language A ValueSet that identifies the language used by a person. DefinitionA ValueSet that identifies the language used by a person. Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect. The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type. A ValueSet that identifies the language used by a person. UKCoreHumanLanguage (extensible)Constraints
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preferred | 0..1 | boolean | There are no (further) constraints on this element Element IdPatient.communication.preferred Language preference indicator DefinitionIndicates whether or not the patient prefers this language (over other languages he masters up a certain level). People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method. This language is specifically identified for communicating healthcare information.
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generalPractitioner | S I | 0..* | Reference(NHSDigitalPractitioner | NHSDigitalPractitionerRole | NHSDigitalOrganization) | Element IdPatient.generalPractitioner Patient's nominated primary care provider Alternate namescareProvider DefinitionGP Surgery SHOULD be provided. It is recommended the patients GP Surgery is the first item in the array and branch surgery is second. It is also suggested type and display (name of practice) is also included.
GP Surgery SHOULD be provided. It is recommended the patients GP Surgery is the first item in the array and branch surgery is second. It is also suggested type and display (name of practice) is also included. This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues. Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type. Reference(NHSDigitalPractitioner | NHSDigitalPractitionerRole | NHSDigitalOrganization) Sliced:Unordered, Open At End, by identifier.system(Value) Constraints
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(All Slices) | There are no (further) constraints on this element | |||||||||||||||||||||||||||
reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element IdPatient.generalPractitioner.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdPatient.generalPractitioner.type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | Σ | 1..1 | Identifier | There are no (further) constraints on this element Element IdPatient.generalPractitioner.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.generalPractitioner.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.generalPractitioner.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | Σ | 1..1 | uri | There are no (further) constraints on this element Element IdPatient.generalPractitioner.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | Σ | 1..1 | string | There are no (further) constraints on this element Element IdPatient.generalPractitioner.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.generalPractitioner.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(UK Core Organization) | There are no (further) constraints on this element Element IdPatient.generalPractitioner.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Reference(UK Core Organization) Constraints
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.generalPractitioner.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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registeredGPPractice | I | 0..1 | Reference(UK Core Practitioner | UK Core Organization | UK Core PractitionerRole) | Element IdPatient.generalPractitioner:registeredGPPractice Patient's nominated primary care provider Alternate namescareProvider DefinitionPatient's registered GP Practice. Use V81998 for no registered practice and V81999 for not known as per NHS Data Dictionary guidelines. This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues. Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type. Reference(UK Core Practitioner | UK Core Organization | UK Core PractitionerRole) Constraints
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reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element IdPatient.generalPractitioner:registeredGPPractice.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdPatient.generalPractitioner:registeredGPPractice.type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdPatient.generalPractitioner:registeredGPPractice.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.generalPractitioner:registeredGPPractice.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.generalPractitioner:registeredGPPractice.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | Σ | 0..1 | uriFixed Value | Element IdPatient.generalPractitioner:registeredGPPractice.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
https://fhir.nhs.uk/Id/ods-organization-code
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value | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.generalPractitioner:registeredGPPractice.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.generalPractitioner:registeredGPPractice.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(UK Core Organization) | There are no (further) constraints on this element Element IdPatient.generalPractitioner:registeredGPPractice.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Reference(UK Core Organization) Constraints
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.generalPractitioner:registeredGPPractice.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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registeredGeneralMedicalPractitioner | I | 0..* | Reference(UK Core Practitioner | UK Core Organization | UK Core PractitionerRole) | Element IdPatient.generalPractitioner:registeredGeneralMedicalPractitioner Patient registered GP Alternate namescareProvider DefinitionThis is to support legacy use cases where the patients GP is present This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues. Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type. Reference(UK Core Practitioner | UK Core Organization | UK Core PractitionerRole) Constraints
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reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element IdPatient.generalPractitioner:registeredGeneralMedicalPractitioner.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdPatient.generalPractitioner:registeredGeneralMedicalPractitioner.type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdPatient.generalPractitioner:registeredGeneralMedicalPractitioner.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.generalPractitioner:registeredGeneralMedicalPractitioner.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.generalPractitioner:registeredGeneralMedicalPractitioner.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | Σ | 0..1 | uriFixed Value | Element IdPatient.generalPractitioner:registeredGeneralMedicalPractitioner.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
https://fhir.nhs.uk/Id/gmp-number
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value | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.generalPractitioner:registeredGeneralMedicalPractitioner.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.generalPractitioner:registeredGeneralMedicalPractitioner.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(UK Core Organization) | There are no (further) constraints on this element Element IdPatient.generalPractitioner:registeredGeneralMedicalPractitioner.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Reference(UK Core Organization) Constraints
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.generalPractitioner:registeredGeneralMedicalPractitioner.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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managingOrganization | Σ I | 0..1 | Reference(UK Core Organization) | There are no (further) constraints on this element Element IdPatient.managingOrganization Organization that is the custodian of the patient record DefinitionOrganization that is the custodian of the patient record. Need to know who recognizes this patient record, manages and updates it. There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association). Reference(UK Core Organization) Constraints
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reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element IdPatient.managingOrganization.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdPatient.managingOrganization.type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | Σ | 1..1 | Identifier | There are no (further) constraints on this element Element IdPatient.managingOrganization.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.managingOrganization.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.managingOrganization.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | Σ | 0..1 | uriFixed Value | Element IdPatient.managingOrganization.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
https://fhir.nhs.uk/Id/ods-organization-code
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value | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.managingOrganization.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.managingOrganization.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(UK Core Organization) | There are no (further) constraints on this element Element IdPatient.managingOrganization.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Reference(UK Core Organization) Constraints
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.managingOrganization.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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link | Σ ?! | 0..* | BackboneElement | There are no (further) constraints on this element Element IdPatient.link Link to another patient resource that concerns the same actual person DefinitionLink to another patient resource that concerns the same actual patient. There are multiple use cases:
There is no assumption that linked patient records have mutual links.
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other | Σ I | 1..1 | Reference(UK Core Patient | UK Core RelatedPerson) | There are no (further) constraints on this element Element IdPatient.link.other The other patient or related person resource that the link refers to DefinitionThe other patient resource that the link refers to. Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual. Reference(UK Core Patient | UK Core RelatedPerson) Constraints
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reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element IdPatient.link.other.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdPatient.link.other.type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdPatient.link.other.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.link.other.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.link.other.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | Σ | 0..1 | uri | There are no (further) constraints on this element Element IdPatient.link.other.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.link.other.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.link.other.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(UK Core Organization) | There are no (further) constraints on this element Element IdPatient.link.other.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Reference(UK Core Organization) Constraints
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.link.other.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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type | Σ | 1..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.link.type replaced-by | replaces | refer | seealso DefinitionThe type of link between this patient resource and another patient resource. Note that FHIR strings SHALL NOT exceed 1MB in size The type of link between this patient resource and another patient resource. LinkType (required)Constraints
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from UK Core Patient
Patient | I | Patient | Element IdPatient Information about an individual or animal receiving health care services Alternate namesSubjectOfCare Client Resident DefinitionDemographics and other administrative information about an individual or animal receiving care or other health-related services.
