Pan-Canadian eReferral-eConsult (CA:eReC) v1.1.0-DFT-Ballot

preBallot - The specification is currently in ballot review and subject to change. . . . For a full list of available versions, see the Directory of published versions

Patient (CA:eReC)

Description

The Patient resources contain demographics and other administrative information about the individual who is the subject of the referral.

References to this resource

Appointment, Communication, DocumentReference, QuestionnaireResponse, ServiceRequest

Resource Content

Patient			Patient	There are no (further) constraints on this element Data type Patient
identifier	S			There are no (further) constraints on this element Element id Patient.identifier Sliced: Unordered, Open, by type(Value)
(All Slices)				There are no (further) constraints on this element
type	S	1..		There are no (further) constraints on this element Element id Patient.identifier.type
system	S	1..		There are no (further) constraints on this element Element id Patient.identifier.system
value	S	1..		There are no (further) constraints on this element Element id Patient.identifier.value
JHN		0..*		There are no (further) constraints on this element Element id Patient.identifier:JHN Short description Jurisdictional Health Number Definition Patient and person health numbers used by all jurisdictions across Canada
versionCode		0..1	Extension(string)	There are no (further) constraints on this element Element id Patient.identifier:JHN.extension:versionCode Short description Health Number Version Code Data type Extension(string) Extension URL http://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-HCNV-code-EXT
type	S		Pattern	There are no (further) constraints on this element Element id Patient.identifier:JHN.type Pattern { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v2-0203", "code": "JHN", "display": "Jurisdictional Health Number" } ] }
system	S			There are no (further) constraints on this element Element id Patient.identifier:JHN.system Short description A Health Number Naming System from the Canadian URI Registry
value	S			There are no (further) constraints on this element Element id Patient.identifier:JHN.value
MRN		0..*		There are no (further) constraints on this element Element id Patient.identifier:MRN Short description Medical Record Number Definition A local patient identifier from the submitting PoS System Comments Some jurisdictions may consider the MRN identifier type to be an alternative to the JHN identifier type under certain scenarios. These business rules are outside the scope of this profile, however the slice is socialized to prepare implementers for potential use of this pattern within certain jurisdictions
type	S		Pattern	There are no (further) constraints on this element Element id Patient.identifier:MRN.type Pattern { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v2-0203", "code": "MR", "display": "Medical Record Number" } ] }
system	S			There are no (further) constraints on this element Element id Patient.identifier:MRN.system Short description An identifier for the system supplying the MRN
value	S			There are no (further) constraints on this element Element id Patient.identifier:MRN.value
name	S	1..		There are no (further) constraints on this element Element id Patient.name
family	S	1..		There are no (further) constraints on this element Element id Patient.name.family
given	S			There are no (further) constraints on this element Element id Patient.name.given
telecom	S			There are no (further) constraints on this element Element id Patient.telecom
system	S			There are no (further) constraints on this element Element id Patient.telecom.system
value	S	1..		There are no (further) constraints on this element Element id Patient.telecom.value
use	S			There are no (further) constraints on this element Element id Patient.telecom.use
gender	S			There are no (further) constraints on this element Element id Patient.gender Comments The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.). 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.
birthDate	S			There are no (further) constraints on this element Element id Patient.birthDate
address	S			There are no (further) constraints on this element Element id Patient.address
text	S			There are no (further) constraints on this element Element id Patient.address.text
postalCode	S			There are no (further) constraints on this element Element id Patient.address.postalCode
country	S			There are no (further) constraints on this element Element id Patient.address.country
maritalStatus				There are no (further) constraints on this element Element id Patient.maritalStatus Comments MAY be used to identify the maritalStatus of the patient
contact				There are no (further) constraints on this element Element id Patient.contact Comments MAY be used to identify alternate contacts for the patient
relationship	S		Binding	There are no (further) constraints on this element Element id Patient.contact.relationship Binding PatientContactRelationships (extensible)
name	S			There are no (further) constraints on this element Element id Patient.contact.name
telecom	S			There are no (further) constraints on this element Element id Patient.contact.telecom
communication				There are no (further) constraints on this element Element id Patient.communication Comments where applicable, SHOULD be used to identify the preferred communication language for the patient
extension				There are no (further) constraints on this element Element id Patient.communication.extension Sliced: Unordered, Open, by url(Value)
CommunicationBarrier	S	0..*	Extension(Coding)	There are no (further) constraints on this element Element id Patient.communication.extension:CommunicationBarrier Data type Extension(Coding) Extension URL http://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-ext-CommunicationBarrier
value[x]	S		Binding	There are no (further) constraints on this element Element id Patient.communication.extension:CommunicationBarrier.value[x] Binding CommunicationBarrier (extensible)
code	S		Binding	There are no (further) constraints on this element Element id Patient.communication.extension:CommunicationBarrier.value[x].code Binding Contains codes required to identify if the patient speaks/understands an offical language (english/french), or if she/he does not and an interpretor is required. CommunicationBarrier (extensible)
language	S		Binding	There are no (further) constraints on this element Element id Patient.communication.language Binding HumanLanguage (preferred)
preferred	S			There are no (further) constraints on this element Element id Patient.communication.preferred
generalPractitioner			Reference(Practitioner \| PractitionerRole \| Organization)	There are no (further) constraints on this element Element id Patient.generalPractitioner Comments where applicable, SHOULD be used to identify patients primary care provider Data type Reference(Practitioner \| PractitionerRole \| Organization)
reference	S			There are no (further) constraints on this element Element id Patient.generalPractitioner.reference
identifier	S			There are no (further) constraints on this element Element id Patient.generalPractitioner.identifier
system	S	1..		There are no (further) constraints on this element Element id Patient.generalPractitioner.identifier.system
value	S	1..		There are no (further) constraints on this element Element id Patient.generalPractitioner.identifier.value

