In this module you will learn more about Extensions. We will use Forge, the official HL7®FHIR® profile editor, to edit our profiles. You can download Forge here.
The topics covered in this module are:
It is common for specific implementations to have valid requirements that are not part of the core FHIR Specification. Incorporating all valid requirements would make the FHIR spec very cumbersome and difficult to implement. Instead, the specification expects that such additional requirements will be implemented as extensions.
Extensions are a way to extend an element or resource to include additional elements not present in the original, e.g. adding a birth place in addition to the date on the Patient
resource. At first glance this appears to conflict with the concept of constraining resources as you are adding an element to the resource. However, in FHIR all resources and elements have the option to be extended by default unless someone specified otherwise.
Extensions are created using the StructureDefinition
resource, the same building block used for resources and profiles. At the bare minimum the extension must be given a canonical url to be able to idenitify it (e.g. http://hl7.org/fhir/StructureDefinition/birthPlace
) and the data type of the elements value must be specified (in this case a string
). You should also fill in the definition
and purpose
as good practice to allow for easy re-use of extensions.
After you've made your extension, you can plug it into your profile for use. In section 4 below we'll show how to define and add extensions using Forge.
If an extension significantly modifies the clinical meaning of a resource - meaning that not understanding it is not an option - it shall be marked with isModifier. The reason is for clinical safety: if a system doesn't understand a normal extension in a resource, it may still process it - but not if the extension is a modifier one. If it is a modifier, the system must know the meaning of the extension before it can process it, and this, for example, allows you to use extensions that negate the meaning of a value safely.
Here is what the FHIR spec has to say about this:
An extension that adds more than one value is called complex extension, as it's defined by a tree of nested extensions. As an example, consider extending a patient with an opt-in status for a clinical trial containing three fields: clinical trial number, period of involvement and a reason for enrollment.
<Patient> <extension url="http://hl7.org/fhir/StructureDefinition/patient-clinicalTrial" > <extension url="NCT" > <valueString value="123456789" /> </extension> <extension url="period" > <valuePeriod> <start value="2009-03-14" /> </valuePeriod> </extension> <extension url="reason" > <valueCodeableConcept> <coding> <system value="http://acme.org/codes/general" /> <code value="tt14j" /> </coding> </valueCodeableConcept> </extension> </extension> <!-- other data for patient --> </Patient>
If you choose to use extensions there are a number of guidelines that must be followed:
If you cannot find a predefined extension, you can build your own. In Forge, go to “New” and click “New Extension” (or Ctrl + E
) to create a new extension, where the “Element Tree” section will be open by default. In the Properties section, you can provide context information, a canonical URL, name and other relevant information.
When you build a new extension in Forge, Forge will automatically show warning messages in the lower section of your screen highlighting the need to provide context information for this new extension. You can provide this information in “Properties” tab of the extension.
Context Type indicates if the extension extends a resource, data type, mapping, or another extension and it must be filled in. You can then give the exact context by pressing the +
symbol after Context. This brings you to a new screen were you can select the specific resource or datatype where the extension needs to be placed. If you extend at the resource level you can click “Select Resource”. If you extend at the element level first select that element and then click “Select Element”. Depending on where the extension will be used, you can add more context information.
A new extension starts with one element containing a “Value[X]”. A “Value[X]” can contain all datatypes, most likely this needs to be constrained to a more specific datatype. In Forge, this can be done in the Element Properties tab by selecting only the wanted datatypes.
In Forge, elements can be added and removed from the extension profile with the use of the Add
and Remove
buttons. When adding an element, it will be placed at a level lower than the selected element. Internally, in the selected (parent) element, the cardinality of the value[x] element will be set to 0 since it will not (and cannot) be used. The Extension.extension element is sliced by URL, and each slice is defined with a fixed relative URI.
In Forge, you can connect your extension to your profile when you have it opened in your session explorer. Select the element in the Element Tree of your profile where you want to add the extension. Then, click the paperclip icon with the name “Extend” which is shown in the tool section above the element tree. If you are extending the profile then position your cursor on the backbone element and then click extend. Forge shows a warning highlighting that the extension element is empty and it should be associated with an extension definition. This is done by selecting the newly made extension element and click the dropdown menu in the Element Properties section under Extension. All of the defined extensions in your session explorer will be available. Click the desired extension definition. It is also possible to provide extension's canonical URL here if you do not have the extension available in Forge.
Here below are examples of customers that we helped building profiles.
Stichting Koppeltaal is a Dutch organization that enables FHIR-based exchange of data between e-health applications in the care sector. The example below shows the KoppeltaalPatient profile, which is derived from the nl-core-patient profile.
This profile has the following extensions:
Patient | 0..* | Patient | There are no (further) constraints on this element Element IdPatient Patient Alternate namesSubjectOfCare Client Resident, Patiënt DefinitionDemographics and other administrative information about an individual or animal receiving care or other health-related services.
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extension | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. In order 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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preferredPharmacy | 0..1 | Extension(Reference(nl-core-organization)) | There are no (further) constraints on this element Element IdPatient.extension:preferredPharmacy References a patient's preferered pharmacy Alternate namesextensions, user content, Verwijst naar de voorkeursapotheek van de patiënt DefinitionOptional Extension Element - found in all resources. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Reference(nl-core-organization)) Extension URLhttp://fhir.nl/fhir/StructureDefinition/nl-core-preferred-pharmacy Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.extension:preferredPharmacy.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://fhir.nl/fhir/StructureDefinition/nl-core-preferred-pharmacy
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valueReference | 0..1 | KoppeltaalReference(KoppeltaalOrganization) | Element IdPatient.extension:preferredPharmacy.value[x] A reference from one resource to another DefinitionA reference from one resource to another. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. KoppeltaalReference(KoppeltaalOrganization) Constraints
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reference | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.extension:preferredPharmacy.value[x]:valueReference.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdPatient.extension:preferredPharmacy.value[x]:valueReference.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
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extension | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.extension:preferredPharmacy.value[x]:valueReference.identifier.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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reference-identifier-resource-type | 1..1 | Extension | Element IdPatient.extension:preferredPharmacy.value[x]:valueReference.identifier.extension:reference-identifier-resource-type Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://ggz.koppeltaal.nl/fhir/StructureDefinition/reference-identifier-resource-type Constraints
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.extension:preferredPharmacy.value[x]:valueReference.identifier.use usual | official | temp | secondary (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.extension:preferredPharmacy.value[x]:valueReference.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
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system | Σ | 0..1 | uri | There are no (further) constraints on this element Element IdPatient.extension:preferredPharmacy.value[x]:valueReference.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
General http://www.acme.com/identifiers/patient Mappings
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value | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.extension:preferredPharmacy.value[x]:valueReference.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension.
General 123456 Mappings
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period | Σ | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.extension:preferredPharmacy.value[x]:valueReference.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.
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assigner | Σ | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdPatient.extension:preferredPharmacy.value[x]:valueReference.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.extension:preferredPharmacy.value[x]:valueReference.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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nationality | 0..* | ExtensionBinding | There are no (further) constraints on this element Element IdPatient.extension:nationality Nationality Alternate namesextensions, user content, Nationaliteit DefinitionThe nationality of the patient. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://hl7.org/fhir/StructureDefinition/patient-nationality BindingNationaliteitCodelijst (extensible) Constraints
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legalStatus | 0..2 | Extension(CodeableConcept) | There are no (further) constraints on this element Element IdPatient.extension:legalStatus legalStatus Alternate namesextensions, user content DefinitionThe legal situation that applies to the patient during the intervention. The code of the legal status is based on the Vektis/AZR code list COD232-VEKT Legal Status. The concept LegalStatus of the HCIM FreedomRestrictingMeasures plays an importand role in the context of mental healthcare (GGZ). This concept will become an independent HCIM with the next release of HCIM (2018 release). The LegalStatus concept and associated valueset will be split in two: legalstatus and guardianship. These concept are currently captured in one valueset. It is possible to have a legalstatus AND a representative. Therefore, we allow this extension to have a cardinality of 0..2. http://nictiz.nl/fhir/StructureDefinition/zib-patient-legalstatus Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.extension:legalStatus.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://nictiz.nl/fhir/StructureDefinition/zib-patient-legalstatus
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valueCodeableConcept | 1..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.extension:legalStatus.value[x]:valueCodeableConcept LegalStatus Alternate namesJuridischeStatus DefinitionThe legal situation that applies to the patient during the intervention. The code of the legal status is based on the Vektis/AZR code list COD232-VEKT Legal Status. A stream of bytes, base64 encoded JuridischeStatusCodelijst (extensible) Constraints
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coding | Σ | 1..* | Coding | There are no (further) constraints on this element Element IdPatient.extension:legalStatus.value[x]:valueCodeableConcept.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
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system | Σ | 1..1 | uri | There are no (further) constraints on this element Element IdPatient.extension:legalStatus.value[x]:valueCodeableConcept.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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 de-reference to some definition that establish the system clearly and unambiguously.