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extension | I | 0..* | Extension | Element IdPatient.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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birthPlace | I | 0..1 | Extension(Address) | There are no (further) constraints on this element Element IdPatient.extension:birthPlace The registered place of birth of the patient. Alternate namesextensions, user content DefinitionThe registered place of birth of the patient. 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. http://hl7.org/fhir/StructureDefinition/patient-birthPlace Constraints
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url | 1..1 | System.StringFixed Value | There are no (further) constraints on this element Element IdPatient.extension:birthPlace.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. System.String Fixed Valuehttp://hl7.org/fhir/StructureDefinition/patient-birthPlace
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value[x] | 1..1 | There are no (further) constraints on this element Element IdPatient.extension:birthPlace.value[x] The registered place of birth of the patient. DefinitionValue of extension - must be one of a constrained set of the data types (see Extensibility for a list).
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valueAddress | Address | There are no (further) constraints on this element Data Type | ||||||||||||||||||||||||||
birthSex | I | 0..1 | Extension(code) | There are no (further) constraints on this element Element IdPatient.extension:birthSex The patient's phenotypic sex at birth. Alternate namesextensions, user content DefinitionThe patient's phenotypic sex at birth. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-BirthSex Constraints
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cadavericDonor | I | 0..1 | Extension(boolean) | There are no (further) constraints on this element Element IdPatient.extension:cadavericDonor Post-mortem donor status. Alternate namesextensions, user content DefinitionFlag indicating whether the patient authorized the donation of body parts after death. 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. http://hl7.org/fhir/StructureDefinition/patient-cadavericDonor Constraints
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url | 1..1 | System.StringFixed Value | There are no (further) constraints on this element Element IdPatient.extension:cadavericDonor.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. System.String Fixed Valuehttp://hl7.org/fhir/StructureDefinition/patient-cadavericDonor
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value[x] | 1..1 | There are no (further) constraints on this element Element IdPatient.extension:cadavericDonor.value[x] Post-mortem donor status. DefinitionFlag indicating whether the patient authorized the donation of body parts after death.
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valueBoolean | boolean | There are no (further) constraints on this element Data Type | ||||||||||||||||||||||||||
contactPreference | I | 0..1 | Extension(Complex) | There are no (further) constraints on this element Element IdPatient.extension:contactPreference The preferred method of contact, contact times and written communication format given by a Patient or Related Person. Alternate namesextensions, user content DefinitionThe preferred method of contact, contact times and written communication format given by a Patient or Related Person. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Complex) Extension URLhttps://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-ContactPreference Constraints
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deathNotificationStatus | I | 0..1 | Extension(Complex) | There are no (further) constraints on this element Element IdPatient.extension:deathNotificationStatus The patient's death notification status. Alternate namesextensions, user content DefinitionThe patient's death notification status. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Complex) Extension URLhttps://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-DeathNotificationStatus Constraints
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ethnicCategory | I | 0..1 | Extension(CodeableConcept) | There are no (further) constraints on this element Element IdPatient.extension:ethnicCategory The ethnicity of the subject Alternate namesextensions, user content DefinitionThe ethnicity of the subject. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-EthnicCategory Constraints
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residentialStatus | I | 0..1 | Extension(CodeableConcept) | There are no (further) constraints on this element Element IdPatient.extension:residentialStatus The residential status of the patient. Alternate namesextensions, user content DefinitionThe residential status of the patient. For example if this patient is a UK resident. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-ResidentialStatus Constraints
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patientInterpreterRequired | I | 0..1 | Extension(boolean) | There are no (further) constraints on this element Element IdPatient.extension:patientInterpreterRequired Whether the patient needs an interpreter Alternate namesextensions, user content DefinitionThis Patient requires an interpreter to communicate healthcare information to the practitioner. The Patient does not speak the default language of the organization, and hence requires an interpreter. If the patient has other languages in the Communications list, then that would be the type of interpreter required. http://hl7.org/fhir/StructureDefinition/patient-interpreterRequired Constraints
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url | 1..1 | System.StringFixed Value | There are no (further) constraints on this element Element IdPatient.extension:patientInterpreterRequired.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. System.String Fixed Valuehttp://hl7.org/fhir/StructureDefinition/patient-interpreterRequired
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value[x] | 1..1 | There are no (further) constraints on this element Element IdPatient.extension:patientInterpreterRequired.value[x] Indicator showing whether the patient needs an interpreter DefinitionIndicator showing if this Patient requires an interpreter to communicate healthcare information to the practitioner.
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valueBoolean | boolean | There are no (further) constraints on this element Data Type | ||||||||||||||||||||||||||
medicalApplianceSupplier | S I | 0..1 | Extension(Reference(UK Core Organization)) | Element IdPatient.extension:medicalApplianceSupplier A patient's medical appliance supplier Alternate namesextensions, user content Definition
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Reference(UK Core Organization)) Extension URLhttps://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-MedicalApplianceSupplier Constraints
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nominatedPharmacy | S I | 0..1 | Extension(Reference(UK Core Organization)) | Element IdPatient.extension:nominatedPharmacy Individual's nominated pharmacy. Alternate namesextensions, user content DefinitionA patient can choose up to three nominated dispensers to cover different contractor types:
Each of those nominations is held in an Extension. All require a ODS/ANANA code from Organisation Data Services. This contains download CSV files for these organisations, for API access please see Organisation Data Service - FHIR API nominatedPharmacy (extension nominatedPharmacy)
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Reference(UK Core Organization)) Extension URLhttps://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NominatedPharmacy Constraints
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preferredDispenserOrganization | S I | 0..1 | Extension(Reference(UK Core Organization)) | Element IdPatient.extension:preferredDispenserOrganization A patient's preferred dispensing organisation Alternate namesextensions, user content DefinitionA patient's preferred dispensing organisation.
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Reference(UK Core Organization)) Extension URLhttps://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-PreferredDispenserOrganization Constraints
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identifier | S Σ | 0..* | Identifier | Element IdPatient.identifier The patient's NHS number. The primary identifier of a patient, unique within NHS England and Wales. Always 10 digits and must be a valid NHS number. DefinitionAt least one patient identifier, MUST be provided. Where a traced NHS number is available for a patient this MUST be included. In general an untraced NHS Number MUST not be used, if an untracted NHS Number is used the extension https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus MUST be used.
Local identifiers such as MRN MUST include a system which identifies NHS provider/assigning authority.