Patient	I		Patient	There are no (further) constraints on this element Element id Patient Short description Information about an individual or animal receiving health care services Alternate names SubjectOfCare Client Resident Definition Demographics and other administrative information about an individual or animal receiving care or other health-related services. Data type Patient Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() Mappings rim: Entity. Role, or Act rim: Patient[classCode=PAT] cda: ClinicalDocument.recordTarget.patientRole
id	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type string
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Patient.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Patient.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
language		0..1	codeBinding	There are no (further) constraints on this element Element id Patient.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
text		0..1	Narrative	There are no (further) constraints on this element Element id Patient.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id Patient.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. Data type Resource Mappings rim: N/A
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id Patient.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
identifier	S Σ	0..*	Identifier	Element id Patient.identifier Short description An identifier for this patient Definition An identifier for this patient. Requirements Patients are almost always assigned specific numerical identifiers. Data type Identifier Sliced: Unordered, Open, by type(Value) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.identifier v2: PID-3 rim: id cda: .id
(All Slices)				There are no (further) constraints on this element
id		0..1	string	There are no (further) constraints on this element Element id Patient.identifier.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.identifier.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Patient.identifier.use Short description usual \| official \| temp \| secondary \| old (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: N/A rim: Role.code or implied by context
type	S Σ	1..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Patient.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.5 rim: Role.code or implied by context
system	S Σ	1..1	uri	There are no (further) constraints on this element Element id Patient.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments Identifier.system is always case sensitive. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General http://www.acme.com/identifiers/patient Mappings v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType
value	S Σ	1..1	string	There are no (further) constraints on this element Element id Patient.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 123456 Mappings v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value
period	Σ	0..1	Period	There are no (further) constraints on this element Element id Patient.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
assigner	Σ	0..1	Reference(Organization)	There are no (further) constraints on this element Element id Patient.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
JHN	Σ	0..*	Identifier	Element id Patient.identifier:JHN Short description Jurisdictional Health Number Definition Patient and person health numbers used by all jurisdictions across Canada Requirements Patients are almost always assigned specific numerical identifiers. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.identifier v2: PID-3 rim: id cda: .id
id		0..1	string	There are no (further) constraints on this element Element id Patient.identifier:JHN.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.identifier:JHN.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
versionCode	I	0..1	Extension(string)	Element id Patient.identifier:JHN.extension:versionCode Short description Health Number Version Code Alternate names extensions, user content Definition An assigned sequence code, uniquely identifying a Health Card issued (or potentially issued) to a Registered Person Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(string) Extension URL http://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-HCNV-code-EXT Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Patient.identifier:JHN.use Short description usual \| official \| temp \| secondary \| old (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: N/A rim: Role.code or implied by context
type	S Σ	0..1	CodeableConceptBindingPattern	Element id Patient.identifier:JHN.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v2-0203", "code": "JHN", "display": "Jurisdictional Health Number" } ] } Mappings v2: CX.5 rim: Role.code or implied by context
system	S Σ	0..1	uri	Element id Patient.identifier:JHN.system Short description A Health Number Naming System from the Canadian URI Registry Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments Identifier.system is always case sensitive. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General http://www.acme.com/identifiers/patient Mappings v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType
value	S Σ	0..1	string	There are no (further) constraints on this element Element id Patient.identifier:JHN.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 123456 Mappings v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value
period	Σ	0..1	Period	There are no (further) constraints on this element Element id Patient.identifier:JHN.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
assigner	Σ	0..1	Reference(Organization)	There are no (further) constraints on this element Element id Patient.identifier:JHN.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
MRN	Σ	0..*	Identifier	Element id Patient.identifier:MRN Short description Medical Record Number Definition A local patient identifier from the submitting PoS System Requirements Patients are almost always assigned specific numerical identifiers. Comments Some jurisdictions may consider the MRN identifier type to be an alternative to the JHN identifier type under certain scenarios. These business rules are outside the scope of this profile, however the slice is socialized to prepare implementers for potential use of this pattern within certain jurisdictions Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.identifier v2: PID-3 rim: id cda: .id
id		0..1	string	There are no (further) constraints on this element Element id Patient.identifier:MRN.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.identifier:MRN.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Patient.identifier:MRN.use Short description usual \| official \| temp \| secondary \| old (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: N/A rim: Role.code or implied by context
type	S Σ	0..1	CodeableConceptBindingPattern	Element id Patient.identifier:MRN.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v2-0203", "code": "MR", "display": "Medical Record Number" } ] } Mappings v2: CX.5 rim: Role.code or implied by context
system	S Σ	0..1	uri	Element id Patient.identifier:MRN.system Short description An identifier for the system supplying the MRN Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments Identifier.system is always case sensitive. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General http://www.acme.com/identifiers/patient Mappings v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType
value	S Σ	0..1	string	There are no (further) constraints on this element Element id Patient.identifier:MRN.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 123456 Mappings v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value
period	Σ	0..1	Period	There are no (further) constraints on this element Element id Patient.identifier:MRN.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
assigner	Σ	0..1	Reference(Organization)	There are no (further) constraints on this element Element id Patient.identifier:MRN.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
active	Σ ?!	0..1	boolean	There are no (further) constraints on this element Element id Patient.active Short description Whether this patient's record is in active use Definition Whether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules. It is often used to filter patient lists to exclude inactive patients Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death. Requirements Need to be able to mark a patient record as not to be used because it was created in error. Comments If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient. Meaning when missing This resource is generally assumed to be active if no value is provided for the active element Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.status rim: statusCode cda: n/a
name	S Σ	1..*	HumanName	There are no (further) constraints on this element Element id Patient.name Short description A name associated with the patient Definition A name associated with the individual. Requirements Need to be able to track the patient by multiple names. Examples are your official name and a partner name. Comments A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns. Data type HumanName Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-5, PID-9 rim: name cda: .patient.name
id		0..1	string	There are no (further) constraints on this element Element id Patient.name.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.name.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Patient.name.use Short description usual \| official \| temp \| nickname \| anonymous \| old \| maiden Definition Identifies the purpose for this name. Requirements Allows the appropriate name for a particular context of use to be selected from among a set of names. Comments Applications can assume that a name is current unless it explicitly says that it is temporary or old. Data type code Binding The use of a human name. NameUse (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XPN.7, but often indicated by which field contains the name rim: unique(./use) servd: ./NamePurpose
