In this module we will give you a general introduction to FHIR and profiling. This module does not contain any exercises as it is meant as a general introduction into FHIR and profiling. Continue with the Start Profiling module and follow the exercises of this module to actually start profiling yourself.
The topics covered in this module are:
Before jumping into profiling a short introduction to FHIR is in order. This section contains a short introduction to FHIR and FHIR resources.
HL7 FHIR is an international standard for digital data exchange in healthcare. FHIR stands for Fast Healthcare Interoperability Resources. The base FHIR specification describes a set of base resources, frameworks and APIs that are used in many different contexts in healthcare.
The FHIR specification is a “platform specification”, which means that it creates a common platform on which a variety of different solutions are implemented. The FHIR specification is designed to be adapted to particular contexts of use:
FHIR Resources are FHIR’s unit of exchange. They have defined behavior and meaning as well as a known identity and location. Some examples of resources are Patient, Appointment, Medication and Practitioner. All resources are listed here: http://hl7.org/fhir/resourcelist.html
A resource consists of the following parts:
A collection of Resources can be “bundled” into a single instance with containing context. These resource bundles are useful for a variety of reasons, such as returning a set of resources that meet some criteria as part of a server operation. Bundle itself is also a Resource.
A resource’s identity consists of the endpoint, the resource type and the logical ID of the resource. This is in fact a URL that you can paste in a browser.
Because of its general nature and wide applicability, the rules made in the FHIR specification are generally fairly loose. As a consequence, different applications may not be able to interoperate, because of how they use optional features. For this reason FHIR provides a conformance layer in which details can be given about how the resources and their exchange paradigms are used to solve particular use cases.
The following key resources implement the conformance layer:
ValueSet | A ValueSet defines a set of coded values (see "Using Codes" for more details) that can be used in a particular element. |
StructureDefinition | A StructureDefinition is what you build when you build a profile. The StructureDefinition contains rules about how a resource (or type) and its data elements are used in a particular context. A structure definition references value sets for the coded elements in a resource. |
CapabilityStatement | A CapabilityStatement is a statement of the kinds of resources and operations provided and/or consumed by an application. The Capability Statement references profiles to describe specific use of resources by the application. |
Implementation Guide | An ImplementationGuide is a document that is published by a domain, institution or vendor that describes how FHIR is adapted to support a certain use case (or set of use cases). An implementation guide is a collection of capability statements, profiles, value sets, and (narrative) documentation describing a set of interoperable applications. |
When you start profiling you start building structure definitions. A structure definition may contain:
This part contains an introduction in profiling. It explains what is meant by a profile and profiling, why it is important and what can be profiled.
A profile is a set of constraints on a FHIR resource or another FHIR profile. The term is however also colloquially used to refer to an implementation guide or a conformance package. The term "profiling" refers to the act of applying constraints to Conformance Resources. Conformance Resources are created by work groups of industry specialists to accommodate a wide audience, that is to say that FHIR aims to standardize functionality that is supported by 80% of systems in use. The chances that you will need something that specifically fits your domain when deciding to use FHIR are high. To suit your needs you will need to apply edits (constraints) to the existing Conformance Resources to create a profile that is specific to your needs. In short, profiling is the act of creating a profile. Once you have created your first profile you are officially a profiler (and should be very proud!).
Below you see an overview of why profiling is important. Although you could theoretically build a FHIR solution without using profiles, this would be very inconvenient as you would not be able to validate instances of resources for conformance. In a profile you can define a set of constraints on the resource, which enables you to validate instances of resources against these constraints and only accept instances that conform to the specified profile. It also enables you to automatically check if these constraints are valid or automatically compare them to other existing profiles. In addition, the profiles serve as documentation of the decisions that were made during the implementation and communicate to developers what kind of content is expected. They can also be published and shared online, so others can reuse them in similar use cases.