Patients are almost always assigned specific numerical identifiers. Unordered, Open, by system(Value) Constraints
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nhsNumber | S Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdPatient.identifier:nhsNumber The patient's NHS number DefinitionAn identifier for this patient. Patients are almost always assigned specific numerical identifiers.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.identifier:nhsNumber.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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nhsNumberVerificationStatus | I | 0..1 | Extension(CodeableConcept) | There are no (further) constraints on this element Element IdPatient.identifier:nhsNumber.extension:nhsNumberVerificationStatus NHS number verification status Alternate namesextensions, user content DefinitionThe verification/tracing status of the NHS number. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus Constraints
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.identifier:nhsNumber.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.identifier:nhsNumber.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | S Σ | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.identifier:nhsNumber.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
https://fhir.nhs.uk/Id/nhs-number
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value | Σ | 1..1 | string | There are no (further) constraints on this element Element IdPatient.identifier:nhsNumber.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.identifier:nhsNumber.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(UK Core Organization) | There are no (further) constraints on this element Element IdPatient.identifier:nhsNumber.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Reference(UK Core Organization) Constraints
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active | Σ ?! | 0..1 | boolean | There are no (further) constraints on this element Element IdPatient.active Whether this patient's record is in active use DefinitionWhether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules. It is often used to filter patient lists to exclude inactive patients Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death. Need to be able to mark a patient record as not to be used because it was created in error. If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient. This resource is generally assumed to be active if no value is provided for the active element
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name | S Σ | 0..* | HumanName | Element IdPatient.name A name associated with the patient DefinitionAt least one patient name must be provided. It is recommended a use is provided.
Need to be able to track the patient by multiple names. Examples are your official name and a partner name. A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.
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use | Σ ?! | 0..1 | codeBinding | Element IdPatient.name.use The following values are allowed: usual, temp, nickname, old, maiden DefinitionHow this name should be used.
The following use codes are included in the name-use value set, but should not be used and is not be returned as part of a retrieval.
Allows the appropriate name for a particular context of use to be selected from among a set of names. Applications can assume that a name is current unless it explicitly says that it is temporary or old. The use of a human name. NameUse (required)Constraints
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.name.text Text representation of the full name DefinitionSpecifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts. A renderable, unencoded form. Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.
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family | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.name.family Family name (often called 'Surname') Alternate namessurname DefinitionThe part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father. Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).
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given | S Σ | 0..5 | string | Element IdPatient.name.given Given names (not always 'first'). Includes middle names Alternate namesfirst name, middle name DefinitionGiven names, including any middle names. If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first.
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prefix | Σ | 0..* | string | There are no (further) constraints on this element Element IdPatient.name.prefix Parts that come before the name DefinitionPart of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name. Note that FHIR strings SHALL NOT exceed 1MB in size
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suffix | Σ | 0..* | string | There are no (further) constraints on this element Element IdPatient.name.suffix Parts that come after the name DefinitionPart of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name. Note that FHIR strings SHALL NOT exceed 1MB in size
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.name.period Time period when name was/is in use DefinitionIndicates the period of time when this name was valid for the named person. Allows names to be placed in historical context. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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telecom | S Σ I | 0..* | ContactPoint | Element IdPatient.telecom A contact detail for the individual DefinitionList of contact points for the patient; for example, phone numbers or email addresses. When a patient tagged as
People have (primary) ways to contact them in some way such as phone, email. A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).
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system | Σ I | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.telecom.system phone | fax | email | pager | url | sms | other DefinitionTelecommunications form for contact point - what communications system is required to make use of the contact. Note that FHIR strings SHALL NOT exceed 1MB in size Telecommunications form for contact point. ContactPointSystem (required)Constraints
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.telecom.system.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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otherContactSystem | I | 0..1 | Extension(Coding) | There are no (further) constraints on this element Element IdPatient.telecom.system.extension:otherContactSystem Other contact system Alternate namesextensions, user content DefinitionOther contact system value which extends the system element in the ContactPoint datatype. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-OtherContactSystem Constraints
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value | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.telecom.value The actual contact point details DefinitionThe actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address). Need to support legacy numbers that are not in a tightly controlled format. Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.telecom.use home | work | temp | old | mobile - purpose of this contact point DefinitionIdentifies the purpose for the contact point. Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose. Applications can assume that a contact is current unless it explicitly says that it is temporary or old. Use of contact point. ContactPointUse (required)Constraints
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rank | Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element IdPatient.telecom.rank Specify preferred order of use (1 = highest) DefinitionSpecifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values. Note that rank does not necessarily follow the order in which the contacts are represented in the instance.
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.telecom.period Time period when the contact point was/is in use DefinitionTime period when the contact point was/is in use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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gender | S Σ | 0..1 | codeBinding | Element IdPatient.gender male | female | other | unknown DefinitionClassification of the gender of a patient. The classification is phenotypical rather than genotypical, i.e. it does not provide codes for medical or scientific purposes. It is the administrative gender that the patient wishes to be known as. In some cases, this may not be the same as the patient’s registered birth gender, or their current clinical gender. Needed for identification of the individual, in combination with (at least) name and birth date. The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex. The gender of a person used for administrative purposes. AdministrativeGender (required)Constraints
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birthDate | S Σ | 0..1 | date | Element IdPatient.birthDate The date of birth for the individual DefinitionThe date on which the patient was born or is officially deemed to have been born. It is a date in the format When a patient tagged as Age of the individual drives many clinical processes. At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternity/infant care systems).
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.birthDate.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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birthTime | I | 0..1 | Extension(dateTime) | There are no (further) constraints on this element Element IdPatient.birthDate.extension:birthTime Time of day of birth. Alternate namesextensions, user content DefinitionThe time of day that the patient was born. This includes the date to ensure that the timezone information can be communicated effectively. 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. http://hl7.org/fhir/StructureDefinition/patient-birthTime Constraints
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url | 1..1 | System.StringFixed Value | There are no (further) constraints on this element Element IdPatient.birthDate.extension:birthTime.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. System.String Fixed Valuehttp://hl7.org/fhir/StructureDefinition/patient-birthTime
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value[x] | 1..1 | There are no (further) constraints on this element Element IdPatient.birthDate.extension:birthTime.value[x] Time of day of birth. DefinitionThe time of day that the patient was born. This includes the date to ensure that the timezone information can be communicated effectively.
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valueDateTime | dateTime | There are no (further) constraints on this element Data Type | ||||||||||||||||||||||||||
deceased[x] | S Σ ?! | 0..1 | Element IdPatient.deceased[x] Indicates if the individual is deceased or not DefinitionThe date and time on which a person died or is officially deemed to have died, if applicable and known. It is a datetime in the format When a patient tagged as The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive. If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.
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deceasedBoolean | boolean | There are no (further) constraints on this element Data Type | ||||||||||||||||||||||||||
deceasedDateTime | dateTime | There are no (further) constraints on this element Data Type | ||||||||||||||||||||||||||
address | S Σ | 0..* | Address | Element IdPatient.address An address for the individual DefinitionList of addresses associated with the patient. These are fully populated on a retrieval or a successful update, only the home address is returned on a search. When a patient tagged as
May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification. Patient may have multiple addresses with different uses or applicable periods.