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.extension:legalStatus.value[x]:valueCodeableConcept.coding.version Version of the system - if relevant DefinitionThe 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. 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.
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code | Σ | 1..1 | code | There are no (further) constraints on this element Element IdPatient.extension:legalStatus.value[x]:valueCodeableConcept.coding.code Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings may not exceed 1MB in size
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.extension:legalStatus.value[x]:valueCodeableConcept.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings may not exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdPatient.extension:legalStatus.value[x]:valueCodeableConcept.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). 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. 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.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.extension:legalStatus.value[x]:valueCodeableConcept.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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person-age | 0..* | ExtensionBinding | Element IdPatient.extension:person-age Nationality Alternate namesextensions, user content DefinitionThe nationality of the patient. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://ggz.koppeltaal.nl/fhir/StructureDefinition/person-age Binding?? (extensible) Constraints
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identifier | Σ | 1..* | Identifier | There are no (further) constraints on this element Element IdPatient.identifier PatientIdentificationNumber Alternate namesIdentificatienummer DefinitionThe Burgerservicenummer or BSN, as one of the possible patient identification numbers, should at least be sent unless there is a reason not to. Reasons for not sending the burgerservicenummer include but are not limited to, research and apps without a contract for processing data (Dutch: bewerkingsovereenkomst). Patients are almost always assigned specific numerical identifiers. Unordered, Open, by system(Value) Constraints
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BSN | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdPatient.identifier:BSN BSN Alternate namesBSN DefinitionAn identifier for this patient. Patients are almost always assigned specific numerical identifiers.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.identifier:BSN.use usual | official | temp | secondary (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.identifier:BSN.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
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system | Σ | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.identifier:BSN.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
http://fhir.nl/fhir/NamingSystem/bsn
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value | Σ | 1..1 | string | There are no (further) constraints on this element Element IdPatient.identifier:BSN.value BSN (Burgerservicenummer (Dutch person identification number)) Alternate namesBSN DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension.
General 123456 Example of a burgerservicenummer 123456782 Mappings
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period | Σ | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.identifier:BSN.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.
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assigner | Σ | 0..1 | Reference(http://hl7.org/fhir/StructureDefinition/KoppeltaalOrganization) | Element IdPatient.identifier:BSN.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Reference(http://hl7.org/fhir/StructureDefinition/KoppeltaalOrganization) Constraints
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active | Σ ?! | 0..1 | boolean | There are no (further) constraints on this element Element IdPatient.active Whether this patient's record is in active use DefinitionThis field determines the status of the 'patient' record in the context of the organization that owns the record. Note that the record is not the medical record, but rather the actual patient 'resource'. Obviously when the patient 'resource' is not active, then by extension his medical record might also be inactive. Patient.active='false' may be used discourage use of the record, but that it is kept beause there is (medical) data attached to it. Another use case is a patient moving to a different GP practice. Patient.active would be 'false' in the system of the previous GP. Need to be able to mark a patient record as not to be used because it was created in error. Default is true. If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient This element is labeled as a modifier because when the patient record is marked as not active it is not expected to be used/referenced without being changed back to active.
true
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name | Σ | 0..* | nl-core-humanname | There are no (further) constraints on this element Element IdPatient.name NameInformation Alternate namesNaamgegevens DefinitionA human's name with the ability to identify parts and usage. Need to be able to track the patient by multiple names. Examples are your official name and a partner name. Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts may or may not be imbued with some implicit meaning; various cultures associate different importance with the name parts and the degree to which systems must care about name parts around the world varies widely. A Dutch HumanName is a proper FHIR HumanName. Systems that do not understand any of the extensions, will be able to render and work with a Dutch name. Dutch names make certain name parts seaprately communicable. These parts are required for use in true Dutch systems when dealing with Dutch names, but may not have value for international systems when information gets sent abroad. To have true compatibility an implementer SHOULD use the core HumanName parts as intended. To have names work for Dutch context, the implementer SHOULD in addition use the extension elements. The extension elements cover birth name (NL: eigennaam / geslachtsnaam) and partner/spouse name. Both may have a prefix (NL: voorvoegsel). When a person marries, he or she may keep their own name, assume the partner name, append the partner name to their own name, or the other way around. For this reason, there are extensions for marking each part for what it is. Example: miss Irma Jongeneel marries mister de Haas and assumes the name Irma Jongeneel-de Haas family = "Jongeneel-de Haas" given = "Irma" humanname-own-name = "Jongeneel" humanname-partner-prefix = "de " humanname-partner-name = "Haas"
General { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/humanname-assembly-order", "valueCode": "NL4" } ], "use": "official", "family": "Jongeneel-de Haas", "_family": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/humanname-own-name", "valueString": "Jongeneel" }, { "url": "http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix", "valueString": "de" }, { "url": "http://hl7.org/fhir/StructureDefinition/humanname-partner-name", "valueString": "Haas" } ] }, "given": [ "Irma", "I." ], "_given": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier", "valueCode": "CL" } ] }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier", "valueCode": "IN" } ] } ] } Mappings
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telecom | Σ | 0..* | ContactPoint | There are no (further) constraints on this element Element IdPatient.telecom ContactInformation Alternate namesContactgegevens DefinitionA contact detail for the individual. Note that there is no support for multiple use values like 'mobile business'. People have (primary) ways to contact them in some way such as phone, email. A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address may 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).
Mobile phone number { "system": "phone", "value": "+31611234567", "use": "mobile" } Private email address { "system": "email", "value": "giesput@myweb.nl", "use": "home" } Mappings
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system | Σ | 1..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.telecom.system phone | fax | email | pager | url | sms | other DefinitionTelecommunications form for contact point - what communications system is required to make use of the contact. Note that FHIR strings may not exceed 1MB in size contact-point-system (required) Constraints
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value | Σ | 1..1 | string | There are no (further) constraints on this element Element IdPatient.telecom.value TelephoneNumber / E-mailAddress Alternate namesTelefoonnummer, EmailAdres DefinitionThe actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address). Need to support legacy numbers that are not in a tightly controlled format. Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.telecom.use NumberType / E-mailAddressType Alternate namesNummerSoort, EmailSoort DefinitionIdentifies the purpose for the contact point. Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose. This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one. Applications can assume that a contact is current unless it explicitly says that it is temporary or old.
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rank | Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element IdPatient.telecom.rank Specify preferred order of use (1 = highest) DefinitionSpecifies a preferred order in which to use a set of contacts. Contacts are ranked with lower values coming before higher values. Note that rank does not necessarily follow the order in which the contacts are represented in the instance.
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period | Σ | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.telecom.period Time period when the contact point was/is in use DefinitionTime period when the contact point was/is in use. This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.
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gender | Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.gender Gender Alternate namesGeslacht DefinitionAdministrative Gender - the gender that the patient is considered to have for administration and record keeping purposes. Needed for identification of the individual, in combination with (at least) name and birth date. Gender of individual drives many clinical processes. The gender may 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 M and F, though the vast majority of systems and contexts only support M and F. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific gender aspect of interest (anatomical, chromosonal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosonal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overrideable error, not a "hard" error. administrative-gender (required) Constraints
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birthDate | Σ | 0..1 | date | There are no (further) constraints on this element Element IdPatient.birthDate Patients date of birth. The date of birth is mandatory for a patient. An incomplete date, e.g. only year or only year + month, is permitted. Alternate namesGeboortedatum DefinitionThe date of birth for the individual. Age of the individual drives many clinical processes. At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternaty/infant care systems).