text	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.name.text Short description Text representation of the full name Definition Specifies 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. Requirements A renderable, unencoded form. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: implied by XPN.11 rim: ./formatted
family	S Σ	1..1	string	There are no (further) constraints on this element Element id Patient.name.family Short description Family name (often called 'Surname') Alternate names surname Definition The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father. Comments Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures). Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XPN.1/FN.1 rim: ./part[partType = FAM] servd: ./FamilyName
given	S Σ	0..*	string	There are no (further) constraints on this element Element id Patient.name.given Short description Given names (not always 'first'). Includes middle names Alternate names first name, middle name Definition Given name. Comments If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XPN.2 + XPN.3 rim: ./part[partType = GIV] servd: ./GivenNames
prefix	Σ	0..*	string	There are no (further) constraints on this element Element id Patient.name.prefix Short description Parts that come before the name Definition Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XPN.5 rim: ./part[partType = PFX] servd: ./TitleCode
suffix	Σ	0..*	string	There are no (further) constraints on this element Element id Patient.name.suffix Short description Parts that come after the name Definition Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XPN/4 rim: ./part[partType = SFX]
period	Σ	0..1	Period	There are no (further) constraints on this element Element id Patient.name.period Short description Time period when name was/is in use Definition Indicates the period of time when this name was valid for the named person. Requirements Allows names to be placed in historical context. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XPN.13 + XPN.14 rim: ./usablePeriod[type="IVL<TS>"] servd: ./StartDate and ./EndDate
telecom	S Σ	0..*	ContactPoint	There are no (further) constraints on this element Element id Patient.telecom Short description A contact detail for the individual Definition A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted. Requirements People have (primary) ways to contact them in some way such as phone, email. Comments A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone). Data type ContactPoint Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-13, PID-14, PID-40 rim: telecom cda: .telecom
id		0..1	string	There are no (further) constraints on this element Element id Patient.telecom.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.telecom.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
system	S Σ I	0..1	codeBinding	There are no (further) constraints on this element Element id Patient.telecom.system Short description phone \| fax \| email \| pager \| url \| sms \| other Definition Telecommunications form for contact point - what communications system is required to make use of the contact. Data type code Binding Telecommunications form for contact point. ContactPointSystem (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XTN.3 rim: ./scheme servd: ./ContactPointType
value	S Σ	1..1	string	There are no (further) constraints on this element Element id Patient.telecom.value Short description The actual contact point details Definition The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address). Requirements Need to support legacy numbers that are not in a tightly controlled format. Comments Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XTN.1 (or XTN.12) rim: ./url servd: ./Value
use	S Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Patient.telecom.use Short description home \| work \| temp \| old \| mobile - purpose of this contact point Definition Identifies the purpose for the contact point. Requirements Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose. Comments Applications can assume that a contact is current unless it explicitly says that it is temporary or old. Data type code Binding Use of contact point. ContactPointUse (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XTN.2 - but often indicated by field rim: unique(./use) servd: ./ContactPointPurpose
rank	Σ	0..1	positiveInt	There are no (further) constraints on this element Element id Patient.telecom.rank Short description Specify preferred order of use (1 = highest) Definition Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values. Comments Note that rank does not necessarily follow the order in which the contacts are represented in the instance. Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: n/a rim: n/a
period	Σ	0..1	Period	There are no (further) constraints on this element Element id Patient.telecom.period Short description Time period when the contact point was/is in use Definition Time period when the contact point was/is in use. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: N/A rim: ./usablePeriod[type="IVL<TS>"] servd: ./StartDate and ./EndDate
gender	S Σ	0..1	codeBinding	Element id Patient.gender Short description male \| female \| other \| unknown Definition Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes. Requirements Needed for identification of the individual, in combination with (at least) name and birth date. Comments The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.). 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. Data type code Binding The gender of a person used for administrative purposes. AdministrativeGender (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-8 rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/administrativeGender cda: .patient.administrativeGenderCode
birthDate	S Σ	0..1	date	There are no (further) constraints on this element Element id Patient.birthDate Short description The date of birth for the individual Definition The date of birth for the individual. Requirements Age of the individual drives many clinical processes. Comments At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternity/infant care systems). Data type date Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-7 rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/birthTime cda: .patient.birthTime loinc: 21112-8
deceased[x]	Σ ?!	0..1		There are no (further) constraints on this element Element id Patient.deceased[x] Short description Indicates if the individual is deceased or not Definition Indicates if the individual is deceased or not. Requirements The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive. Comments If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-30 (bool) and PID-29 (datetime) rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN\|ANM and determinerCode=INSTANCE]/deceasedTime cda: n/a
deceasedBoolean			boolean	There are no (further) constraints on this element Data type boolean
deceasedDateTime			dateTime	There are no (further) constraints on this element Data type dateTime
address	S Σ	0..*	Address	There are no (further) constraints on this element Element id Patient.address Short description An address for the individual Definition An address for the individual. Requirements May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification. Comments Patient may have multiple addresses with different uses or applicable periods. Data type Address Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-11 rim: addr cda: .addr
id		0..1	string	There are no (further) constraints on this element Element id Patient.address.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.address.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Patient.address.use Short description home \| work \| temp \| old \| billing - purpose of this address Definition The purpose of this address. Requirements Allows an appropriate address to be chosen from a list of many. Comments Applications can assume that an address is current unless it explicitly says that it is temporary or old. Data type code Binding The use of an address. AddressUse (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General home Mappings v2: XAD.7 rim: unique(./use) servd: ./AddressPurpose
type	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id Patient.address.type Short description postal \| physical \| both Definition Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both. Comments The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource). Data type code Binding The type of an address (physical / postal). AddressType (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General both Mappings v2: XAD.18 rim: unique(./use) vcard: address type parameter
text	S Σ	0..1	string	There are no (further) constraints on this element Element id Patient.address.text Short description Text representation of the address Definition Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts. Requirements A renderable, unencoded form. Comments Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 137 Nowhere Street, Erewhon 9132 Mappings v2: XAD.1 + XAD.2 + XAD.3 + XAD.4 + XAD.5 + XAD.6 rim: ./formatted vcard: address label parameter
line	Σ	0..*	string	There are no (further) constraints on this element Element id Patient.address.line Short description Street name, number, direction & P.O. Box etc. Definition This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 137 Nowhere Street Mappings v2: XAD.1 + XAD.2 (note: XAD.1 and XAD.2 have different meanings for a company address than for a person address) rim: AD.part[parttype = AL] vcard: street servd: ./StreetAddress (newline delimitted)