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extension | I | 0..* | Extension | Element IdPatient.address.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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addressKey | S I | 0..1 | Extension(Complex) | Element IdPatient.address.extension:addressKey A patient's address key and type Alternate namesextensions, user content DefinitionPostal Address File (PAF) key associated with this address formatted as a FHIR extension. Empty if no PAF key for the address is known, or an object specifying the code system of the address key and the value of the address key. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Complex) Extension URLhttps://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-AddressKey Constraints
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use | Σ ?! | 0..1 | codeBinding | Element IdPatient.address.use The following values are allowed: home, work, temp, billing DefinitionPurpose of this address:
A patient should have no more than one current temp and/or billing address. However, historically this was constrained only by the integration requirements and was not enforced so theoretically more than one can exist for a patient when retrieving. Where multiple instances already exist for the patient it is not expected that local systems should manage those, but should choose the most appropriate one to maintain (e.g. by examining period dates). A home address is the patient's main residential address and should normally be used for all clinical and demographic purposes, including clinical and appointment correspondence. However additionally, temp and billing addresses may be provided by a patient when there is a requirement to record an alternative location for the purposes of unbroken care. When sending correspondence to a patient:
Allows an appropriate address to be chosen from a list of many. Applications can assume that an address is current unless it explicitly says that it is temporary or old. The use of an address. AddressUse (required)Constraints
General home Mappings
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type | Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.address.type postal | physical | both DefinitionDistinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both. The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource). The type of an address (physical / postal). AddressType (required)Constraints
General both Mappings
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.address.text Text representation of the address DefinitionSpecifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts. A renderable, unencoded form. Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.
General 137 Nowhere Street, Erewhon 9132 Mappings
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line | Σ | 0..* | string | Element IdPatient.address.line Street name, number, direction & P.O. Box etc. DefinitionAll lines of the address except the postal code. Systems must apply the following formatting convention when adding or replacing addresses lines:
If any of the lines are blank, they are not returned due to FHIR conformance constraints. must contain at most 5 items Note that FHIR strings SHALL NOT exceed 1MB in size
General 137 Nowhere Street Mappings
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city | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.address.city Name of city, town etc. Alternate namesMunicpality DefinitionThe name of the city, town, suburb, village or other community or delivery center. Note that FHIR strings SHALL NOT exceed 1MB in size
General Erewhon Mappings
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district | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.address.district District name (aka county) Alternate namesCounty DefinitionThe name of the administrative area (county). District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.
General Madison Mappings
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state | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.address.state Sub-unit of country (abbreviations ok) Alternate namesProvince, Territory DefinitionSub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes). Note that FHIR strings SHALL NOT exceed 1MB in size
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postalCode | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.address.postalCode Postal code for area Alternate namesZip DefinitionA postal code designating a region defined by the postal service. Note that FHIR strings SHALL NOT exceed 1MB in size
General 9132 Mappings
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country | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.address.country Country (e.g. can be ISO 3166 2 or 3 letter code) DefinitionCountry - a nation as commonly understood or generally accepted. ISO 3166 3 letter codes can be used in place of a human readable country name.
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.address.period Time period when address was/is in use DefinitionTime period when address was/is in use. Allows addresses to be placed in historical context. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
General { "start": "2010-03-23", "end": "2010-07-01" } Mappings
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maritalStatus | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.maritalStatus Marital (civil) status of a patient DefinitionThis field contains a patient's most recent marital (civil) status. Most, if not all systems capture it. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. An indicator to identify the legal marital status of a person UKCorePersonMaritalStatusCode (extensible)Constraints
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multipleBirth[x] | 0..1 | Element IdPatient.multipleBirth[x] Whether patient is part of a multiple birth DefinitionIndicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer). For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs. The order in which the patient was born, with 1 indicating the first or only birth in the sequence, 2 indicating the second birth in the sequence, 3 indicating the third, and so on up to 7. There are two other valid values; 8 meaning Not applicable and 9 meaning Not known. 1 ≤ value ≤ 9
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multipleBirthBoolean | boolean | There are no (further) constraints on this element Data Type | ||||||||||||||||||||||||||
multipleBirthInteger | integer | There are no (further) constraints on this element Data Type | ||||||||||||||||||||||||||
photo | I | 0..* | Attachment | There are no (further) constraints on this element Element IdPatient.photo Image of the patient DefinitionImage of the patient. Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too. Guidelines:
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contact | S I | 0..* | BackboneElement | Element IdPatient.contact A contact party (e.g. guardian, partner, friend) for the patient DefinitionA list of patient contacts. Only emergency contacts are returned and only emergency contacts should be added. Any other contacts should be added to the patients Related Person. Patients designate here any contact number they desire to be used in case of an emergency. Note, while a patient may also desire to record various related persons telecom details, these do not separately allow for a concept of emergency contact; only ranking. See RelatedPerson endpoint. When a patient tagged as restricted or very restricted is retrieved, all contacts are removed from the response. Need to track people you can contact about the patient. Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.contact.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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contactRank | I | 0..1 | Extension(positiveInt) | There are no (further) constraints on this element Element IdPatient.contact.extension:contactRank Preferred ranking or order of contact applied to a contact on a patient's contact list Alternate namesextensions, user content DefinitionThe preferred ranking or order of contact applied to a contact on a patient's contact list. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-ContactRank Constraints
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copyCorrespondenceIndicator | I | 0..1 | Extension(boolean) | There are no (further) constraints on this element Element IdPatient.contact.extension:copyCorrespondenceIndicator Indicator showing that a patient's contact or related person SHALL be copied in to patient correspondence Alternate namesextensions, user content DefinitionExtension carrying a boolean indicator showing that a patient's contact or related person SHALL be copied in to patient correspondence. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-CopyCorrespondenceIndicator Constraints
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relationship | 0..* | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.contact.relationship The kind of relationship DefinitionThe nature of the relationship between the patient and the contact person. Used to determine which contact person is the most relevant to approach, depending on circumstances. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The nature of the relationship between a patient and a contact person for that patient. UKCorePersonRelationshipType (extensible)Constraints
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name | 0..1 | HumanName | There are no (further) constraints on this element Element IdPatient.contact.name A name associated with the contact person DefinitionA name associated with the contact person. Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person. Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts might or might not be imbued with some implicit meaning; various cultures associate different importance with the name parts and the degree to which systems must care about name parts around the world varies widely.
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telecom | I | 0..* | ContactPoint | There are no (further) constraints on this element Element IdPatient.contact.telecom A contact detail for the person DefinitionA contact detail for the person, e.g. a telephone number or an email address. People have (primary) ways to contact them in some way such as phone, email. Contact may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification.