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deceased[x] | Σ ?! | 0..1 | There are no (further) constraints on this element Element IdPatient.deceased[x] DeathIndicator/DateOfDeath Alternate namesOverlijdensindicator/DatumOverlijden DefinitionIndicates if the individual is deceased or not. The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive. If there's no value in the instance it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive. This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
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deceasedBoolean | boolean | There are no (further) constraints on this element Data Type | ||
deceasedDateTime | dateTime | There are no (further) constraints on this element Data Type | ||
address | Σ | 0..* | nl-core-address | There are no (further) constraints on this element Element IdPatient.address AddressInformation Alternate namesAdresInformatie, Adresgegevens DefinitionThere is a variety of postal address formats defined around the world. This format defines a superset that is the basis for all addresses around the world and adds all relevant components to express Dutch addresses. A Dutch Address is a proper FHIR Address. Systems that do not understand any of the extensions, will be able to render and work with a Dutch address. Dutch addresses make certain address parts separately communicable. These parts are required for use in true Dutch systems when dealing with Dutch addresses, but may not have value for international systems when information gets sent abroad. To have true compatibility an implementer SHOULD use the core Address parts as intended. To have addresses work for Dutch context, the implementer SHOULD in addition use the extension elements. The HCIM defines certain address types in the AdresSoortCodelijst. These do not all have a one to one mapping in the FHIR Address datatype. The following explains how to deal with that. HCIM Postal Address maps to Address.type 'postal'; HCIM Primary Home Address maps to Address.extension:official 'true' + Address.use 'home' + Address.use.extension 'HP'; HCIM Visit Address (Woon-/verblijfadres) maps to Address.use 'home' + Address.type 'physical' + Address.use.extension 'PHYS'; HCIM Temporary Address maps to Address.use 'temp'; HCIM Work Place Address maps to Address.use 'work'; HCIM Vacation Home Address maps to Address.type 'temp' + Address.use.extension 'HV'. If Address.type is "both" then this is to be understood as a dual purpose address (postal and physical). Systems that support importing it like this are encouraged to do so, otherwise they may need to import this as two separate addresses. May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification. Note: address is for postal addresses, not physical locations.
Example of a vacation home address { "extension": [ { "url": "http://fhir.nl/fhir/StructureDefinition/nl-core-address-official", "valueBoolean": false } ], "use": "temp", "_use": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-AD-use", "valueCode": "HV" } ] }, "line": [ "Binnenkant 12A Hoog" ], "_line": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName", "valueString": "Binnenkant" }, { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber", "valueString": "12" }, { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-buildingNumberSuffix", "valueString": "A" }, { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-unitID", "valueString": "Hoog" } ] } ], "city": "Amsterdam", "state": "NH", "postalCode": "1000AA", "country": "NLD" } Example of a primary home address { "extension": [ { "url": "http://fhir.nl/fhir/StructureDefinition/nl-core-address-official", "valueBoolean": true } ], "use": "home", "line": [ "Binnenkant to 10" ], "_line": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName", "valueString": "Binnenkant" }, { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator", "valueString": "to" }, { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber", "valueString": "10" } ] } ], "city": "Amsterdam", "state": "NH", "postalCode": "1001AA", "country": "NLD" } Mappings
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extension | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.address.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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official | 0..1 | Extension(boolean) | There are no (further) constraints on this element Element IdPatient.address.extension:official Mark an address as an 'officially registered' address. Alternate namesextensions, user content, Markeer een adres als een 'officieel geregistreerd adres. DefinitionMark an address as an 'officially registered' address. In Dutch context that means it is registered in the Basisregistratie persoonsgegevens (BRP) There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://fhir.nl/fhir/StructureDefinition/nl-core-address-official Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.address.extension:official.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://fhir.nl/fhir/StructureDefinition/nl-core-address-official
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valueBoolean | 1..1 | boolean | There are no (further) constraints on this element Element IdPatient.address.extension:official.value[x]:valueBoolean true if part of an official registry. false if it is not Alternate namestrue als deze deel is van een officieel register. false indien dat niet het geval is DefinitionWhen the value is true, this address is marked to be part of an official registry (Dutch realm: BRP). When the value is false, this address is explicitly marked as not part of an official registry. A stream of bytes, base64 encoded
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.address.use home | work | temp | old - purpose of this address DefinitionPurpose of this address Allows an appropriate address to be chosen from a list of many. This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one. Applications can assume that an address is current unless it explicitly says that it is temporary or old.
General home Mappings
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extension | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.address.use.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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AD_use | 0..1 | Extension | There are no (further) constraints on this element Element IdPatient.address.use.extension:AD_use Further define the address use with the exact HCIM code. Alternate namesextensions, user content, Precieze definiëring van adressoort op basis van exacte zib-code DefinitionFurther define the address use with the exact HCIM code. Mostly relevant to distinguish between different types of temporasry addresses. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://hl7.org/fhir/StructureDefinition/iso21090-AD-use Constraints
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type | Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.address.type postal | physical | both DefinitionDistinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both. Note that FHIR strings may not exceed 1MB in size
General both Mappings
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.address.text Text representation of the address DefinitionA full text representation of the address. A renderable, unencoded form. Can provide both a text representation and parts.
General 137 Nowhere Street, Erewhon 9132 Mappings
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line | Σ | 0..* | string | There are no (further) constraints on this element Element IdPatient.address.line Street name, number, direction & P.O. Box etc. DefinitionThis component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information. home | work | temp | old - purpose of this address. Note that FHIR strings may not exceed 1MB in size
General 137 Nowhere Street Mappings
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extension | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.address.line.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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streetName | 0..1 | Extension | There are no (further) constraints on this element Element IdPatient.address.line.extension:streetName streetName Alternate namesextensions, user content DefinitionStreet name. If the address is a P.O. Box then the Dutch word "Postbus" shall be communicated. If the address is an answer number (mailing address where the receiver pays postage) then the Dutch word "Antwoordnummer" shall be communicated. Basisregistratie Persoonsgegevens 11.10 Straatnaam There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.address.line.extension:streetName.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName
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valueString | 0..1 | string | There are no (further) constraints on this element Element IdPatient.address.line.extension:streetName.value[x] Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded
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houseNumber | 0..1 | Extension | There are no (further) constraints on this element Element IdPatient.address.line.extension:houseNumber houseNumber Alternate namesextensions, user content DefinitionThe element houseNumber shall contain the house number. The house number may contains non-numeric parts that further determine the address, e.g. "23a", but only if the source system cannot discretely communicate those. House letter shall, if possible, be communicated through the element buildingNumberSuffix. Information such as "to" (house boats that do not have their own house number, but are across (tegenover) a house with a house number or "3 hoog achter" are not part of this attribute. This type of information is conveyed elsewhere in the Address datatype. Basisregistratie Persoonsgegevens 11.20 Huisnummer There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.address.line.extension:houseNumber.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber
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valueString | 0..1 | string | There are no (further) constraints on this element Element IdPatient.address.line.extension:houseNumber.value[x] Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded
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buildingNumbersuffix | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.address.line.extension:buildingNumbersuffix buildingNumberSuffix Alternate namesextensions, user content DefinitionHouseNumberLetter
HouseNumberAddition
Basisregistratie Persoonsgegevens 11.30 Huisletter 11.40 Huisnummertoevoeging 12.10 Locatieomschrijving Export
Import
http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-buildingNumberSuffix Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.address.line.extension:buildingNumbersuffix.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-buildingNumberSuffix
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valueString | 0..1 | string | There are no (further) constraints on this element Element IdPatient.address.line.extension:buildingNumbersuffix.value[x] Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded
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unitID | 0..1 | Extension | There are no (further) constraints on this element Element IdPatient.address.line.extension:unitID unitID Alternate namesextensions, user content DefinitionExtra information such as the building name, building number, entrance, route number. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-unitID Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.address.line.extension:unitID.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-unitID
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valueString | 0..1 | string | There are no (further) constraints on this element Element IdPatient.address.line.extension:unitID.value[x] Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded
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additionalLocator | 0..1 | Extension | There are no (further) constraints on this element Element IdPatient.address.line.extension:additionalLocator additionalLocator Alternate namesextensions, user content DefinitionHouseNumberIndication - The indication used for addresses that do not consist of the usual street name and house number. Basisregistratie Persoonsgegevens 11.50 Aanduiding bij huisnummer There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.address.line.extension:additionalLocator.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator
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valueString | 0..1 | string | There are no (further) constraints on this element Element IdPatient.address.line.extension:additionalLocator.value[x] Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded
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city | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.address.city Name of city, town etc. Alternate namesMunicpality, Municipality, woonplaats DefinitionThe name of the city, town, village or other community or delivery center. Basisregistratie Persoonsgegevens 11.70 Woonplaatsnaam Note that FHIR strings may not exceed 1MB in size
General Erewhon Example city Den Haag Mappings
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district | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.address.district District name (aka county) Alternate namesCounty, Gemeente DefinitionThe name of the administrative area (county). Basisregistratie Persoonsgegevens 09.10 Gemeente van inschrijving 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. In a Dutch address this element is used for the population of a "gemeente"
General Madison Example district Wateringen Mappings
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state | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.address.state Sub-unit of country (abbreviations ok). Alternate namesProvince, Territory, Provincie DefinitionSub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (i.e. US 2 letter state codes). For Dutch addresses this element should contain the "provincie" code Some (Dutch) cities have the same name in multiple provinces. Dutch examples include Bergen (Noord-Holland / Limburg) and Geesteren (Gelderland / Overijssel). Note that FHIR strings may not exceed 1MB in size
Example province ZH Mappings
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postalCode | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.address.postalCode Postal code for area Alternate namesZip, Postcode DefinitionA postal code designating a region defined by the postal service. Dutch postal codes have pattern '\d{4}[A-Z]{2}' so they do not have spaces. Systems can easily render postal codes with a space if necessary.