city	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.address.city Short description Name of city, town etc. Alternate names Municpality Definition The name of the city, town, suburb, village or other community or delivery center. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General Erewhon Mappings v2: XAD.3 rim: AD.part[parttype = CTY] vcard: locality servd: ./Jurisdiction
district	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.address.district Short description District name (aka county) Alternate names County Definition The name of the administrative area (county). Comments District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General Madison Mappings v2: XAD.9 rim: AD.part[parttype = CNT \| CPA]
state	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.address.state Short description Sub-unit of country (abbreviations ok) Alternate names Province, Territory Definition Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes). Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XAD.4 rim: AD.part[parttype = STA] vcard: region servd: ./Region
postalCode	S Σ	0..1	string	There are no (further) constraints on this element Element id Patient.address.postalCode Short description Postal code for area Alternate names Zip Definition A postal code designating a region defined by the postal service. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 9132 Mappings v2: XAD.5 rim: AD.part[parttype = ZIP] vcard: code servd: ./PostalIdentificationCode
country	S Σ	0..1	string	There are no (further) constraints on this element Element id Patient.address.country Short description Country (e.g. can be ISO 3166 2 or 3 letter code) Definition Country - a nation as commonly understood or generally accepted. Comments ISO 3166 3 letter codes can be used in place of a human readable country name. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: XAD.6 rim: AD.part[parttype = CNT] vcard: country servd: ./Country
period	Σ	0..1	Period	There are no (further) constraints on this element Element id Patient.address.period Short description Time period when address was/is in use Definition Time period when address was/is in use. Requirements Allows addresses to be placed in historical context. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General { "start": "2010-03-23", "end": "2010-07-01" } Mappings v2: XAD.12 / XAD.13 + XAD.14 rim: ./usablePeriod[type="IVL<TS>"] servd: ./StartDate and ./EndDate
maritalStatus		0..1	CodeableConceptBinding	Element id Patient.maritalStatus Short description Marital (civil) status of a patient Definition This field contains a patient's most recent marital (civil) status. Requirements Most, if not all systems capture it. Comments MAY be used to identify the maritalStatus of the patient Data type CodeableConcept Binding The domestic partnership status of a person. Marital Status Codes (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-16 rim: player[classCode=PSN]/maritalStatusCode cda: .patient.maritalStatusCode
multipleBirth[x]		0..1		There are no (further) constraints on this element Element id Patient.multipleBirth[x] Short description Whether patient is part of a multiple birth Definition Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer). Requirements For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs. Comments Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in triplets would be valueInteger=2 and the third born would have valueInteger=3 If a boolean value was provided for this triplets example, then all 3 patient records would have valueBoolean=true (the ordering is not indicated). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-24 (bool), PID-25 (integer) rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/multipleBirthInd, player[classCode=PSN\|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber cda: n/a
multipleBirthBoolean			boolean	There are no (further) constraints on this element Data type boolean
multipleBirthInteger			integer	There are no (further) constraints on this element Data type integer
photo		0..*	Attachment	There are no (further) constraints on this element Element id Patient.photo Short description Image of the patient Definition Image of the patient. Requirements Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too. Comments Guidelines: Use id photos, not clinical photos. Limit dimensions to thumbnail. Keep byte count low to ease resource updates. Data type Attachment Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: OBX-5 - needs a profile rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/desc cda: n/a
contact	I	0..*	BackboneElement	Element id Patient.contact Short description A contact party (e.g. guardian, partner, friend) for the patient Definition A contact party (e.g. guardian, partner, friend) for the patient. Requirements Need to track people you can contact about the patient. Comments MAY be used to identify alternate contacts for the patient Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` pat-1: SHALL at least contain a contact's details or a reference to an organization `name.exists() or telecom.exists() or address.exists() or organization.exists()` Mappings rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON] cda: n/a
id		0..1	string	There are no (further) constraints on this element Element id Patient.contact.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.contact.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Patient.contact.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
relationship	S	0..*	CodeableConceptBinding	Element id Patient.contact.relationship Short description The kind of relationship Definition The nature of the relationship between the patient and the contact person. Requirements Used to determine which contact person is the most relevant to approach, depending on circumstances. Data type CodeableConcept Binding The nature of the relationship between a patient and a contact person for that patient. PatientContactRelationships (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: NK1-7, NK1-3 rim: code cda: n/a
name	S	0..1	HumanName	There are no (further) constraints on this element Element id Patient.contact.name Short description A name associated with the contact person Definition A name associated with the contact person. Requirements Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person. Data type HumanName Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: NK1-2 rim: name cda: n/a
telecom	S	0..*	ContactPoint	There are no (further) constraints on this element Element id Patient.contact.telecom Short description A contact detail for the person Definition A contact detail for the person, e.g. a telephone number or an email address. Requirements People have (primary) ways to contact them in some way such as phone, email. Comments Contact may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification. Data type ContactPoint Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: NK1-5, NK1-6, NK1-40 rim: telecom cda: n/a
address		0..1	Address	There are no (further) constraints on this element Element id Patient.contact.address Short description Address for the contact person Definition Address for the contact person. Requirements Need to keep track where the contact person can be contacted per postal mail or visited. Data type Address Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: NK1-4 rim: addr cda: n/a
gender		0..1	codeBinding	There are no (further) constraints on this element Element id Patient.contact.gender Short description male \| female \| other \| unknown Definition Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes. Requirements Needed to address the person correctly. Data type code Binding The gender of a person used for administrative purposes. AdministrativeGender (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: NK1-15 rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/administrativeGender cda: n/a
organization	I	0..1	Reference(Organization)	There are no (further) constraints on this element Element id Patient.contact.organization Short description Organization that is associated with the contact Definition Organization on behalf of which the contact is acting or for which the contact is working. Requirements For guardians or business related contacts, the organization is relevant. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: NK1-13, NK1-30, NK1-31, NK1-32, NK1-41 rim: scoper cda: n/a
period		0..1	Period	There are no (further) constraints on this element Element id Patient.contact.period Short description The period during which this contact person or organization is valid to be contacted relating to this patient Definition The period during which this contact person or organization is valid to be contacted relating to this patient. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: effectiveTime cda: n/a
communication		0..*	BackboneElement	Element id Patient.communication Short description A language which may be used to communicate with the patient about his or her health Definition A language which may be used to communicate with the patient about his or her health. Requirements If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest. Comments where applicable, SHOULD be used to identify the preferred communication language for the patient Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: LanguageCommunication cda: patient.languageCommunication
id		0..1	string	There are no (further) constraints on this element Element id Patient.communication.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	Element id Patient.communication.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