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system | Σ I | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.contact.telecom.system phone | fax | email | pager | url | sms | other DefinitionTelecommunications form for contact point - what communications system is required to make use of the contact. Note that FHIR strings SHALL NOT exceed 1MB in size Telecommunications form for contact point. ContactPointSystem (required)Constraints
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.contact.telecom.system.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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otherContactSystem | I | 0..1 | Extension(Coding) | There are no (further) constraints on this element Element IdPatient.contact.telecom.system.extension:otherContactSystem Other contact system Alternate namesextensions, user content DefinitionOther contact system value which extends the system element in the ContactPoint datatype. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-OtherContactSystem Constraints
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value | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.contact.telecom.value The actual contact point details DefinitionThe actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address). Need to support legacy numbers that are not in a tightly controlled format. Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.contact.telecom.use home | work | temp | old | mobile - purpose of this contact point DefinitionIdentifies the purpose for the contact point. Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose. Applications can assume that a contact is current unless it explicitly says that it is temporary or old. Use of contact point. ContactPointUse (required)Constraints
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rank | Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element IdPatient.contact.telecom.rank Specify preferred order of use (1 = highest) DefinitionSpecifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values. Note that rank does not necessarily follow the order in which the contacts are represented in the instance.
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.contact.telecom.period Time period when the contact point was/is in use DefinitionTime period when the contact point was/is in use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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address | 0..1 | Address | There are no (further) constraints on this element Element IdPatient.contact.address Address for the contact person DefinitionAddress for the contact person. Need to keep track where the contact person can be contacted per postal mail or visited. Note: address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource).
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gender | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.contact.gender male | female | other | unknown DefinitionAdministrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes. Needed to address the person correctly. Note that FHIR strings SHALL NOT exceed 1MB in size The gender of a person used for administrative purposes. AdministrativeGender (required)Constraints
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organization | I | 0..1 | Reference(UK Core Organization) | There are no (further) constraints on this element Element IdPatient.contact.organization Organization that is associated with the contact DefinitionOrganization on behalf of which the contact is acting or for which the contact is working. For guardians or business related contacts, the organization is relevant. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(UK Core Organization) Constraints
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reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element IdPatient.contact.organization.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdPatient.contact.organization.type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdPatient.contact.organization.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.contact.organization.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.contact.organization.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | Σ | 0..1 | uri | There are no (further) constraints on this element Element IdPatient.contact.organization.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.contact.organization.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.contact.organization.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(UK Core Organization) | There are no (further) constraints on this element Element IdPatient.contact.organization.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Reference(UK Core Organization) Constraints
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.contact.organization.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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period | I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.contact.period The period during which this contact person or organization is valid to be contacted relating to this patient DefinitionThe period during which this contact person or organization is valid to be contacted relating to this patient. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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communication | S | 0..* | BackboneElement | There are no (further) constraints on this element Element IdPatient.communication A language which may be used to communicate with the patient about his or her health DefinitionA language which may be used to communicate with the patient about his or her health. If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest. If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.communication.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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proficiency | I | 0..1 | Extension(Complex) | There are no (further) constraints on this element Element IdPatient.communication.extension:proficiency Proficiency level of the communication Alternate namesextensions, user content DefinitionProficiency level of the communication. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Complex) Extension URLhttp://hl7.org/fhir/StructureDefinition/patient-proficiency Constraints
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.communication.extension:proficiency.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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level | I | 0..1 | Extension | There are no (further) constraints on this element Element IdPatient.communication.extension:proficiency.extension:level The proficiency level of the communication Alternate namesextensions, user content DefinitionHow well the patient can communicate this communication (good, poor, etc.). 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.
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.communication.extension:proficiency.extension:level.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. level
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value[x] | 1..1 | Binding | There are no (further) constraints on this element Element IdPatient.communication.extension:proficiency.extension:level.value[x] The proficiency level for the communication DefinitionThe proficiency level for the communication. The proficiency level for the communication. v3.LanguageAbilityProficiency (preferred)Constraints
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valueCoding | Coding | There are no (further) constraints on this element Data Type | ||||||||||||||||||||||||||
type | I | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.communication.extension:proficiency.extension:type The proficiency type of the communication Alternate namesextensions, user content DefinitionWhat type of communication for the proficiency (spoken, written, etc.). 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.
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.communication.extension:proficiency.extension:type.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. type
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value[x] | 1..1 | Binding | There are no (further) constraints on this element Element IdPatient.communication.extension:proficiency.extension:type.value[x] The proficiency type for the communication DefinitionThe proficiency type for the communication. The proficiency type for the communication. v3.LanguageAbilityMode (preferred)Constraints
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valueCoding | Coding | There are no (further) constraints on this element Data Type | ||||||||||||||||||||||||||
url | 1..1 | System.StringFixed Value | There are no (further) constraints on this element Element IdPatient.communication.extension:proficiency.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. System.String Fixed Valuehttp://hl7.org/fhir/StructureDefinition/patient-proficiency
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value[x] | 0..0 | There are no (further) constraints on this element Element IdPatient.communication.extension:proficiency.value[x] Value of extension DefinitionValue of extension - must be one of a constrained set of the data types (see Extensibility for a list).
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language | 1..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.communication.language A ValueSet that identifies the language used by a person. DefinitionA ValueSet that identifies the language used by a person. Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect. The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type. A ValueSet that identifies the language used by a person. UKCoreHumanLanguage (extensible)Constraints
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preferred | 0..1 | boolean | There are no (further) constraints on this element Element IdPatient.communication.preferred Language preference indicator DefinitionIndicates whether or not the patient prefers this language (over other languages he masters up a certain level). People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method. This language is specifically identified for communicating healthcare information.
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generalPractitioner | S I | 0..* | Reference(NHSDigitalPractitioner | NHSDigitalPractitionerRole | NHSDigitalOrganization) | Element IdPatient.generalPractitioner Patient's nominated primary care provider Alternate namescareProvider DefinitionGP Surgery SHOULD be provided. It is recommended the patients GP Surgery is the first item in the array and branch surgery is second. It is also suggested type and display (name of practice) is also included.