Below is an overview of what can be profiled. Usually you would start profiling a core resource, for example you would start building a profile for the Patient resource. You can profile anything that is used, not used or extended. For example, you could use the element name and specify in your profile that this element is obligatory by setting the minimum cardinality to 1. Or you could not use the element birthplace by setting the maximum cardinality to 0. It is also possible to add elements that are not available yet in the core resource. Maybe you would like to add hair color and build an extension for this. The concepts cardinality and extension are explained in the next part of the course. Other parts of the resource that you could profile are the codes in coded elements (you could either use standard codes or create your own), the interactions, operations and search parameters that will be supported and even the security details. Finally, you can specify your own mapping to a local view of the data.
In addition to profiling core resources, you can also profile data types or even another profile. The latter would result in a derived profile. Derived profiles and the profiling of data types will be explained in the next paragraph.
Constraints can also be applied to existing profiles. These "profiles on profiles" are called derived profiles. These profiles are made by further constraining profiles that have been made by yourself of by someone else, the so-called base profile. On the documentation site for Forge you can find detailed information about derived profiles and how to create one in Forge.
Derived profiles enable organizations to benefit from existing profiles and to further customize those profiles to their specific needs. Core resources are designed to fit approximately 80% of the use cases. A country can take a core resource and constrain it to fit the specific needs that reflect the situation in their country. This then becomes that country's version of that core resource, and acts as their national profile. An organization in that country realizes that they would like to use the national profile but need extra constraints to reflect the specific situation in their centers. They will make a derived profile of this national profile. This new organizational profile will have all the inherited changes from the national profile that were made to the original core resource.
It is also possible that there are additional layers (this is what we call layered profiles). For example, Norway has introduced regional profiles to incorporate regional differences. The regional profiles are derived from the national profile. A Norwegian organization uses the regional profile to derive their own use-case specific profile and reflect their own organization specific needs. If the regional profile is too specific for their needs they can provide feedback to the regional organization. If more organizations have the same comments, the regional organization can consider updating the profile on a higher level to meet their needs. In the same way, the regional organization can provide feedback to the national organization.
The image below illustrates the concept of derived and layered profiles. At a higher level, the profiles are more generic and have a lower volume, while a higher volume of resources will conform to these profiles. At a lower level, the profiles will be more specific and have a higher volume, while there will be less resources conforming to these profiles.
The project Basisprofil DE in Simplifier contains the national profiles for Germany. Below is an example of the German national profile for Patient. The canonical URL or identity of this profile is: http://fhir.de/StructureDefinition/patient-de-basis/0.2 The first part (http://fhir.de) is the end-point were all German profiles are located. The resource type is a StructureDefinition (each profile is stored as a StructureDefinition resource). Finally, the logical ID of the resource is "patient-de-basis-0.2". Below you see the snapshot view of this resource, which means that all elements of the core Patient resource are shown whether these are changed compared to the core resource or not.
Patient | 0..* | Patient | There are no (further) constraints on this element Element IdPatient Patient Alternate namesSubjectOfCare Client Resident DefinitionDemografische und andere administrative Informationen über ein Individuum, das Behandlungs- oder andere gesundheitsbezogene Leistungen erhält.
| |
identifier | Σ | 0..* | Identifier | There are no (further) constraints on this element Element IdPatient.identifier Identifikator für diesen Patienten DefinitionIdentifikator für diesen Patienten Patients are almost always assigned specific numerical identifiers. Unordered, Open, by system(Value) Constraints
|
VersichertenID_GKV | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdPatient.identifier:VersichertenID_GKV Die Krankenversichertennummer wie auf der eGK abgebildet. DefinitionDie Krankenversichertennummer wie auf der eGK abgebildet (10-stellige, unveränderliche Nummer). Die gesetzliche Krankenversichertennummer ist ein zentrales Identififaktionsmerkmal im deutschen Gesundheitswesen.
|
use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.identifier:VersichertenID_GKV.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.
|
type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.identifier:VersichertenID_GKV.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.
|
coding | Σ | 1..1 | Coding | There are no (further) constraints on this element Element IdPatient.identifier:VersichertenID_GKV.type.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.
|
system | Σ | 1..1 | uri | There are no (further) constraints on this element Element IdPatient.identifier:VersichertenID_GKV.type.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.
|
version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.identifier:VersichertenID_GKV.type.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.
|
code | Σ | 1..1 | code | There are no (further) constraints on this element Element IdPatient.identifier:VersichertenID_GKV.type.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
|
display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.identifier:VersichertenID_GKV.type.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
|
userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdPatient.identifier:VersichertenID_GKV.type.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.