CommunicationBarrier	S I	0..*	Extension(Coding)	Element id Patient.communication.extension:CommunicationBarrier Short description Optional Extensions Element Alternate names extensions, user content Definition To identify if the patient speaks/understands an offical language (english/french), or if she/he does not an interpretor is required. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(Coding) Extension URL http://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-ext-CommunicationBarrier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
id		0..1	string	There are no (further) constraints on this element Element id Patient.communication.extension:CommunicationBarrier.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..0	Extension	There are no (further) constraints on this element Element id Patient.communication.extension:CommunicationBarrier.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Patient.communication.extension:CommunicationBarrier.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value http://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-ext-CommunicationBarrier Mappings rim: N/A
value[x]	S	0..1	Binding	There are no (further) constraints on this element Element id Patient.communication.extension:CommunicationBarrier.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Binding CommunicationBarrier (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
valueCoding			Coding	There are no (further) constraints on this element Data type Coding
id		0..1	string	There are no (further) constraints on this element Element id Patient.communication.extension:CommunicationBarrier.value[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.communication.extension:CommunicationBarrier.value[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
system	Σ	0..1	uri	There are no (further) constraints on this element Element id Patient.communication.extension:CommunicationBarrier.value[x].system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.communication.extension:CommunicationBarrier.value[x].version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	S Σ	0..1	codeBinding	Element id Patient.communication.extension:CommunicationBarrier.value[x].code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Data type code Binding Contains codes required to identify if the patient speaks/understands an offical language (english/french), or if she/he does not and an interpretor is required. CommunicationBarrier (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.communication.extension:CommunicationBarrier.value[x].display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id Patient.communication.extension:CommunicationBarrier.value[x].userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Patient.communication.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
language	S	1..1	CodeableConceptBinding	Element id Patient.communication.language Short description The language which can be used to communicate with the patient about his or her health Definition The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English. Requirements Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect. Comments The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type. Data type CodeableConcept Binding A human language. HumanLanguage (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-15, LAN-2 rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/languageCommunication/code cda: .languageCode
preferred	S	0..1	boolean	There are no (further) constraints on this element Element id Patient.communication.preferred Short description Language preference indicator Definition Indicates whether or not the patient prefers this language (over other languages he masters up a certain level). Requirements People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method. Comments This language is specifically identified for communicating healthcare information. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-15 rim: preferenceInd cda: .preferenceInd
generalPractitioner		0..*	Reference(Practitioner \| PractitionerRole \| Organization)	Element id Patient.generalPractitioner Short description Patient's nominated primary care provider Alternate names careProvider Definition Patient's nominated care provider. Comments where applicable, SHOULD be used to identify patients primary care provider Data type Reference(Practitioner \| PractitionerRole \| Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PD1-4 rim: subjectOf.CareEvent.performer.AssignedEntity cda: n/a
id		0..1	string	There are no (further) constraints on this element Element id Patient.generalPractitioner.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.generalPractitioner.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
reference	S Σ I	0..1	string	There are no (further) constraints on this element Element id Patient.generalPractitioner.reference Short description Literal reference, Relative, internal or absolute URL Definition A 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. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id Patient.generalPractitioner.type Short description Type the reference refers to (e.g. "Patient") Definition The 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). Comments 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. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
identifier	S Σ	0..1	Identifier	There are no (further) constraints on this element Element id Patient.generalPractitioner.identifier Short description Logical reference, when literal reference is not known Definition An 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. Comments 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). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .identifier
id		0..1	string	There are no (further) constraints on this element Element id Patient.generalPractitioner.identifier.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.generalPractitioner.identifier.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Patient.generalPractitioner.identifier.use Short description usual \| official \| temp \| secondary \| old (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: N/A rim: Role.code or implied by context
type	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Patient.generalPractitioner.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.5 rim: Role.code or implied by context
system	S Σ	1..1	uri	There are no (further) constraints on this element Element id Patient.generalPractitioner.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments Identifier.system is always case sensitive. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General http://www.acme.com/identifiers/patient Mappings v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType
value	S Σ	1..1	string	There are no (further) constraints on this element Element id Patient.generalPractitioner.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 123456 Mappings v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value
period	Σ	0..1	Period	There are no (further) constraints on this element Element id Patient.generalPractitioner.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
assigner	Σ	0..1	Reference(Organization)	There are no (further) constraints on this element Element id Patient.generalPractitioner.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
display	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.generalPractitioner.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
managingOrganization	Σ	0..1	Reference(Organization)	There are no (further) constraints on this element Element id Patient.managingOrganization Short description Organization that is the custodian of the patient record Definition Organization that is the custodian of the patient record. Requirements Need to know who recognizes this patient record, manages and updates it. Comments There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association). Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: scoper cda: .providerOrganization
link	Σ ?!	0..*	BackboneElement	There are no (further) constraints on this element Element id Patient.link Short description Link to another patient resource that concerns the same actual person Definition Link to another patient resource that concerns the same actual patient. Requirements There are multiple use cases: Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and Distribution of patient information across multiple servers. Comments There is no assumption that linked patient records have mutual links. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: outboundLink cda: n/a
id		0..1	string	There are no (further) constraints on this element Element id Patient.link.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.link.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Patient.link.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
other	Σ	1..1	Reference(Patient \| RelatedPerson)	There are no (further) constraints on this element Element id Patient.link.other Short description The other patient or related person resource that the link refers to Definition The other patient resource that the link refers to. Comments Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual. Data type Reference(Patient \| RelatedPerson) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: PID-3, MRG-1 rim: id cda: n/a
type	Σ	1..1	codeBinding	There are no (further) constraints on this element Element id Patient.link.type Short description replaced-by \| replaces \| refer \| seealso Definition The type of link between this patient resource and another patient resource. Data type code Binding The type of link between this patient resource and another patient resource. LinkType (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: typeCode cda: n/a