General 9132 Example postcode 9132AG Mappings
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country | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.address.country Country (can be ISO 3166 3 letter code) Alternate namesland DefinitionA country (code) for the address. The FHIR datatype does not properly support coding the country using a CodeableConcept or Coding datatype. If the sender supports coded countries, it SHALL send the coded value using the code-specification extension under Address.country.
Example country NLD Mappings
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extension | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.address.country.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value), value.coding.system(Value) Constraints
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LandGBACodelijst | 0..1 | Extension(CodeableConcept) | There are no (further) constraints on this element Element IdPatient.address.country.extension:LandGBACodelijst LandGBACode Alternate namesextensions, user content, Bevat de specifieke code conform de zib, bij een FHIR-element die een verplichte koppeling heeft met een bepaalde FHIR waardelijst of een FHIR element die niet gecodeerd is gedefinieerd, terwijl de zib dit wel doet. DefinitionDefines a more specific coded value for a code or string. Especially useful for FHIR's required ValueSets. These extensions are primarily used on codes bound to a required value set, where you would like to use a more specific code than the codes in the bounded value set. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://nictiz.nl/fhir/StructureDefinition/code-specification Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.address.country.extension:LandGBACodelijst.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://nictiz.nl/fhir/StructureDefinition/code-specification
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valueCodeableConcept | 1..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.address.country.extension:LandGBACodelijst.value[x] Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded
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LandISOCodelijst | 0..1 | Extension(CodeableConcept) | There are no (further) constraints on this element Element IdPatient.address.country.extension:LandISOCodelijst LandISOCode Alternate namesextensions, user content, Bevat de specifieke code conform de zib, bij een FHIR-element die een verplichte koppeling heeft met een bepaalde FHIR waardelijst of een FHIR element die niet gecodeerd is gedefinieerd, terwijl de zib dit wel doet. DefinitionDefines a more specific coded value for a code or string. Especially useful for FHIR's required ValueSets. These extensions are primarily used on codes bound to a required value set, where you would like to use a more specific code than the codes in the bounded value set. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://nictiz.nl/fhir/StructureDefinition/code-specification Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.address.country.extension:LandISOCodelijst.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://nictiz.nl/fhir/StructureDefinition/code-specification
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valueCodeableConcept | 1..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.address.country.extension:LandISOCodelijst.value[x] Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded
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period | Σ | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.address.period Time period when address was/is in use DefinitionTime period when address was/is in use. Allows addresses to be placed in historical context. This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.
General { "start": "2010-03-23", "end": "2010-07-01" } Mappings
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maritalStatus | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.maritalStatus MaritalStatus Alternate namesBurgerlijkeStaat DefinitionThis field contains a patient's most recent marital (civil) status. A person’s marital status according to the terms and definition in the Dutch civil code. Most, if not all systems capture it. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. BurgerlijkeStaatCodelijst (required) Constraints
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multipleBirth[x] | 0..1 | There are no (further) constraints on this element Element IdPatient.multipleBirth[x] MultipleBirthIndicator Alternate namesMeerlingindicator DefinitionIndicates whether the patient is part of a multiple (bool) or indicates the actual birth order (integer). For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs. Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in tripplets would be valueInteger=2 and the third born would have valueInteger=3 If a bool value was provided for this tripplets examle, then all 3 patient records would have valueBool=true (the ordering is not indicated).
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multipleBirthBoolean | boolean | There are no (further) constraints on this element Data Type | ||
multipleBirthInteger | integer | There are no (further) constraints on this element Data Type | ||
photo | 0..* | Attachment | There are no (further) constraints on this element Element IdPatient.photo Image of the patient DefinitionImage of the patient. Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too. When providing a summary view (for example with Observation.value[x]) Attachment should be represented with a brief display text such as "Attachment".
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contact | 0..* | BackboneElement | There are no (further) constraints on this element Element IdPatient.contact ContactPerson Alternate namesContactpersoon DefinitionContacts are related persons in some way, but not all related persons are contacts. The HCIM ContactPerson is designed to deal with both related persons and contacts. An HCIM ContactPerson who is a contact, is expected to have an NL-CM:3.1.2 Role primary contact ('Eerste relatie/contactpersoon') or secondary contact ('Tweede relatie/contactpersoon'). See Patient.contact.relationship in slice 'role'. Need to track people you can contact about the patient. Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.
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relationship | 0..* | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.contact.relationship The kind of relationship DefinitionThe nature of the relationship between the patient and the contact person. Used to determine which contact person is the most relevant to approach, depending on circumstances. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Unordered, Open, by coding.system(Value) BindingHL7 v2 Value Set 0131 (extensible) Constraints
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relationship | 0..* | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.contact.relationship:relationship Relationship Alternate namesRelatie DefinitionThe nature of the relationship between the patient and the contact person. Used to determine which contact person is the most relevant to approach, depending on circumstances. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
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role | 0..* | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.contact.relationship:role Role Alternate namesRol DefinitionExpectation is to have at least one of primary contact ('Eerste relatie/contactpersoon') or secondary contact ('Tweede relatie/contactpersoon') Used to determine which contact person is the most relevant to approach, depending on circumstances. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
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name | 0..1 | nl-core-humanname | There are no (further) constraints on this element Element IdPatient.contact.name NameInformation Alternate namesNaamgegevens DefinitionA human's name with the ability to identify parts and usage. Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person. Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts may or may not be imbued with some implicit meaning; various cultures associate different importance with the name parts and the degree to which systems must care about name parts around the world varies widely. A Dutch HumanName is a proper FHIR HumanName. Systems that do not understand any of the extensions, will be able to render and work with a Dutch name. Dutch names make certain name parts seaprately communicable. These parts are required for use in true Dutch systems when dealing with Dutch names, but may not have value for international systems when information gets sent abroad. To have true compatibility an implementer SHOULD use the core HumanName parts as intended. To have names work for Dutch context, the implementer SHOULD in addition use the extension elements. The extension elements cover birth name (NL: eigennaam / geslachtsnaam) and partner/spouse name. Both may have a prefix (NL: voorvoegsel). When a person marries, he or she may keep their own name, assume the partner name, append the partner name to their own name, or the other way around. For this reason, there are extensions for marking each part for what it is. Example: miss Irma Jongeneel marries mister de Haas and assumes the name Irma Jongeneel-de Haas family = "Jongeneel-de Haas" given = "Irma" humanname-own-name = "Jongeneel" humanname-partner-prefix = "de " humanname-partner-name = "Haas"
General { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/humanname-assembly-order", "valueCode": "NL4" } ], "use": "official", "family": "Jongeneel-de Haas", "_family": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/humanname-own-name", "valueString": "Jongeneel" }, { "url": "http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix", "valueString": "de" }, { "url": "http://hl7.org/fhir/StructureDefinition/humanname-partner-name", "valueString": "Haas" } ] }, "given": [ "Irma", "I." ], "_given": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier", "valueCode": "CL" } ] }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier", "valueCode": "IN" } ] } ] } Mappings
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telecom | 0..* | ContactPoint | There are no (further) constraints on this element Element IdPatient.contact.telecom ContactInformation Alternate namesContactgegevens DefinitionA contact detail for the person, e.g. a telephone number or an email address. People have (primary) ways to contact them in some way such as phone, email. Telecommunication data details (phone/email) is physically modeled in the HCIM Patient, which is why the telecommunication mappings appear to be coming from the HCIM Patient instead of the HCIM ContactPerson
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system | Σ | 1..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.contact.telecom.system phone | fax | email | pager | url | sms | other DefinitionTelecommunications form for contact point - what communications system is required to make use of the contact. Note that FHIR strings may not exceed 1MB in size contact-point-system (required) Constraints
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value | Σ | 1..1 | string | There are no (further) constraints on this element Element IdPatient.contact.telecom.value TelephoneNumber / E-mailAddress Alternate namesTelefoonnummer, EmailAdres DefinitionThe actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address). Need to support legacy numbers that are not in a tightly controlled format. Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.contact.telecom.use NumberType / E-mailAddressType Alternate namesNummerSoort, EmailSoort DefinitionIdentifies the purpose for the contact point. Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose. This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one. Applications can assume that a contact is current unless it explicitly says that it is temporary or old.