|
text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.identifier:VersichertenID_GKV.type.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.
|
system | Σ | 1..1 | uriFixed Value | There are no (further) constraints on this element Element IdPatient.identifier:VersichertenID_GKV.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. Die Versicherten-ID ist der 10-stellige unveränderliche Teil der 30-stelligen Krankenversichertennummer.
http://fhir.de/NamingSystem/gkv/kvid-10
|
value | Σ | 1..1 | string | There are no (further) constraints on this element Element IdPatient.identifier:VersichertenID_GKV.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
|
period | Σ | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.identifier:VersichertenID_GKV.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.
|
assigner | Σ | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdPatient.identifier:VersichertenID_GKV.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.
|
active | Σ ?! | 0..1 | boolean | There are no (further) constraints on this element Element IdPatient.active Whether this patient's record is in active use DefinitionWhether this patient record is in active use. 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
|
name | Σ | 0..* | HumanName, deutsches Basisprofil (Version 0.2) | There are no (further) constraints on this element Element IdPatient.name Personenname nach deutschem Profil DefinitionPersonenname nach deutschem Profil. Dieser enthält bestimmte Extensions, die in Deutschland Verwendung finden. Need to be able to track the patient by multiple names. Examples are your official name and a partner name. Hinweis zur Repräsentation von Anreden: Diese sollten, sofern erforderlich, ausschließlich in HumanName.text erscheinen (z.B. "Frsu Dr. Martha Musterfrau"). Nach Möglichkeit sollte die Anrede aus dem Geschlecht der Person abgeleitet werden. Das Element prefix wird nur für akademische Titel und andere Namensbestandteile verwendet. HumanName, deutsches Basisprofil (Version 0.2) Constraints
|
telecom | Σ | 0..* | ContactPoint | There are no (further) constraints on this element Element IdPatient.telecom A contact detail for the individual DefinitionA contact detail (e.g. a telephone number or an email address) by which the individual may be contacted. People have (primary) ways to contact them in some way such as phone, email. A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address 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).
|
system | Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.telecom.system phone | fax | email | pager | url | sms | other DefinitionTelecommunications form for contact point - what communications system is required to make use of the contact. Note that FHIR strings may not exceed 1MB in size contact-point-system (required) Constraints
|
value | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.telecom.value The actual contact point details DefinitionThe actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address). Need to support legacy numbers that are not in a tightly controlled format. Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.
|
use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.telecom.use home | work | temp | old | mobile - purpose of this contact point DefinitionIdentifies the purpose for the contact point. Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose. 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.
|
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.
|
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.
|
gender | Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.gender male | female | other | unknown 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
|
extension | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.gender.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
| |
other-amtlich | 0..1 | Extension | There are no (further) constraints on this element Element IdPatient.gender.extension:other-amtlich 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://fhir.de/StructureDefinition/gender-amtlich-de/0.2 Constraints
| |
birthDate | Σ | 0..1 | date | There are no (further) constraints on this element Element IdPatient.birthDate The date of birth for the individual 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).
|
deceased[x] | Σ ?! | 0..1 | There are no (further) constraints on this element Element IdPatient.deceased[x] Indicates if the individual is deceased or not 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.
| |
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..* | Adresse, deutsches Basisprofil (Version 0.2) | There are no (further) constraints on this element Element IdPatient.address Adresse nach deutschem Profil DefinitionAdresse nach deutschem Profil. Die in diesem Profil verwendeten Extensions bilden die Struktur der Adresse ab, wie sie im VSDM-Format der elektronischen Versichertenkarte verwendet wird. 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. Adresse, deutsches Basisprofil (Version 0.2) Constraints
Beispiel für einfache Adresse { "use": "home", "type": "postal", "line": [ "Musterweg 42" ], "city": "Musterhausen", "postalCode": "99999" } Mappings
|
maritalStatus | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.maritalStatus Marital (civil) status of a patient DefinitionThis field contains a patient's most recent marital (civil) status. Most, if not all systems capture it. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
| |
multipleBirth[x] | 0..1 | There are no (further) constraints on this element Element IdPatient.multipleBirth[x] Whether patient is part of a multiple birth 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).