<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="CA-eReC-Patient" />
    <url value="http://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-Patient" />
    <name value="Patient" />
    <status value="draft" />
    <description value="The Patient resources contain demographics and other administrative information about the individual who is the subject of the referral." />
    <fhirVersion value="4.0.1" />
    <kind value="resource" />
    <abstract value="false" />
    <type value="Patient" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Patient" />
    <derivation value="constraint" />
    <differential>
        <element id="Patient.identifier">
            <path value="Patient.identifier" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="type" />
                </discriminator>
                <ordered value="false" />
                <rules value="open" />
            </slicing>
            <mustSupport value="true" />
        </element>
        <element id="Patient.identifier.type">
            <path value="Patient.identifier.type" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.identifier.system">
            <path value="Patient.identifier.system" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.identifier.value">
            <path value="Patient.identifier.value" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.identifier:JHN">
            <path value="Patient.identifier" />
            <sliceName value="JHN" />
            <short value="Jurisdictional Health Number" />
            <definition value="Patient and person health numbers used by all jurisdictions across Canada" />
            <min value="0" />
            <max value="*" />
        </element>
        <element id="Patient.identifier:JHN.extension:versionCode">
            <path value="Patient.identifier.extension" />
            <sliceName value="versionCode" />
            <short value="Health Number Version Code" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="Extension" />
                <profile value="http://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-HCNV-code-EXT" />
            </type>
        </element>
        <element id="Patient.identifier:JHN.type">
            <path value="Patient.identifier.type" />
            <patternCodeableConcept>
                <coding>
                    <system value="http://terminology.hl7.org/CodeSystem/v2-0203" />
                    <code value="JHN" />
                    <display value="Jurisdictional Health Number" />
                </coding>
            </patternCodeableConcept>
            <mustSupport value="true" />
        </element>
        <element id="Patient.identifier:JHN.system">
            <path value="Patient.identifier.system" />
            <short value="A Health Number Naming System from the Canadian URI Registry" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.identifier:JHN.value">
            <path value="Patient.identifier.value" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.identifier:MRN">
            <path value="Patient.identifier" />
            <sliceName value="MRN" />
            <short value="Medical Record Number" />
            <definition value="A local patient identifier from the submitting PoS System" />
            <comment value="Some jurisdictions may consider the MRN identifier type to be an alternative to the JHN identifier type under certain scenarios. These business rules are outside the scope of this profile, however the slice is socialized to prepare implementers for potential use of this pattern within certain jurisdictions" />
            <min value="0" />
            <max value="*" />
        </element>
        <element id="Patient.identifier:MRN.type">
            <path value="Patient.identifier.type" />
            <patternCodeableConcept>
                <coding>
                    <system value="http://terminology.hl7.org/CodeSystem/v2-0203" />
                    <code value="MR" />
                    <display value="Medical Record Number" />
                </coding>
            </patternCodeableConcept>
            <mustSupport value="true" />
        </element>
        <element id="Patient.identifier:MRN.system">
            <path value="Patient.identifier.system" />
            <short value="An identifier for the system supplying the MRN" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.identifier:MRN.value">
            <path value="Patient.identifier.value" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.name">
            <path value="Patient.name" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.name.family">
            <path value="Patient.name.family" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.name.given">
            <path value="Patient.name.given" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.telecom">
            <path value="Patient.telecom" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.telecom.system">
            <path value="Patient.telecom.system" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.telecom.value">
            <path value="Patient.telecom.value" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.telecom.use">
            <path value="Patient.telecom.use" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.gender">
            <path value="Patient.gender" />
            <comment value="The gender might not match the biological sex as determined by genetics or the individual&#39;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.).  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 &quot;hard&quot; error." />
            <mustSupport value="true" />
        </element>
        <element id="Patient.birthDate">
            <path value="Patient.birthDate" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.address">
            <path value="Patient.address" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.address.text">
            <path value="Patient.address.text" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.address.postalCode">
            <path value="Patient.address.postalCode" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.address.country">
            <path value="Patient.address.country" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.maritalStatus">
            <path value="Patient.maritalStatus" />
            <comment value="MAY be used to identify the maritalStatus of the patient" />
        </element>
        <element id="Patient.contact">
            <path value="Patient.contact" />
            <comment value="MAY be used to identify alternate contacts for the patient" />
        </element>
        <element id="Patient.contact.relationship">
            <path value="Patient.contact.relationship" />
            <mustSupport value="true" />
            <binding>
                <strength value="extensible" />
                <valueSet value="http://fhir.infoway-inforoute.ca/io/CA-eReC/ValueSet/patient-contact-relationship" />
            </binding>
        </element>
        <element id="Patient.contact.name">
            <path value="Patient.contact.name" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.contact.telecom">
            <path value="Patient.contact.telecom" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.communication">
            <path value="Patient.communication" />
            <comment value="where applicable, SHOULD be used to identify the preferred communication language for the patient" />
        </element>
        <element id="Patient.communication.extension">
            <path value="Patient.communication.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <ordered value="false" />
                <rules value="open" />
            </slicing>
        </element>
        <element id="Patient.communication.extension:CommunicationBarrier">
            <path value="Patient.communication.extension" />
            <sliceName value="CommunicationBarrier" />
            <min value="0" />
            <max value="*" />
            <type>
                <code value="Extension" />
                <profile value="http://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-ext-CommunicationBarrier" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="Patient.communication.extension:CommunicationBarrier.value[x]">
            <path value="Patient.communication.extension.value[x]" />
            <mustSupport value="true" />
            <binding>
                <strength value="extensible" />
                <valueSet value="http://fhir.infoway-inforoute.ca/io/CA-eReC/ValueSet/communication-barrier" />
            </binding>
        </element>
        <element id="Patient.communication.extension:CommunicationBarrier.value[x].code">
            <path value="Patient.communication.extension.value[x].code" />
            <mustSupport value="true" />
            <binding>
                <strength value="extensible" />
                <description value="Contains codes required to identify if the patient speaks/understands an offical language (english/french), or if she/he does not and an interpretor is required." />
                <valueSet value="http://fhir.infoway-inforoute.ca/io/CA-eReC/ValueSet/communication-barrier" />
            </binding>
        </element>
        <element id="Patient.communication.language">
            <path value="Patient.communication.language" />
            <mustSupport value="true" />
            <binding>
                <strength value="preferred" />
                <valueSet value="http://fhir.infoway-inforoute.ca/io/CA-eReC/ValueSet/human-language" />
            </binding>
        </element>
        <element id="Patient.communication.preferred">
            <path value="Patient.communication.preferred" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.generalPractitioner">
            <path value="Patient.generalPractitioner" />
            <comment value="where applicable, SHOULD be used to identify patients primary care provider" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-Practitioner" />
                <targetProfile value="http://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-PractitionerRole" />
                <targetProfile value="http://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-Organization" />
            </type>
        </element>
        <element id="Patient.generalPractitioner.reference">
            <path value="Patient.generalPractitioner.reference" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.generalPractitioner.identifier">
            <path value="Patient.generalPractitioner.identifier" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.generalPractitioner.identifier.system">
            <path value="Patient.generalPractitioner.identifier.system" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="Patient.generalPractitioner.identifier.value">
            <path value="Patient.generalPractitioner.identifier.value" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
    </differential>
</StructureDefinition>