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rank | Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element IdPatient.contact.telecom.rank Specify preferred order of use (1 = highest) DefinitionSpecifies a preferred order in which to use a set of contacts. Contacts are ranked with lower values coming before higher values. Note that rank does not necessarily follow the order in which the contacts are represented in the instance.
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period | Σ | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.contact.telecom.period Time period when the contact point was/is in use DefinitionTime period when the contact point was/is in use. This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.
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address | 0..1 | nl-core-address | There are no (further) constraints on this element Element IdPatient.contact.address AddressInformation Alternate namesAdresInformatie, Adresgegevens DefinitionThere is a variety of postal address formats defined around the world. This format defines a superset that is the basis for all addresses around the world and adds all relevant components to express Dutch addresses. A Dutch Address is a proper FHIR Address. Systems that do not understand any of the extensions, will be able to render and work with a Dutch address. Dutch addresses make certain address parts separately communicable. These parts are required for use in true Dutch systems when dealing with Dutch addresses, but may not have value for international systems when information gets sent abroad. To have true compatibility an implementer SHOULD use the core Address parts as intended. To have addresses work for Dutch context, the implementer SHOULD in addition use the extension elements. The HCIM defines certain address types in the AdresSoortCodelijst. These do not all have a one to one mapping in the FHIR Address datatype. The following explains how to deal with that. HCIM Postal Address maps to Address.type 'postal'; HCIM Primary Home Address maps to Address.extension:official 'true' + Address.use 'home' + Address.use.extension 'HP'; HCIM Visit Address (Woon-/verblijfadres) maps to Address.use 'home' + Address.type 'physical' + Address.use.extension 'PHYS'; HCIM Temporary Address maps to Address.use 'temp'; HCIM Work Place Address maps to Address.use 'work'; HCIM Vacation Home Address maps to Address.type 'temp' + Address.use.extension 'HV'. If Address.type is "both" then this is to be understood as a dual purpose address (postal and physical). Systems that support importing it like this are encouraged to do so, otherwise they may need to import this as two separate addresses. Need to keep track where the contact person can be contacted per postal mail or visited. Note: address is for postal addresses, not physical locations.
Example of a vacation home address { "extension": [ { "url": "http://fhir.nl/fhir/StructureDefinition/nl-core-address-official", "valueBoolean": false } ], "use": "temp", "_use": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-AD-use", "valueCode": "HV" } ] }, "line": [ "Binnenkant 12A Hoog" ], "_line": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName", "valueString": "Binnenkant" }, { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber", "valueString": "12" }, { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-buildingNumberSuffix", "valueString": "A" }, { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-unitID", "valueString": "Hoog" } ] } ], "city": "Amsterdam", "state": "NH", "postalCode": "1000AA", "country": "NLD" } Example of a primary home address { "extension": [ { "url": "http://fhir.nl/fhir/StructureDefinition/nl-core-address-official", "valueBoolean": true } ], "use": "home", "line": [ "Binnenkant to 10" ], "_line": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName", "valueString": "Binnenkant" }, { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator", "valueString": "to" }, { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber", "valueString": "10" } ] } ], "city": "Amsterdam", "state": "NH", "postalCode": "1001AA", "country": "NLD" } Mappings
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extension | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.contact.address.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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official | 0..1 | Extension(boolean) | There are no (further) constraints on this element Element IdPatient.contact.address.extension:official Mark an address as an 'officially registered' address. Alternate namesextensions, user content, Markeer een adres als een 'officieel geregistreerd adres. DefinitionMark an address as an 'officially registered' address. In Dutch context that means it is registered in the Basisregistratie persoonsgegevens (BRP) There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://fhir.nl/fhir/StructureDefinition/nl-core-address-official Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.contact.address.extension:official.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://fhir.nl/fhir/StructureDefinition/nl-core-address-official
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valueBoolean | 1..1 | boolean | There are no (further) constraints on this element Element IdPatient.contact.address.extension:official.value[x]:valueBoolean true if part of an official registry. false if it is not Alternate namestrue als deze deel is van een officieel register. false indien dat niet het geval is DefinitionWhen the value is true, this address is marked to be part of an official registry (Dutch realm: BRP). When the value is false, this address is explicitly marked as not part of an official registry. A stream of bytes, base64 encoded
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.contact.address.use home | work | temp | old - purpose of this address DefinitionPurpose of this address Allows an appropriate address to be chosen from a list of many. This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one. Applications can assume that an address is current unless it explicitly says that it is temporary or old.
General home Mappings
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extension | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.contact.address.use.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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AD_use | 0..1 | Extension | There are no (further) constraints on this element Element IdPatient.contact.address.use.extension:AD_use Further define the address use with the exact HCIM code. Alternate namesextensions, user content, Precieze definiëring van adressoort op basis van exacte zib-code DefinitionFurther define the address use with the exact HCIM code. Mostly relevant to distinguish between different types of temporasry addresses. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://hl7.org/fhir/StructureDefinition/iso21090-AD-use Constraints
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type | Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.contact.address.type postal | physical | both DefinitionDistinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both. Note that FHIR strings may not exceed 1MB in size
General both Mappings
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.contact.address.text Text representation of the address DefinitionA full text representation of the address. A renderable, unencoded form. Can provide both a text representation and parts.
General 137 Nowhere Street, Erewhon 9132 Mappings
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line | Σ | 0..* | string | There are no (further) constraints on this element Element IdPatient.contact.address.line Street name, number, direction & P.O. Box etc. DefinitionThis component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information. home | work | temp | old - purpose of this address. Note that FHIR strings may not exceed 1MB in size
General 137 Nowhere Street Mappings
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extension | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.contact.address.line.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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streetName | 0..1 | Extension | There are no (further) constraints on this element Element IdPatient.contact.address.line.extension:streetName streetName Alternate namesextensions, user content DefinitionStreet name. If the address is a P.O. Box then the Dutch word "Postbus" shall be communicated. If the address is an answer number (mailing address where the receiver pays postage) then the Dutch word "Antwoordnummer" shall be communicated. Basisregistratie Persoonsgegevens 11.10 Straatnaam There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.contact.address.line.extension:streetName.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName
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valueString | 0..1 | string | There are no (further) constraints on this element Element IdPatient.contact.address.line.extension:streetName.value[x] Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded
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houseNumber | 0..1 | Extension | There are no (further) constraints on this element Element IdPatient.contact.address.line.extension:houseNumber houseNumber Alternate namesextensions, user content DefinitionThe element houseNumber shall contain the house number. The house number may contains non-numeric parts that further determine the address, e.g. "23a", but only if the source system cannot discretely communicate those. House letter shall, if possible, be communicated through the element buildingNumberSuffix. Information such as "to" (house boats that do not have their own house number, but are across (tegenover) a house with a house number or "3 hoog achter" are not part of this attribute. This type of information is conveyed elsewhere in the Address datatype. Basisregistratie Persoonsgegevens 11.20 Huisnummer There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.contact.address.line.extension:houseNumber.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber
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valueString | 0..1 | string | There are no (further) constraints on this element Element IdPatient.contact.address.line.extension:houseNumber.value[x] Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded
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buildingNumbersuffix | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.contact.address.line.extension:buildingNumbersuffix buildingNumberSuffix Alternate namesextensions, user content DefinitionHouseNumberLetter
HouseNumberAddition
Basisregistratie Persoonsgegevens 11.30 Huisletter 11.40 Huisnummertoevoeging 12.10 Locatieomschrijving Export
Import
http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-buildingNumberSuffix Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.contact.address.line.extension:buildingNumbersuffix.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-buildingNumberSuffix
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valueString | 0..1 | string | There are no (further) constraints on this element Element IdPatient.contact.address.line.extension:buildingNumbersuffix.value[x] Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded
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unitID | 0..1 | Extension | There are no (further) constraints on this element Element IdPatient.contact.address.line.extension:unitID unitID Alternate namesextensions, user content DefinitionExtra information such as the building name, building number, entrance, route number. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-unitID Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.contact.address.line.extension:unitID.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-unitID
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valueString | 0..1 | string | There are no (further) constraints on this element Element IdPatient.contact.address.line.extension:unitID.value[x] Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded
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additionalLocator | 0..1 | Extension | There are no (further) constraints on this element Element IdPatient.contact.address.line.extension:additionalLocator additionalLocator Alternate namesextensions, user content DefinitionHouseNumberIndication - The indication used for addresses that do not consist of the usual street name and house number. Basisregistratie Persoonsgegevens 11.50 Aanduiding bij huisnummer There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.contact.address.line.extension:additionalLocator.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator
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valueString | 0..1 | string | There are no (further) constraints on this element Element IdPatient.contact.address.line.extension:additionalLocator.value[x] Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded
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city | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.contact.address.city Name of city, town etc. Alternate namesMunicpality, Municipality, woonplaats DefinitionThe name of the city, town, village or other community or delivery center. Basisregistratie Persoonsgegevens 11.70 Woonplaatsnaam Note that FHIR strings may not exceed 1MB in size
General Erewhon Example city Den Haag Mappings
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district | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.contact.address.district District name (aka county) Alternate namesCounty, Gemeente DefinitionThe name of the administrative area (county). Basisregistratie Persoonsgegevens 09.10 Gemeente van inschrijving 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. In a Dutch address this element is used for the population of a "gemeente"
General Madison Example district Wateringen Mappings
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state | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.contact.address.state Sub-unit of country (abbreviations ok). Alternate namesProvince, Territory, Provincie DefinitionSub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (i.e. US 2 letter state codes). For Dutch addresses this element should contain the "provincie" code Some (Dutch) cities have the same name in multiple provinces. Dutch examples include Bergen (Noord-Holland / Limburg) and Geesteren (Gelderland / Overijssel). Note that FHIR strings may not exceed 1MB in size
Example province ZH Mappings
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postalCode | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.contact.address.postalCode Postal code for area Alternate namesZip, Postcode DefinitionA postal code designating a region defined by the postal service. Dutch postal codes have pattern '\d{4}[A-Z]{2}' so they do not have spaces. Systems can easily render postal codes with a space if necessary.