| ||
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".
| |
contact | 0..* | BackboneElement | There are no (further) constraints on this element Element IdPatient.contact A contact party (e.g. guardian, partner, friend) for the patient DefinitionA contact party (e.g. guardian, partner, friend) for the patient. Need to track people you can contact about the patient. Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.
| |
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. HL7 v2 Value Set 0131 (extensible) Constraints
| |
name | 0..* | HumanName, deutsches Basisprofil (Version 0.2) | There are no (further) constraints on this element Element IdPatient.contact.name Personenname nach deutschem Profil. DefinitionPersonenname nach deutschem Profil. Dieser enthält bestimmte Extensions, die in Deutschland Verwendung finden. Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person. Hinweis zur Repräsentation von Anreden: Diese sollten, sofern erforderlich, ausschließlich in HumanName.text erscheinen (z.B. "Frsu Dr. Martha Musterfrau"). Nach Möglichkeit sollte die Anrede aus dem Geschlecht der Person abgeleitet werden. Das Element prefix wird nur für akademische Titel und andere Namensbestandteile verwendet. HumanName, deutsches Basisprofil (Version 0.2) Constraints
| |
telecom | 0..* | ContactPoint | There are no (further) constraints on this element Element IdPatient.contact.telecom A contact detail for the person DefinitionA contact detail for the person, e.g. a telephone number or an email address. People have (primary) ways to contact them in some way such as phone, email. Contact may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification.
| |
address | 0..* | Adresse, deutsches Basisprofil (Version 0.2) | There are no (further) constraints on this element Element IdPatient.contact.address Adresse nach deutschem Profil. DefinitionAdresse nach deutschem Profil. Die in diesem Profil verwendeten Extensions bilden die Struktur der Adresse ab, wie sie im VSDM-Format der elektronischen Versichertenkarte verwendet wird. 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. Adresse, deutsches Basisprofil (Version 0.2) Constraints
Beispiel für einfache Adresse { "use": "home", "type": "postal", "line": [ "Musterweg 42" ], "city": "Musterhausen", "postalCode": "99999" } Mappings
| |
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
| |
organization | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdPatient.contact.organization Organization that is associated with the contact DefinitionOrganization on behalf of which the contact is acting or for which the contact is working. For guardians or business related contacts, the organization is relevant. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
| |
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.
| |
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. Die verterinärmedizinische Profilierung von FHIR is außerhalb des Scopes der Basisprofile
|
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 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.
| |
language | 1..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.communication.language The language which can be used to communicate with the patient about his or her health DefinitionThe ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English. Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect. The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.
| |
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.
| |
generalPractitioner | 0..* | Reference(Organisation, deutsches Basisprofil (Version 0.2) | Practitioner, deutsches Basisprofil (Version 0.2)) | There are no (further) constraints on this element Element IdPatient.generalPractitioner Patient's nominated primary care provider Alternate namescareProvider DefinitionPatient's nominated care provider. This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disablity setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Reference(Organisation, deutsches Basisprofil (Version 0.2) | Practitioner, deutsches Basisprofil (Version 0.2)) Constraints
| |
managingOrganization | Σ | 0..1 | Reference(Organisation, deutsches Basisprofil (Version 0.2)) | There are no (further) constraints on this element Element IdPatient.managingOrganization haupt-behandelnde Organisation nach deutschem Profil Definitionhaupt-behandelnde Organisation nach deutschem Profil. Dieses Profil enthält für Deutschland spezififische Besonderheiten und Extensions. Need to know who recognizes this patient record, manages and updates it. There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association). Reference(Organisation, deutsches Basisprofil (Version 0.2)) Constraints
|
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'.
|
other | Σ | 1..1 | Reference(Patient | RelatedPerson) | There are no (further) constraints on this element Element IdPatient.link.other The other patient or related person resource that the link refers to DefinitionThe other patient resource that the link refers to. Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual. Reference(Patient | RelatedPerson) Constraints
|
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
|
Below is an example of the Norwegian national profile for Patient as defined by HL7 Norway. This national profile was reused in the HelseVest Perioperative project. Below you see the differential view of this resource, which means that not all elements of the core Patient resource are visible. Only the elements that are changed compared to the core Patient resource are shown.