{
    "resourceType": "StructureDefinition",
    "id": "CA-eReC-Patient",
    "url": "http://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-Patient",
    "name": "Patient",
    "status": "draft",
    "description": "The Patient resources contain demographics and other administrative information about the individual who is the subject of the referral.",
    "fhirVersion": "4.0.1",
    "kind": "resource",
    "abstract": false,
    "type": "Patient",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Patient",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "Patient.identifier",
                "path": "Patient.identifier",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "type"
                        }
                    ],
                    "ordered": false,
                    "rules": "open"
                },
                "mustSupport": true
            },
            {
                "id": "Patient.identifier.type",
                "path": "Patient.identifier.type",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Patient.identifier.system",
                "path": "Patient.identifier.system",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Patient.identifier.value",
                "path": "Patient.identifier.value",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Patient.identifier:JHN",
                "path": "Patient.identifier",
                "sliceName": "JHN",
                "short": "Jurisdictional Health Number",
                "definition": "Patient and person health numbers used by all jurisdictions across Canada",
                "min": 0,
                "max": "*"
            },
            {
                "id": "Patient.identifier:JHN.extension:versionCode",
                "path": "Patient.identifier.extension",
                "sliceName": "versionCode",
                "short": "Health Number Version Code",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-HCNV-code-EXT"
                        ]
                    }
                ]
            },
            {
                "id": "Patient.identifier:JHN.type",
                "path": "Patient.identifier.type",
                "patternCodeableConcept": {
                    "coding":  [
                        {
                            "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                            "code": "JHN",
                            "display": "Jurisdictional Health Number"
                        }
                    ]
                },
                "mustSupport": true
            },
            {
                "id": "Patient.identifier:JHN.system",
                "path": "Patient.identifier.system",
                "short": "A Health Number Naming System from the Canadian URI Registry",
                "mustSupport": true
            },
            {
                "id": "Patient.identifier:JHN.value",
                "path": "Patient.identifier.value",
                "mustSupport": true
            },
            {
                "id": "Patient.identifier:MRN",
                "path": "Patient.identifier",
                "sliceName": "MRN",
                "short": "Medical Record Number",
                "definition": "A local patient identifier from the submitting PoS System",
                "comment": "Some jurisdictions may consider the MRN identifier type to be an alternative to the JHN identifier type under certain scenarios. These business rules are outside the scope of this profile, however the slice is socialized to prepare implementers for potential use of this pattern within certain jurisdictions",
                "min": 0,
                "max": "*"
            },
            {
                "id": "Patient.identifier:MRN.type",
                "path": "Patient.identifier.type",
                "patternCodeableConcept": {
                    "coding":  [
                        {
                            "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                            "code": "MR",
                            "display": "Medical Record Number"
                        }
                    ]
                },
                "mustSupport": true
            },
            {
                "id": "Patient.identifier:MRN.system",
                "path": "Patient.identifier.system",
                "short": "An identifier for the system supplying the MRN",
                "mustSupport": true
            },
            {
                "id": "Patient.identifier:MRN.value",
                "path": "Patient.identifier.value",
                "mustSupport": true
            },
            {
                "id": "Patient.name",
                "path": "Patient.name",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Patient.name.family",
                "path": "Patient.name.family",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Patient.name.given",
                "path": "Patient.name.given",
                "mustSupport": true
            },
            {
                "id": "Patient.telecom",
                "path": "Patient.telecom",
                "mustSupport": true
            },
            {
                "id": "Patient.telecom.system",
                "path": "Patient.telecom.system",
                "mustSupport": true
            },
            {
                "id": "Patient.telecom.value",
                "path": "Patient.telecom.value",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Patient.telecom.use",
                "path": "Patient.telecom.use",
                "mustSupport": true
            },
            {
                "id": "Patient.gender",
                "path": "Patient.gender",
                "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.).  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.",
                "mustSupport": true
            },
            {
                "id": "Patient.birthDate",
                "path": "Patient.birthDate",
                "mustSupport": true
            },
            {
                "id": "Patient.address",
                "path": "Patient.address",
                "mustSupport": true
            },
            {
                "id": "Patient.address.text",
                "path": "Patient.address.text",
                "mustSupport": true
            },
            {
                "id": "Patient.address.postalCode",
                "path": "Patient.address.postalCode",
                "mustSupport": true
            },
            {
                "id": "Patient.address.country",
                "path": "Patient.address.country",
                "mustSupport": true
            },
            {
                "id": "Patient.maritalStatus",
                "path": "Patient.maritalStatus",
                "comment": "MAY be used to identify the maritalStatus of the patient"
            },
            {
                "id": "Patient.contact",
                "path": "Patient.contact",
                "comment": "MAY be used to identify alternate contacts for the patient"
            },
            {
                "id": "Patient.contact.relationship",
                "path": "Patient.contact.relationship",
                "mustSupport": true,
                "binding": {
                    "strength": "extensible",
                    "valueSet": "http://fhir.infoway-inforoute.ca/io/CA-eReC/ValueSet/patient-contact-relationship"
                }
            },
            {
                "id": "Patient.contact.name",
                "path": "Patient.contact.name",
                "mustSupport": true
            },
            {
                "id": "Patient.contact.telecom",
                "path": "Patient.contact.telecom",
                "mustSupport": true
            },
            {
                "id": "Patient.communication",
                "path": "Patient.communication",
                "comment": "where applicable, SHOULD be used to identify the preferred communication language for the patient"
            },
            {
                "id": "Patient.communication.extension",
                "path": "Patient.communication.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "ordered": false,
                    "rules": "open"
                }
            },
            {
                "id": "Patient.communication.extension:CommunicationBarrier",
                "path": "Patient.communication.extension",
                "sliceName": "CommunicationBarrier",
                "min": 0,
                "max": "*",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-ext-CommunicationBarrier"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "Patient.communication.extension:CommunicationBarrier.value[x]",
                "path": "Patient.communication.extension.value[x]",
                "mustSupport": true,
                "binding": {
                    "strength": "extensible",
                    "valueSet": "http://fhir.infoway-inforoute.ca/io/CA-eReC/ValueSet/communication-barrier"
                }
            },
            {
                "id": "Patient.communication.extension:CommunicationBarrier.value[x].code",
                "path": "Patient.communication.extension.value[x].code",
                "mustSupport": true,
                "binding": {
                    "strength": "extensible",
                    "description": "Contains codes required to identify if the patient speaks/understands an offical language (english/french), or if she/he does not and an interpretor is required.",
                    "valueSet": "http://fhir.infoway-inforoute.ca/io/CA-eReC/ValueSet/communication-barrier"
                }
            },
            {
                "id": "Patient.communication.language",
                "path": "Patient.communication.language",
                "mustSupport": true,
                "binding": {
                    "strength": "preferred",
                    "valueSet": "http://fhir.infoway-inforoute.ca/io/CA-eReC/ValueSet/human-language"
                }
            },
            {
                "id": "Patient.communication.preferred",
                "path": "Patient.communication.preferred",
                "mustSupport": true
            },
            {
                "id": "Patient.generalPractitioner",
                "path": "Patient.generalPractitioner",
                "comment": "where applicable, SHOULD be used to identify patients primary care provider",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-Practitioner",
                            "http://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-PractitionerRole",
                            "http://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "Patient.generalPractitioner.reference",
                "path": "Patient.generalPractitioner.reference",
                "mustSupport": true
            },
            {
                "id": "Patient.generalPractitioner.identifier",
                "path": "Patient.generalPractitioner.identifier",
                "mustSupport": true
            },
            {
                "id": "Patient.generalPractitioner.identifier.system",
                "path": "Patient.generalPractitioner.identifier.system",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Patient.generalPractitioner.identifier.value",
                "path": "Patient.generalPractitioner.identifier.value",
                "min": 1,
                "mustSupport": true
            }
        ]
    }
}