GP Surgery SHOULD be provided. It is recommended the patients GP Surgery is the first item in the array and branch surgery is second. It is also suggested type and display (name of practice) is also included. This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues. Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type. Reference(NHSDigitalPractitioner | NHSDigitalPractitionerRole | NHSDigitalOrganization) Sliced:Unordered, Open At End, by identifier.system(Value) Constraints
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reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element IdPatient.generalPractitioner.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdPatient.generalPractitioner.type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | Σ | 1..1 | Identifier | There are no (further) constraints on this element Element IdPatient.generalPractitioner.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.generalPractitioner.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.generalPractitioner.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | Σ | 1..1 | uri | There are no (further) constraints on this element Element IdPatient.generalPractitioner.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | Σ | 1..1 | string | There are no (further) constraints on this element Element IdPatient.generalPractitioner.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.generalPractitioner.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(UK Core Organization) | There are no (further) constraints on this element Element IdPatient.generalPractitioner.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Reference(UK Core Organization) Constraints
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.generalPractitioner.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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registeredGPPractice | I | 0..1 | Reference(UK Core Practitioner | UK Core Organization | UK Core PractitionerRole) | Element IdPatient.generalPractitioner:registeredGPPractice Patient's nominated primary care provider Alternate namescareProvider DefinitionPatient's registered GP Practice. Use V81998 for no registered practice and V81999 for not known as per NHS Data Dictionary guidelines. This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues. Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type. Reference(UK Core Practitioner | UK Core Organization | UK Core PractitionerRole) Constraints
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reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element IdPatient.generalPractitioner:registeredGPPractice.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdPatient.generalPractitioner:registeredGPPractice.type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdPatient.generalPractitioner:registeredGPPractice.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.generalPractitioner:registeredGPPractice.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.generalPractitioner:registeredGPPractice.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | Σ | 0..1 | uriFixed Value | Element IdPatient.generalPractitioner:registeredGPPractice.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
https://fhir.nhs.uk/Id/ods-organization-code
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value | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.generalPractitioner:registeredGPPractice.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.generalPractitioner:registeredGPPractice.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(UK Core Organization) | There are no (further) constraints on this element Element IdPatient.generalPractitioner:registeredGPPractice.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Reference(UK Core Organization) Constraints
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.generalPractitioner:registeredGPPractice.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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registeredGeneralMedicalPractitioner | I | 0..* | Reference(UK Core Practitioner | UK Core Organization | UK Core PractitionerRole) | Element IdPatient.generalPractitioner:registeredGeneralMedicalPractitioner Patient registered GP Alternate namescareProvider DefinitionThis is to support legacy use cases where the patients GP is present This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues. Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type. Reference(UK Core Practitioner | UK Core Organization | UK Core PractitionerRole) Constraints
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reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element IdPatient.generalPractitioner:registeredGeneralMedicalPractitioner.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdPatient.generalPractitioner:registeredGeneralMedicalPractitioner.type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdPatient.generalPractitioner:registeredGeneralMedicalPractitioner.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.generalPractitioner:registeredGeneralMedicalPractitioner.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.generalPractitioner:registeredGeneralMedicalPractitioner.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | Σ | 0..1 | uriFixed Value | Element IdPatient.generalPractitioner:registeredGeneralMedicalPractitioner.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
https://fhir.nhs.uk/Id/gmp-number
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value | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.generalPractitioner:registeredGeneralMedicalPractitioner.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.generalPractitioner:registeredGeneralMedicalPractitioner.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(UK Core Organization) | There are no (further) constraints on this element Element IdPatient.generalPractitioner:registeredGeneralMedicalPractitioner.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Reference(UK Core Organization) Constraints
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.generalPractitioner:registeredGeneralMedicalPractitioner.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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managingOrganization | Σ I | 0..1 | Reference(UK Core Organization) | There are no (further) constraints on this element Element IdPatient.managingOrganization Organization that is the custodian of the patient record DefinitionOrganization that is the custodian of the patient record. Need to know who recognizes this patient record, manages and updates it. There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association). Reference(UK Core Organization) Constraints
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reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element IdPatient.managingOrganization.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdPatient.managingOrganization.type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | Σ | 1..1 | Identifier | There are no (further) constraints on this element Element IdPatient.managingOrganization.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.managingOrganization.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.managingOrganization.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | Σ | 0..1 | uriFixed Value | Element IdPatient.managingOrganization.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
https://fhir.nhs.uk/Id/ods-organization-code
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value | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.managingOrganization.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.managingOrganization.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(UK Core Organization) | There are no (further) constraints on this element Element IdPatient.managingOrganization.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Reference(UK Core Organization) Constraints
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.managingOrganization.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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link | Σ ?! | 0..* | BackboneElement | There are no (further) constraints on this element Element IdPatient.link Link to another patient resource that concerns the same actual person DefinitionLink to another patient resource that concerns the same actual patient. There are multiple use cases:
There is no assumption that linked patient records have mutual links.
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other | Σ I | 1..1 | Reference(UK Core Patient | UK Core RelatedPerson) | There are no (further) constraints on this element Element IdPatient.link.other The other patient or related person resource that the link refers to DefinitionThe other patient resource that the link refers to. Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual. Reference(UK Core Patient | UK Core RelatedPerson) Constraints
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reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element IdPatient.link.other.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdPatient.link.other.type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdPatient.link.other.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.link.other.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.link.other.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | Σ | 0..1 | uri | There are no (further) constraints on this element Element IdPatient.link.other.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.link.other.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.link.other.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(UK Core Organization) | There are no (further) constraints on this element Element IdPatient.link.other.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Reference(UK Core Organization) Constraints
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.link.other.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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type | Σ | 1..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.link.type replaced-by | replaces | refer | seealso DefinitionThe type of link between this patient resource and another patient resource. Note that FHIR strings SHALL NOT exceed 1MB in size The type of link between this patient resource and another patient resource. LinkType (required)Constraints
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key | human | severity | expression |
---|---|---|---|
patient-nhs | Supplied NHS Number is outside the English and Welsh NHS Number range or length of the number is wrong. | error | identifier.where(system='https://fhir.nhs.uk/Id/nhs-number').exists().not() or (identifier.where(system='https://fhir.nhs.uk/Id/nhs-number').exists() and identifier.where(system='https://fhir.nhs.uk/Id/nhs-number').value.matches('^([456789]{1}[0-9]{9})$')) |
- Patient - Jane Smith - PDS Example - Jane Smith
- Patient - Jack Dawkins
- Patient - Richard Smith
Constraint Profiles
name | profile | purpose |
---|---|---|
NHSDigitalPatientMinimal | https://fhir.nhs.uk/StructureDefinition/NHSDigital-Patient-Minimal | Constraint profile for which enforces elements in contained Patient resources. |
NHSDigitalPatientPDS | https://fhir.nhs.uk/StructureDefinition/NHSDigital-Patient-PDS | Constraint profile which represents the full NHS Digital requirement for Patient resources as defined in Personnel Demogrpahics Service (PDS). |
This profile is designed around Patient Demographics Services and PDS may be used as the source of this data. Use of PDS is not mandatory for Patient resources, Patient Administration Systems (PAS) and Master Patient Index (MPI) may be used instead. Only traced NHS Number SHOULD be used with this resource unless explicitly stated. Within NHS Trusts the inclusion of MRN (Medical Record Numbers) identifiers is highly recommended.
Definition
Demographics and other administrative information about an individual or animal receiving care or other health-related services.
Constraints
- patient-nhs (ERROR) Supplied NHS Number is outside the English and Welsh NHS Number range or length of the number is wrong.