General 9132 Example postcode 9132AG Mappings
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country | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.contact.address.country Country (can be ISO 3166 3 letter code) Alternate namesland DefinitionA country (code) for the address. The FHIR datatype does not properly support coding the country using a CodeableConcept or Coding datatype. If the sender supports coded countries, it SHALL send the coded value using the code-specification extension under Address.country.
Example country NLD Mappings
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extension | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.contact.address.country.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value), value.coding.system(Value) Constraints
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LandGBACodelijst | 0..1 | Extension(CodeableConcept) | There are no (further) constraints on this element Element IdPatient.contact.address.country.extension:LandGBACodelijst LandGBACode Alternate namesextensions, user content, Bevat de specifieke code conform de zib, bij een FHIR-element die een verplichte koppeling heeft met een bepaalde FHIR waardelijst of een FHIR element die niet gecodeerd is gedefinieerd, terwijl de zib dit wel doet. DefinitionDefines a more specific coded value for a code or string. Especially useful for FHIR's required ValueSets. These extensions are primarily used on codes bound to a required value set, where you would like to use a more specific code than the codes in the bounded value set. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://nictiz.nl/fhir/StructureDefinition/code-specification Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.contact.address.country.extension:LandGBACodelijst.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://nictiz.nl/fhir/StructureDefinition/code-specification
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valueCodeableConcept | 1..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.contact.address.country.extension:LandGBACodelijst.value[x] Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded
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LandISOCodelijst | 0..1 | Extension(CodeableConcept) | There are no (further) constraints on this element Element IdPatient.contact.address.country.extension:LandISOCodelijst LandISOCode Alternate namesextensions, user content, Bevat de specifieke code conform de zib, bij een FHIR-element die een verplichte koppeling heeft met een bepaalde FHIR waardelijst of een FHIR element die niet gecodeerd is gedefinieerd, terwijl de zib dit wel doet. DefinitionDefines a more specific coded value for a code or string. Especially useful for FHIR's required ValueSets. These extensions are primarily used on codes bound to a required value set, where you would like to use a more specific code than the codes in the bounded value set. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://nictiz.nl/fhir/StructureDefinition/code-specification Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.contact.address.country.extension:LandISOCodelijst.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://nictiz.nl/fhir/StructureDefinition/code-specification
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valueCodeableConcept | 1..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.contact.address.country.extension:LandISOCodelijst.value[x] Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded
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period | Σ | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.contact.address.period Time period when address was/is in use DefinitionTime period when address was/is in use. Allows addresses to be placed in historical context. This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.
General { "start": "2010-03-23", "end": "2010-07-01" } Mappings
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gender | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.contact.gender male | female | other | unknown DefinitionAdministrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes. Needed to address the person correctly. Note that FHIR strings may not exceed 1MB in size administrative-gender (required) Constraints
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organization | 0..1 | KoppeltaalReference(KoppeltaalOrganization) | Element IdPatient.contact.organization A reference from one resource to another DefinitionA reference from one resource to another. For guardians or business related contacts, the organization is relevant. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. KoppeltaalReference(KoppeltaalOrganization) Constraints
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reference | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.contact.organization.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdPatient.contact.organization.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
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extension | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.contact.organization.identifier.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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reference-identifier-resource-type | 1..1 | Extension | Element IdPatient.contact.organization.identifier.extension:reference-identifier-resource-type Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://ggz.koppeltaal.nl/fhir/StructureDefinition/reference-identifier-resource-type Constraints
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.contact.organization.identifier.use usual | official | temp | secondary (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.contact.organization.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
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system | Σ | 0..1 | uri | There are no (further) constraints on this element Element IdPatient.contact.organization.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
General http://www.acme.com/identifiers/patient Mappings
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value | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.contact.organization.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension.
General 123456 Mappings
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period | Σ | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.contact.organization.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.
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assigner | Σ | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdPatient.contact.organization.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.contact.organization.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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period | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.contact.period The period during which this contact person or organization is valid to be contacted relating to this patient DefinitionThe period during which this contact person or organization is valid to be contacted relating to this patient. This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.
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animal | Σ ?! | 0..0 | BackboneElement | There are no (further) constraints on this element Element IdPatient.animal This patient is known to be an animal (non-human) DefinitionThis patient is known to be an animal. Many clinical systems are extended to care for animal patients as well as human. The animal element is labeled "Is Modifier" since patients may be non-human. Systems SHALL either handle patient details appropriately (e.g. inform users patient is not human) or reject declared animal records. The absense of the animal element does not imply that the patient is a human. If a system requires such a positive assertion that the patient is human, an extension will be required. (Do not use a species of homo-sapiens in animal species, as this would incorrectly infer that the patient is an animal).
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communication | 0..* | BackboneElement | There are no (further) constraints on this element Element IdPatient.communication A list of Languages which may be used to communicate with the patient about his or her health Alternate namesTaalvaardigheid DefinitionLanguages which may be used to communicate with the patient about his or her health. If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency is an important things to keep track of both for patient and other persons of interest. If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.
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extension | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.communication.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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languageProficiency | 0..* | Extension(Complex) | There are no (further) constraints on this element Element IdPatient.communication.extension:languageProficiency Proficiency level of the communication Alternate namesextensions, user content DefinitionProficiency level of the communication. A mocked offical HL7 core extension from the R4 FHIR specification is used as extension. This extension is used to capture the three ZIB concepts: LanguageControlListening, LanguageControlSpeaking, LanguageControlReading. Extension(Complex) Extension URLhttp://nictiz.nl/fhir/StructureDefinition/patient-proficiency Constraints
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extension | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.communication.extension:languageProficiency.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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level | 0..1 | Extension | There are no (further) constraints on this element Element IdPatient.communication.extension:languageProficiency.extension:level The proficiency level of the communication Alternate namesextensions, user content DefinitionHow well the patient can communicate this communication (good, poor, etc.). There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.communication.extension:languageProficiency.extension:level.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
level
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valueCoding | 0..1 | CodingBinding | There are no (further) constraints on this element Element IdPatient.communication.extension:languageProficiency.extension:level.value[x]:valueCoding Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded LanguageAbilityProficiency (extensible) Constraints
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type | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.communication.extension:languageProficiency.extension:type The proficiency type of the communication Alternate namesextensions, user content DefinitionWhat type of communication for the proficiency (spoken, written, etc.). There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.communication.extension:languageProficiency.extension:type.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
type
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valueCoding | 0..1 | CodingBinding | There are no (further) constraints on this element Element IdPatient.communication.extension:languageProficiency.extension:type.value[x]:valueCoding Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded LanguageAbilityMode (extensible) Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.communication.extension:languageProficiency.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://nictiz.nl/fhir/StructureDefinition/patient-proficiency
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value[x] | 0..0 | There are no (further) constraints on this element Element IdPatient.communication.extension:languageProficiency.value[x] Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded
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comment | 0..* | Extension(string) | There are no (further) constraints on this element Element IdPatient.communication.extension:comment Comment Alternate namesextensions, user content, Toelichting DefinitionOptional Extension Element - found in all resources. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://nictiz.nl/fhir/StructureDefinition/Comment Constraints
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language | 1..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.communication.language CommunicationLanguage Alternate namesCommunicatieTaal DefinitionThe language of communication. The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English. Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect. The FHIR valueset http://hl7.org/fhir/valueset-languages.html is used instead of the ZIB valueset CommunicationLanguageCodelist. The FHIR valueset uses the codesystem urn:ietf:bcp:47 which includes the ISO-639-2 alpha codesystem used by the ZIB valueset.