Terminology bindings

Path	Conformance	ValueSet
Patient.contact.relationship	extensible	http://fhir.infoway-inforoute.ca/io/CA-eReC/ValueSet/patient-contact-relationship
Patient.communication.extension:CommunicationBarrier.value[x]	extensible	http://fhir.infoway-inforoute.ca/io/CA-eReC/ValueSet/communication-barrier
Patient.communication.extension:CommunicationBarrier.value[x].code	extensible	http://fhir.infoway-inforoute.ca/io/CA-eReC/ValueSet/communication-barrier
Patient.communication.language	preferred	http://fhir.infoway-inforoute.ca/io/CA-eReC/ValueSet/human-language

Constraints

Path	Id	Grade	Details	Expression
Patient; Patient; Patient; Patient; Patient; Patient.meta; Patient.implicitRules; Patient.language; Patient.text; Patient.extension; Patient.extension; Patient.modifierExtension; Patient.modifierExtension; Patient.identifier; Patient.identifier.extension; Patient.identifier.extension; Patient.identifier.use; Patient.identifier.type; Patient.identifier.system; Patient.identifier.value; Patient.identifier.period; Patient.identifier.assigner; Patient.identifier:JHN; Patient.identifier:JHN.extension; Patient.identifier:JHN.extension; Patient.identifier:JHN.extension:versionCode; Patient.identifier:JHN.extension:versionCode; Patient.identifier:JHN.use; Patient.identifier:JHN.type; Patient.identifier:JHN.system; Patient.identifier:JHN.value; Patient.identifier:JHN.period; Patient.identifier:JHN.assigner; Patient.identifier:MRN; Patient.identifier:MRN.extension; Patient.identifier:MRN.extension; Patient.identifier:MRN.use; Patient.identifier:MRN.type; Patient.identifier:MRN.system; Patient.identifier:MRN.value; Patient.identifier:MRN.period; Patient.identifier:MRN.assigner; Patient.active; Patient.name; Patient.name.extension; Patient.name.extension; Patient.name.use; Patient.name.text; Patient.name.family; Patient.name.given; Patient.name.prefix; Patient.name.suffix; Patient.name.period; Patient.telecom; Patient.telecom.extension; Patient.telecom.extension; Patient.telecom.system; Patient.telecom.value; Patient.telecom.use; Patient.telecom.rank; Patient.telecom.period; Patient.gender; Patient.birthDate; Patient.deceased[x]; Patient.address; Patient.address.extension; Patient.address.extension; Patient.address.use; Patient.address.type; Patient.address.text; Patient.address.line; Patient.address.city; Patient.address.district; Patient.address.state; Patient.address.postalCode; Patient.address.country; Patient.address.period; Patient.maritalStatus; Patient.multipleBirth[x]; Patient.photo; Patient.contact; Patient.contact; Patient.contact.extension; Patient.contact.extension; Patient.contact.modifierExtension; Patient.contact.modifierExtension; Patient.contact.relationship; Patient.contact.name; Patient.contact.telecom; Patient.contact.address; Patient.contact.gender; Patient.contact.organization; Patient.contact.period; Patient.communication; Patient.communication.extension; Patient.communication.extension; Patient.communication.extension:CommunicationBarrier; Patient.communication.extension:CommunicationBarrier; Patient.communication.extension:CommunicationBarrier.extension; Patient.communication.extension:CommunicationBarrier.extension; Patient.communication.extension:CommunicationBarrier.value[x]; Patient.communication.extension:CommunicationBarrier.value[x].extension; Patient.communication.extension:CommunicationBarrier.value[x].extension; Patient.communication.extension:CommunicationBarrier.value[x].system; Patient.communication.extension:CommunicationBarrier.value[x].version; Patient.communication.extension:CommunicationBarrier.value[x].code; Patient.communication.extension:CommunicationBarrier.value[x].display; Patient.communication.extension:CommunicationBarrier.value[x].userSelected; Patient.communication.modifierExtension; Patient.communication.modifierExtension; Patient.communication.language; Patient.communication.preferred; Patient.generalPractitioner; Patient.generalPractitioner.extension; Patient.generalPractitioner.extension; Patient.generalPractitioner.reference; Patient.generalPractitioner.type; Patient.generalPractitioner.identifier; Patient.generalPractitioner.identifier.extension; Patient.generalPractitioner.identifier.extension; Patient.generalPractitioner.identifier.use; Patient.generalPractitioner.identifier.type; Patient.generalPractitioner.identifier.system; Patient.generalPractitioner.identifier.value; Patient.generalPractitioner.identifier.period; Patient.generalPractitioner.identifier.assigner; Patient.generalPractitioner.display; Patient.managingOrganization; Patient.link; Patient.link.extension; Patient.link.extension; Patient.link.modifierExtension; Patient.link.modifierExtension; Patient.link.other; Patient.link.type	dom-2; dom-3; dom-4; dom-5; dom-6; ele-1; ele-1; ele-1; ele-1; ele-1; ext-1; ele-1; ext-1; ele-1; ele-1; ext-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ext-1; ele-1; ext-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ext-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ext-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ext-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ext-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; pat-1; ele-1; ext-1; ele-1; ext-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ext-1; ele-1; ext-1; ele-1; ext-1; ele-1; ele-1; ext-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ext-1; ele-1; ele-1; ele-1; ele-1; ext-1; ele-1; ele-1; ele-1; ele-1; ext-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ext-1; ele-1; ext-1; ele-1; ele-1	error; error; error; error; warning; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error	If the resource is contained in another resource, it SHALL NOT contain nested Resources; If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource; If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated; If a resource is contained in another resource, it SHALL NOT have a security label; A resource should have narrative for robust management; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; Must have either extensions or value[x], not both; All FHIR elements must have a @value or children; Must have either extensions or value[x], not both; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; Must have either extensions or value[x], not both; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; Must have either extensions or value[x], not both; All FHIR elements must have a @value or children; Must have either extensions or value[x], not both; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; Must have either extensions or value[x], not both; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; Must have either extensions or value[x], not both; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; Must have either extensions or value[x], not both; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; Must have either extensions or value[x], not both; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; SHALL at least contain a contact's details or a reference to an organization; All FHIR elements must have a @value or children; Must have either extensions or value[x], not both; All FHIR elements must have a @value or children; Must have either extensions or value[x], not both; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; Must have either extensions or value[x], not both; All FHIR elements must have a @value or children; Must have either extensions or value[x], not both; All FHIR elements must have a @value or children; Must have either extensions or value[x], not both; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; Must have either extensions or value[x], not both; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; Must have either extensions or value[x], not both; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; Must have either extensions or value[x], not both; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; Must have either extensions or value[x], not both; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; Must have either extensions or value[x], not both; All FHIR elements must have a @value or children; Must have either extensions or value[x], not both; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children	contained.contained.empty(); contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty(); contained.meta.versionId.empty() and contained.meta.lastUpdated.empty(); contained.meta.security.empty(); text.`div`.exists(); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); extension.exists() != value.exists(); hasValue() or (children().count() > id.count()); extension.exists() != value.exists(); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); extension.exists() != value.exists(); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); extension.exists() != value.exists(); hasValue() or (children().count() > id.count()); extension.exists() != value.exists(); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); extension.exists() != value.exists(); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); extension.exists() != value.exists(); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); extension.exists() != value.exists(); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); extension.exists() != value.exists(); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); name.exists() or telecom.exists() or address.exists() or organization.exists(); hasValue() or (children().count() > id.count()); extension.exists() != value.exists(); hasValue() or (children().count() > id.count()); extension.exists() != value.exists(); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); extension.exists() != value.exists(); hasValue() or (children().count() > id.count()); extension.exists() != value.exists(); hasValue() or (children().count() > id.count()); extension.exists() != value.exists(); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); extension.exists() != value.exists(); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); extension.exists() != value.exists(); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); extension.exists() != value.exists(); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); extension.exists() != value.exists(); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); extension.exists() != value.exists(); hasValue() or (children().count() > id.count()); extension.exists() != value.exists(); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count())

Usage

The Patient resources contain demographics and other administrative information about the individual who is the subject of the referral.

Notes

.id

used to uniquely identify the resource
if a persistent identity for the resource is not available to use when constructing a message Bundle for transmission via Direct Messaging, a UUID SHOULD be used in this element (with a corresponding value in Bundle.entry.fullUrl)

.identifier

Business identifier(s) for the patient, multiple allowed
Requirements will vary by use case and jurisdiction, typically:
- eReC Requesters:
  - SHOULD include patient health card number (HCN) when available, including a version code in Jurisdictions where it is applicable (see: HealthCardNumberVersionCode)
  - MAY include other business identifiers including medical record numbers
- eReC Performers SHOULD only store and return identifiers that are needed to support referral processing

.extension:HealthCardNumberVersionCode

An assigned sequence code, uniquely identifying a Health Card issued (or potentially issued) to a Registered Person

.name

The name of the patient
.name.family SHALL always be populated
.name.given use multiple instances if patient has multiple given names (e.g. first and middle names)

.telecom

Used to provide information to contact the patient when informing them about appointments etc.
SHALL be populated when available to send
SHOULD have multiple ways to be contacted

.gender

MAY be used by receivers for patient matching / identifications
SHOULD be populated when available to send
if sending an administrative gender that is not in the value set (i.e. "X" non-binary), that MAY be sent as "Other" with an appropriate extension sent with the proper value.

.birthDate

MAY be used by receivers for patient matching / identifications
SHOULD be populated when available to send

.maritalStatus

MAY be populated when available to send

.contact

Used to identify a contact party for the patient (e.g. partner, parent, friend)
MAY be populated when available to send

.communication

Used to indicate which language the patient speaks, multiple allowed
SHOULD be populated when available to send
.language SHALL always be populated when used

.generalPractitioner

Identifies the patients primary care provider / family doctor
MAY be populated when available to send
SHALL be populated with a reference to a Practitioner (CA:eReC), PractitionerRole (CA:eReC), or Organization (CA:eReC) resource
If the information is being transmitted via messaging, the referenced resource SHALL be included in the message as a Bundle.entry