- extension:birthPlace.url
- extension:cadavericDonor.url
- extension:patientReligion.url
- extension:patientInterpreterRequired.url
- extension:medicalApplianceSupplier
- extension:nominatedPharmacy
- extension:preferredDispenserOrganization
- identifier
- identifier:nhsNumber
- identifier:nhsNumber.system
- name
- name.family
- name.given
- telecom
- gender
- birthDate
- birthDate.extension:birthTime.url
- deceased
- address
- address.extension:addressKey
- contact
- communication
- communication.extension:proficiency.extension:level.url
- communication.extension:proficiency.extension:type.url
- communication.extension:proficiency.url
- generalPractitioner
- generalPractitioner:registeredGPPractice
- generalPractitioner:registeredGPPractice.identifier.system
- generalPractitioner:registeredGeneralMedicalPractitioner
- generalPractitioner:registeredGeneralMedicalPractitioner.identifier.system
- managingOrganization.identifier.system
extension:birthPlace.url
Element Id | Patient.extension:birthPlace.url |
Cardinality | 1..1 |
Fixed Value | http://hl7.org/fhir/StructureDefinition/patient-birthPlace |
type | http://hl7.org/fhirpath/System.String |
Definition
Source of the definition for the extension code - a logical name or a URL.
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.
extension:cadavericDonor.url
Element Id | Patient.extension:cadavericDonor.url |
Cardinality | 1..1 |
Fixed Value | http://hl7.org/fhir/StructureDefinition/patient-cadavericDonor |
type | http://hl7.org/fhirpath/System.String |
Definition
Source of the definition for the extension code - a logical name or a URL.
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.
extension:patientReligion.url
Element Id | Patient.extension:patientReligion.url |
Cardinality | 1..1 |
Fixed Value | http://hl7.org/fhir/StructureDefinition/patient-religion |
type | http://hl7.org/fhirpath/System.String |
Definition
Source of the definition for the extension code - a logical name or a URL.
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.
extension:patientInterpreterRequired.url
Element Id | Patient.extension:patientInterpreterRequired.url |
Cardinality | 1..1 |
Fixed Value | http://hl7.org/fhir/StructureDefinition/patient-interpreterRequired |
type | http://hl7.org/fhirpath/System.String |
Definition
Source of the definition for the extension code - a logical name or a URL.
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.
extension:medicalApplianceSupplier
Element Id | Patient.extension:medicalApplianceSupplier |
Cardinality | 0..1 |
Slice Name | medicalApplianceSupplier |
type | Extension(ExtensionUKCoreMedicalApplianceSupplier) |
Definition
{ "url": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-PreferredDispenserOrganization", "valueReference": { "identifier": { "system": "https://fhir.nhs.uk/Id/ods-organization-code", "value": "Y23456" } } }
extension:nominatedPharmacy
Element Id | Patient.extension:nominatedPharmacy |
Cardinality | 0..* |
Slice Name | nominatedPharmacy |
type | Extension(ExtensionUKCoreNominatedPharmacy) |
Definition
A patient can choose up to three nominated dispensers to cover different contractor types:
- Community Pharmacy
- Appliance Contractor
- Dispensing Doctor
Each of those nominations is held in an Extension.
All require a ODS/ANANA code from Organisation Data Services. This contains download CSV files for these organisations, for API access please see Organisation Data Service - FHIR API
nominatedPharmacy (extension nominatedPharmacy)
"extension": [ { "url": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NominatedPharmacy", "valueReference": { "identifier": { "system": "https://fhir.nhs.uk/Id/ods-organization-code", "value": "Y12345" } } },
extension:preferredDispenserOrganization
Element Id | Patient.extension:preferredDispenserOrganization |
Cardinality | 0..1 |
Slice Name | preferredDispenserOrganization |
type | Extension(ExtensionUKCorePreferredDispenserOrganization) |
Definition
{ "url": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-MedicalApplianceSupplier", "valueReference": { "identifier": { "system": "https://fhir.nhs.uk/Id/ods-organization-code", "value": "Y34567" } } }
identifier
Element Id | Patient.identifier |
Cardinality | 0..* |
Slicing | OPEN discriminator - VALUE system |
type | Identifier |
Definition
At least one patient identifier, MUST be provided.
Where a traced NHS number is available for a patient this MUST be included. In general an untraced NHS Number MUST not be used, if an untracted NHS Number is used the extension https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus MUST be used.
Name | FHIR identifier | OID/HL7v3 | HL7v2 ITK | Format | Description |
---|---|---|---|---|---|
NHS Number | https://fhir.nhs.uk/Id/nhs-number | 2.16.840.1.113883.2.1.4.1 | NHS | NNNNNNNNNN | NHS Number allocated to the patient in England and Wales |
CHI Number | 2.16.840.1.113883.2.1.3.2.4.16.53 | NNNNNNNNNN | CHI Number allocated to the patient in Scotland | ||
NHS Logon ID | https://fhir.nhs.uk/Id/nhs-login-sub | uuid | NHS Login unique identifier which is referred to as sub in NHS Login (OpenID) |
Local identifiers such as MRN MUST include a system which identifies NHS provider/assigning authority.
"identifier": [ { "system": "https://fhir.nhs.uk/Id/nhs-number", "value": "9000000009" }, { "system": "https://fhir.elmet.nhs.uk/Id/MRN", "value": "X54321" } ],
Requirements
Patients are almost always assigned specific numerical identifiers.
identifier:nhsNumber
Element Id | Patient.identifier:nhsNumber |
Cardinality | 0..1 |
Slice Name | nhsNumber |
type | Identifier |
Definition
An identifier for this patient.
Requirements
Patients are almost always assigned specific numerical identifiers.
identifier:nhsNumber.system
Element Id | Patient.identifier:nhsNumber.system |
Cardinality | 1..1 |
Fixed Value | https://fhir.nhs.uk/Id/nhs-number |
type | uri |
Definition
Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Requirements
There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Comment
Identifier.system is always case sensitive.
name
Element Id | Patient.name |
Cardinality | 0..* |
type | HumanName |
Definition
At least one patient name must be provided. It is recommended a use is provided.
"name": [ { "family": "Smith", "given": [ "Jane" ], "prefix": [ "Mrs" ], "suffix": [ "MBE" ], "use": "usual" } ]
Requirements
Need to be able to track the patient by multiple names. Examples are your official name and a partner name.
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.
name.family
Element Id | Patient.name.family |
Cardinality | 0..1 |
type | string |
Definition
The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.
Comment
Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).
name.given
Element Id | Patient.name.given |
Cardinality | 0..5 |
type | string |
Definition
Given names, including any middle names.
Comment
If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to practical limitations. This element is not called "first name" since given names do not always come first.
telecom
Element Id | Patient.telecom |
Cardinality | 0..* |
type | ContactPoint |
Definition
List of contact points for the patient; for example, phone numbers or email addresses. When a patient tagged as restricted
or very restricted
is retrieved, all contact points are removed from the response.
"telecom": [ { "system": "phone", "use": "work", "value": "01632960587" } ]
Requirements
People have (primary) ways to contact them in some way such as phone, email.
Comment
A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).
gender
Element Id | Patient.gender |
Cardinality | 0..1 |
Terminology Binding | AdministrativeGender (Required) The gender of a person used for administrative purposes. |
type | code |
Definition
Classification of the gender of a patient. The classification is phenotypical rather than genotypical, i.e. it does not provide codes for medical or scientific purposes. It is the administrative gender that the patient wishes to be known as. In some cases, this may not be the same as the patient’s registered birth gender, or their current clinical gender.