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preferred | 0..1 | boolean | There are no (further) constraints on this element Element IdPatient.communication.preferred Language preference indicator DefinitionIndicates whether or not the patient prefers this language (over other languages he masters up a certain level). People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method. This language is specifically identified for communicating healthcare information.
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generalPractitioner | 0..1 | KoppeltaalReference(KoppeltaalOrganization | KoppeltaalPractitioner) | Element IdPatient.generalPractitioner A reference from one resource to another Alternate namescareProvider, Huisarts DefinitionA reference from one resource to another. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. KoppeltaalReference(KoppeltaalOrganization | KoppeltaalPractitioner) Constraints
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reference | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.generalPractitioner.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdPatient.generalPractitioner.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
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extension | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.generalPractitioner.identifier.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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reference-identifier-resource-type | 1..1 | Extension | Element IdPatient.generalPractitioner.identifier.extension:reference-identifier-resource-type Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://ggz.koppeltaal.nl/fhir/StructureDefinition/reference-identifier-resource-type Constraints
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.generalPractitioner.identifier.use usual | official | temp | secondary (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.generalPractitioner.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
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system | Σ | 0..1 | uri | There are no (further) constraints on this element Element IdPatient.generalPractitioner.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
General http://www.acme.com/identifiers/patient Mappings
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value | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.generalPractitioner.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension.
General 123456 Mappings
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period | Σ | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.generalPractitioner.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.
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assigner | Σ | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdPatient.generalPractitioner.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.generalPractitioner.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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managingOrganization | Σ | 0..1 | KoppeltaalReference(KoppeltaalOrganization) | Element IdPatient.managingOrganization A reference from one resource to another DefinitionA reference from one resource to another. Need to know who recognizes this patient record, manages and updates it. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. KoppeltaalReference(KoppeltaalOrganization) Constraints
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reference | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.managingOrganization.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdPatient.managingOrganization.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
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extension | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.managingOrganization.identifier.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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reference-identifier-resource-type | 1..1 | Extension | Element IdPatient.managingOrganization.identifier.extension:reference-identifier-resource-type Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://ggz.koppeltaal.nl/fhir/StructureDefinition/reference-identifier-resource-type Constraints
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.managingOrganization.identifier.use usual | official | temp | secondary (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.managingOrganization.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
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system | Σ | 0..1 | uri | There are no (further) constraints on this element Element IdPatient.managingOrganization.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
General http://www.acme.com/identifiers/patient Mappings
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value | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.managingOrganization.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension.
General 123456 Mappings
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period | Σ | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.managingOrganization.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.
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assigner | Σ | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdPatient.managingOrganization.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.managingOrganization.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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link | Σ ?! | 0..* | BackboneElement | There are no (further) constraints on this element Element IdPatient.link Link to another patient resource that concerns the same actual person DefinitionLink to another patient resource that concerns the same actual patient. There are multiple usecases:
There is no assumption that linked patient records have mutual links. This element is labelled as a modifier because it may not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'.
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other | Σ | 0..1 | KoppeltaalReference(KoppeltaalRelatedPerson | KoppeltaalPatient) | Element IdPatient.link.other A reference from one resource to another DefinitionA reference from one resource to another. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. KoppeltaalReference(KoppeltaalRelatedPerson | KoppeltaalPatient) Constraints
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reference | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.link.other.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdPatient.link.other.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
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extension | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.link.other.identifier.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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reference-identifier-resource-type | 1..1 | Extension | Element IdPatient.link.other.identifier.extension:reference-identifier-resource-type Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://ggz.koppeltaal.nl/fhir/StructureDefinition/reference-identifier-resource-type Constraints
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.link.other.identifier.use usual | official | temp | secondary (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.link.other.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
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system | Σ | 0..1 | uri | There are no (further) constraints on this element Element IdPatient.link.other.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
General http://www.acme.com/identifiers/patient Mappings
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value | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.link.other.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension.
General 123456 Mappings
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period | Σ | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.link.other.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.
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assigner | Σ | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdPatient.link.other.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.link.other.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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type | Σ | 1..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.link.type replaced-by | replaces | refer | seealso - type of link DefinitionThe type of link between this patient resource and another patient resource. Note that FHIR strings may not exceed 1MB in size
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HelseVest is a Norwegian health authority, responsible for the western region of Norway.
The HelseVest Perioperative project aims to provide integrations covering the perioperative domain. Below is an example of a complex extension that was built for this project. This extension is used in the HelseVestProcedure profile for the registration of timestamps during a procedure (e.g. time of first cut or start of surgery). To make the extension as generic and reusable as possible, instead of building an extension for each type of timestamp, the type is specified in the extension itself by adding the following "child" extensions:
Extension | 0..* | Extension | There are no (further) constraints on this element Element IdExtension Optional Extensions Element DefinitionOptional Extension Element - found in all resources.
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extension | 0..* | Extension | Element IdExtension.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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TimeType | 0..1 | Extension | There are no (further) constraints on this element Element IdExtension.extension:TimeType Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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url | 1..1 | uriFixed Value | Element IdExtension.extension:TimeType.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
TimeType
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valueCoding | 0..1 | Coding | Element IdExtension.extension:TimeType.value[x]:valueCoding Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded
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StartDateTime | 0..1 | Extension | There are no (further) constraints on this element Element IdExtension.extension:StartDateTime Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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url | 1..1 | uriFixed Value | Element IdExtension.extension:StartDateTime.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
StartDateTime
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valueDateTime | 0..1 | dateTime | Element IdExtension.extension:StartDateTime.value[x]:valueDateTime Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded
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Comment | 0..1 | Extension | There are no (further) constraints on this element Element IdExtension.extension:Comment Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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url | 1..1 | uriFixed Value | Element IdExtension.extension:Comment.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Comment
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valueString | 0..1 | string | Element IdExtension.extension:Comment.value[x]:valueString Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded
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url | 1..1 | uriFixed Value | Element IdExtension.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://hl7.org/fhir/StructureDefinition/procedure-timestamp
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value[x] | 0..0 | There are no (further) constraints on this element Element IdExtension.value[x] Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). A stream of bytes, base64 encoded
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Below you can see the HelseVestProcedure profile that uses this extension.
Procedure | 0..* | Procedure | There are no (further) constraints on this element Element IdProcedure An action that is being or was performed on a patient DefinitionAn action that is or was performed on a patient. This can be a physical intervention like an operation, or less invasive like counseling or hypnotherapy.
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extension | 0..* | Extension | Element IdProcedure.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. In order 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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timestamp | 0..* | Extension | Element IdProcedure.extension:timestamp Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://hl7.org/fhir/StructureDefinition/procedure-timestamp Constraints
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identifier | Σ | 0..* | Identifier | There are no (further) constraints on this element Element IdProcedure.identifier External Identifiers for this procedure DefinitionThis records identifiers associated with this procedure that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation). Need to allow connection to a wider workflow.