Requirements
Needed for identification of the individual, in combination with (at least) name and birth date.
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.
birthDate
Element Id | Patient.birthDate |
Cardinality | 0..1 |
type | date |
Definition
The date on which the patient was born or is officially deemed to have been born.
It is a date in the format yyyy-mm-dd
. Due to data quality issues on a small number of patients yyyy-mm
and yyyy
format may also be returned.
When a patient tagged as very restricted
is retrieved, birth date is removed from the response.
Requirements
Age of the individual drives many clinical processes.
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).
birthDate.extension:birthTime.url
Element Id | Patient.birthDate.extension:birthTime.url |
Cardinality | 1..1 |
Fixed Value | http://hl7.org/fhir/StructureDefinition/patient-birthTime |
type | http://hl7.org/fhirpath/System.String |
Definition
Source of the definition for the extension code - a logical name or a URL.
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.
deceased[x]
Element Id | Patient.deceased[x] |
Cardinality | 0..1 |
type | booleandateTime |
Definition
The date and time on which a person died or is officially deemed to have died, if applicable and known.
It is a datetime in the format yyyy-mm-ddTHH:MM:SS+HH:MM
or yyyy-mm-dd
. Due to data quality issues on a small number of patients yyyy-mm
and yyyy
format may also be returned.
When a patient tagged as very restricted
is retrieved, death date is removed from the response.
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.
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.
address
Element Id | Patient.address |
Cardinality | 0..* |
type | Address |
Definition
List of addresses associated with the patient.
These are fully populated on a retrieval or a successful update, only the home address is returned on a search. When a patient tagged as restricted
or very restricted
is retrieved, all addresses are removed from the response.
"address": [ { "line": [ "1 Trevelyan Square", "Boar Lane", "City Centre", "Leeds", "West Yorkshire" ], "postalCode": "LS1 6AE", "use": "home" } ],
Requirements
May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.
Comment
Patient may have multiple addresses with different uses or applicable periods.
address.extension:addressKey
Element Id | Patient.address.extension:addressKey |
Cardinality | 0..1 |
Slice Name | addressKey |
type | Extension(ExtensionUKCoreAddressKey) |
Definition
Postal Address File (PAF) key associated with this address formatted as a FHIR extension. Empty if no PAF key for the address is known, or an object specifying the code system of the address key and the value of the address key.
contact
Element Id | Patient.contact |
Cardinality | 0..* |
type | BackboneElement |
Definition
A list of patient contacts. Only emergency contacts are returned and only emergency contacts should be added. Any other contacts should be added to the patients Related Person. Patients designate here any contact number they desire to be used in case of an emergency. Note, while a patient may also desire to record various related persons telecom details, these do not separately allow for a concept of emergency contact; only ranking. See RelatedPerson endpoint. When a patient tagged as restricted or very restricted is retrieved, all contacts are removed from the response.
Requirements
Need to track people you can contact about the patient.
Comment
Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.
Constraints
- pat-1 (ERROR) SHALL at least contain a contact's details or a reference to an organization
communication
Element Id | Patient.communication |
Cardinality | 0..* |
type | BackboneElement |
Definition
A language which may be used to communicate with the patient about his or her health.
Requirements
If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest.
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.
communication.extension:proficiency.extension:level.url
Element Id | Patient.communication.extension:proficiency.extension:level.url |
Cardinality | 1..1 |
Fixed Value | level |
type | uri |
Definition
Source of the definition for the extension code - a logical name or a URL.
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.
communication.extension:proficiency.extension:type.url
Element Id | Patient.communication.extension:proficiency.extension:type.url |
Cardinality | 1..1 |
Fixed Value | type |
type | uri |
Definition
Source of the definition for the extension code - a logical name or a URL.
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.
communication.extension:proficiency.url
Element Id | Patient.communication.extension:proficiency.url |
Cardinality | 1..1 |
Fixed Value | http://hl7.org/fhir/StructureDefinition/patient-proficiency |
type | http://hl7.org/fhirpath/System.String |
Definition
Source of the definition for the extension code - a logical name or a URL.
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.
generalPractitioner
Element Id | Patient.generalPractitioner |
Cardinality | 0..* |
Slicing | OPENATEND discriminator - VALUE identifier.system |
type | Reference(NHSDigitalPractitioner NHSDigitalPractitionerRole NHSDigitalOrganization) |
Definition
GP Surgery SHOULD be provided. It is recommended the patients GP Surgery is the first item in the array and branch surgery is second. It is also suggested type and display (name of practice) is also included.
"generalPractitioner": [ { "type": "Organization" "identifier": { "system": "https://fhir.nhs.uk/Id/ods-organization-code", "value": "Y12345" }, "display": "Kirkgate Practice" } ]
Requirements
GP Surgery SHOULD be provided. It is recommended the patients GP Surgery is the first item in the array and branch surgery is second. It is also suggested type and display (name of practice) is also included.
Comment
This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues. Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type.
Constraints
- nhsd-5 (WARNING) generalPractitioner - a display name should be provided
generalPractitioner:registeredGPPractice
Element Id | Patient.generalPractitioner:registeredGPPractice |
Cardinality | 0..1 |
Slice Name | registeredGPPractice |
type | Reference(UKCorePractitioner UKCoreOrganization UKCorePractitionerRole) |
Definition
Patient's registered GP Practice. Use V81998 for no registered practice and V81999 for not known as per NHS Data Dictionary guidelines.
Comment
This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues. Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type.
generalPractitioner:registeredGPPractice.identifier.system
Element Id | Patient.generalPractitioner:registeredGPPractice.identifier.system |
Cardinality | 0..1 |
Fixed Value | https://fhir.nhs.uk/Id/ods-organization-code |
type | uri |
Definition
Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Requirements
There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Comment
Identifier.system is always case sensitive.
generalPractitioner:registeredGeneralMedicalPractitioner
Element Id | Patient.generalPractitioner:registeredGeneralMedicalPractitioner |
Cardinality | 0..* |
Slice Name | registeredGeneralMedicalPractitioner |
type | Reference(UKCorePractitioner UKCoreOrganization UKCorePractitionerRole) |
Definition
This is to support legacy use cases where the patients GP is present
Comment
This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues. Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type.
generalPractitioner:registeredGeneralMedicalPractitioner.identifier.system
Element Id | Patient.generalPractitioner:registeredGeneralMedicalPractitioner.identifier.system |
Cardinality | 0..1 |
Fixed Value | https://fhir.nhs.uk/Id/gmp-number |
type | uri |
Definition
Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Requirements
There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Comment
Identifier.system is always case sensitive.
managingOrganization.identifier.system
Element Id | Patient.managingOrganization.identifier.system |
Cardinality | 0..1 |
Fixed Value | https://fhir.nhs.uk/Id/ods-organization-code |
type | uri |
Definition
Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Requirements
There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Comment
Identifier.system is always case sensitive.