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definition | Σ | 0..* | Reference(PlanDefinition | ActivityDefinition | HealthcareService) | There are no (further) constraints on this element Element IdProcedure.definition Instantiates protocol or definition DefinitionA protocol, guideline, orderset or other definition that was adhered to in whole or in part by this procedure. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(PlanDefinition | ActivityDefinition | HealthcareService) Constraints
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basedOn | Σ | 0..* | Reference(HelseVestProcedureRequest) | Element IdProcedure.basedOn A request for this procedure Alternate namesfulfills DefinitionA reference to a resource that contains details of the request for this procedure. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(HelseVestProcedureRequest) Constraints
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partOf | Σ | 0..* | Reference(Procedure | Observation | MedicationAdministration) | There are no (further) constraints on this element Element IdProcedure.partOf Part of referenced event Alternate namescontainer DefinitionA larger event of which this particular procedure is a component or step. The MedicationAdministration has a partOf reference to Procedure, but this is not a circular reference. For a surgical procedure, the anesthesia related medicationAdministration is part of the procedure. For an IV medication administration, the procedure to insert the IV port is part of the medication administration. Reference(Procedure | Observation | MedicationAdministration) Constraints
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status | Σ ?! | 1..1 | codeBinding | There are no (further) constraints on this element Element IdProcedure.status preparation | in-progress | suspended | aborted | completed | entered-in-error | unknown DefinitionA code specifying the state of the procedure. Generally this will be in-progress or completed state. The unknown code is not to be used to convey other statuses. The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the procedure. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
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notDone | Σ ?! | 0..1 | boolean | There are no (further) constraints on this element Element IdProcedure.notDone True if procedure was not performed as scheduled DefinitionSet this to true if the record is saying that the procedure was NOT performed. If true, it means the procedure did not occur as described. Typically it would be accompanied by attributes describing the type of activity. It might also be accompanied by body site information or time information (i.e. no procedure was done to the left arm or no procedure was done in this 2-year period). Specifying additional information such as performer, outcome, etc. is generally inappropriate. For example, it's not that useful to say "There was no appendectomy done at 12:03pm June 6th by Dr. Smith with a successful outcome" as it implies that there could have been an appendectomy done at any other time, by any other clinician or with any other outcome. This element is labeled as a modifier because it indicates that a procedure didn't happen.
false
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notDoneReason | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdProcedure.notDoneReason Reason procedure was not performed DefinitionA code indicating why the procedure was not performed. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. procedure-not-performed-reason (example) Constraints
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category | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdProcedure.category Classification of the procedure DefinitionA code that classifies the procedure for searching, sorting and display purposes (e.g. "Surgical Procedure"). Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
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code | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdProcedure.code Identification of the procedure Alternate namestype DefinitionThe specific procedure that is performed. Use text if the exact nature of the procedure cannot be coded (e.g. "Laparoscopic Appendectomy"). 0..1 to account for primarily narrative only resources. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
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subject | Σ | 1..1 | Reference(http://hl7.no/fhir/StructureDefinition/LabPatientNorway) | Element IdProcedure.subject Who the procedure was performed on Alternate namespatient DefinitionThe person, animal or group on which the procedure was performed. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(http://hl7.no/fhir/StructureDefinition/LabPatientNorway) Constraints
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context | Σ | 0..1 | Reference(Encounter | EpisodeOfCare) | There are no (further) constraints on this element Element IdProcedure.context Encounter or episode associated with the procedure Alternate namesencounter DefinitionThe encounter during which the procedure was performed. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Encounter | EpisodeOfCare) Constraints
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performed[x] | Σ | 0..1 | There are no (further) constraints on this element Element IdProcedure.performed[x] Date/Period the procedure was performed DefinitionThe date(time)/period over which the procedure was performed. Allows a period to support complex procedures that span more than one date, and also allows for the length of the procedure to be captured.
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performedDateTime | dateTime | There are no (further) constraints on this element Data Type | ||
performedPeriod | Period | There are no (further) constraints on this element Data Type | ||
performer | Σ | 0..* | BackboneElement | There are no (further) constraints on this element Element IdProcedure.performer The people who performed the procedure DefinitionLimited to 'real' people rather than equipment.
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role | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdProcedure.performer.role The role the actor was in DefinitionFor example: surgeon, anaethetist, endoscopist. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
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actor | Σ | 1..1 | Reference(Practitioner | Organization | Patient | RelatedPerson | Device) | There are no (further) constraints on this element Element IdProcedure.performer.actor The reference to the practitioner DefinitionThe practitioner who was involved in the procedure. A reference to Device supports use cases, such as pacemakers. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Practitioner | Organization | Patient | RelatedPerson | Device) Constraints
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onBehalfOf | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdProcedure.performer.onBehalfOf Organization the device or practitioner was acting for DefinitionThe organization the device or practitioner was acting on behalf of. Practitioners and Devices can be associated with multiple organizations. This element indicates which organization they were acting on behalf of when performing the action. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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location | Σ | 0..1 | Reference(Location) | There are no (further) constraints on this element Element IdProcedure.location Where the procedure happened DefinitionThe location where the procedure actually happened. E.g. a newborn at home, a tracheostomy at a restaurant. Ties a procedure to where the records are likely kept. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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reasonCode | Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdProcedure.reasonCode Coded reason procedure performed DefinitionThe coded reason why the procedure was performed. This may be coded entity of some type, or may simply be present as text. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
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reasonReference | Σ | 0..* | Reference(Condition | Observation) | There are no (further) constraints on this element Element IdProcedure.reasonReference Condition that is the reason the procedure performed DefinitionThe condition that is the reason why the procedure was performed. e.g. endoscopy for dilatation and biopsy, combination diagnosis and therapeutic. Reference(Condition | Observation) Constraints
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bodySite | Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdProcedure.bodySite Target body sites DefinitionDetailed and structured anatomical location information. Multiple locations are allowed - e.g. multiple punch biopsies of a lesion. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
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outcome | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdProcedure.outcome The result of procedure DefinitionThe outcome of the procedure - did it resolve reasons for the procedure being performed? If outcome contains narrative text only, it can be captured using the CodeableConcept.text.
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report | 0..* | Reference(DiagnosticReport) | There are no (further) constraints on this element Element IdProcedure.report Any report resulting from the procedure DefinitionThis could be a histology result, pathology report, surgical report, etc.. There could potentially be multiple reports - e.g. if this was a procedure which took multiple biopsies resulting in a number of anatomical pathology reports.
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complication | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdProcedure.complication Complication following the procedure DefinitionAny complications that occurred during the procedure, or in the immediate post-performance period. These are generally tracked separately from the notes, which will typically describe the procedure itself rather than any 'post procedure' issues. If complications are only expressed by the narrative text, they can be captured using the CodeableConcept.text.
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complicationDetail | 0..* | Reference(Condition) | There are no (further) constraints on this element Element IdProcedure.complicationDetail A condition that is a result of the procedure DefinitionAny complications that occurred during the procedure, or in the immediate post-performance period. This is used to document a condition that is a result of the procedure, not the condition that was the reason for the procedure. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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followUp | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdProcedure.followUp Instructions for follow up DefinitionIf the procedure required specific follow up - e.g. removal of sutures. The followup may be represented as a simple note, or could potentially be more complex in which case the CarePlan resource can be used. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
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note | 0..* | Annotation | There are no (further) constraints on this element Element IdProcedure.note Additional information about the procedure DefinitionAny other notes about the procedure. E.g. the operative notes. For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).
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focalDevice | 0..* | BackboneElement | There are no (further) constraints on this element Element IdProcedure.focalDevice Device changed in procedure DefinitionA device that is implanted, removed or otherwise manipulated (calibration, battery replacement, fitting a prosthesis, attaching a wound-vac, etc.) as a focal portion of the Procedure.
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action | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdProcedure.focalDevice.action Kind of change to device DefinitionThe kind of change that happened to the device during the procedure. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
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manipulated | 1..1 | Reference(Device) | There are no (further) constraints on this element Element IdProcedure.focalDevice.manipulated Device that was changed DefinitionThe device that was manipulated (changed) during the procedure. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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usedReference | 0..* | Reference(Device | Medication | Substance) | There are no (further) constraints on this element Element IdProcedure.usedReference Items used during procedure DefinitionIdentifies medications, devices and any other substance used as part of the procedure. Used for tracking contamination, etc. For devices actually implanted or removed, use Procedure.device. Reference(Device | Medication | Substance) Constraints
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usedCode | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdProcedure.usedCode Coded items used during the procedure DefinitionIdentifies coded items that were used as part of the procedure. For devices actually implanted or removed, use Procedure.device.
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The Helsevest Prescription project aims to provide integrations for medication prescription. The example below shows the MedicationStatement profile that was built for this project. It contains two extensions at the base profile level and a couple of extensions on the underlying elements. The prescriptionStatus extension on the status is an example of a Modifier extension as it changes the meaning of the element. Receiving systems should prioritise prescriptionStatus over status if it is present. When the prescriptionStatus is set to 'on-hold', MedicationStatement.status should be set to 'intended'.
In this exercise you will continue with the Patient profile that you created in the Start Profiling module. If you did not follow this module, please create a new profile on Patient and complete the required fields in the Properties tab. Start by reading the case description. Here below are a couple of links that you may find useful during this exercise:
We are always looking for ways to improve our products. The Profiling Academy was built using our own IG-editor in Simplifier. If you have any feedback on this module or on our Profiling Academy in general, please leave a comment in the Issue Tracker of the project.
Most modules end with an exercise. Use Forge to start profiling yourself. Just contact us at simplifier@fire.ly if you need any help.
Follow one of our predefined or tailor-made courses. We will make sure you know FHIR inside-out.
Let us assist you with your FHIR use case. Visit our company website to know more about our services or get into contact with Rien Wertheim right away.
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