Patient | Patient | There are no (further) constraints on this element Data Type | ||
identifier | There are no (further) constraints on this element Element IdPatient.identifier Unordered, Open, by system(Value) | |||
F-number | 1..1 | There are no (further) constraints on this element Element IdPatient.identifier:F-number | ||
system | 1.. | Fixed Value | There are no (further) constraints on this element Element IdPatient.identifier:F-number.system urn:oid:2.16.578.1.12.4.1.4.1 | |
value | 1.. | There are no (further) constraints on this element Element IdPatient.identifier:F-number.value | ||
D-number | 1..1 | There are no (further) constraints on this element Element IdPatient.identifier:D-number | ||
system | 1.. | Fixed Value | There are no (further) constraints on this element Element IdPatient.identifier:D-number.system urn:oid:2.16.578.1.12.4.1.4.2 | |
value | 1.. | There are no (further) constraints on this element Element IdPatient.identifier:D-number.value | ||
FH-number | 1..1 | There are no (further) constraints on this element Element IdPatient.identifier:FH-number | ||
system | 1.. | Fixed Value | There are no (further) constraints on this element Element IdPatient.identifier:FH-number.system urn:oid:2.16.578.1.12.4.1.4.3 | |
value | 1.. | There are no (further) constraints on this element Element IdPatient.identifier:FH-number.value |
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 Dutch national profile for Patient, called nl-core-patient profile. This is a snapshot view of the resource.
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.
| |
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
| |
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 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
| |
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
| |
valueReference | 0..* | KoppeltaalReference(KoppeltaalOrganization) | There are no (further) constraints on this element 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
| |
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.
|
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.
|
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
| |
reference-identifier-resource-type | 1..1 | Extension | There are no (further) constraints on this element 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
| |
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.
|
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.
|
coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element IdPatient.extension:preferredPharmacy.value[x]:valueReference.identifier.type.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.
|
system | Σ | 0..1 | uri | There are no (further) constraints on this element Element IdPatient.extension:preferredPharmacy.value[x]:valueReference.identifier.type.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.
|
version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.extension:preferredPharmacy.value[x]:valueReference.identifier.type.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.
|
code | Σ | 0..1 | code | There are no (further) constraints on this element Element IdPatient.extension:preferredPharmacy.value[x]:valueReference.identifier.type.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
|
display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.extension:preferredPharmacy.value[x]:valueReference.identifier.type.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
|
userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdPatient.extension:preferredPharmacy.value[x]:valueReference.identifier.type.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.
|
text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.extension:preferredPharmacy.value[x]:valueReference.identifier.type.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.
|
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 or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri Mappings
|
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
|
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.
|
start | Σ | 0..1 | dateTime | There are no (further) constraints on this element Element IdPatient.extension:preferredPharmacy.value[x]:valueReference.identifier.period.start Starting time with inclusive boundary DefinitionThe start of the period. The boundary is inclusive. If the low element is missing, the meaning is that the low boundary is not known.
|
end | Σ | 0..1 | dateTime | There are no (further) constraints on this element Element IdPatient.extension:preferredPharmacy.value[x]:valueReference.identifier.period.end End time with inclusive boundary, if not ongoing DefinitionThe end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time. The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.
|
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.
|
reference | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.extension:preferredPharmacy.value[x]:valueReference.identifier.assigner.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.
|
identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdPatient.extension:preferredPharmacy.value[x]:valueReference.identifier.assigner.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.
|
display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.extension:preferredPharmacy.value[x]:valueReference.identifier.assigner.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.
|
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.
|
nationality | 0..* | ExtensionBinding | There are no (further) constraints on this element Element IdPatient.extension:nationality 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://hl7.org/fhir/StructureDefinition/patient-nationality Binding?? (extensible) Constraints
| |
person-age | 0..1 | ExtensionBinding | There are no (further) constraints on this element 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
| |
identifier | Σ | 1..* | Identifier | There are no (further) constraints on this element Element IdPatient.identifier PatientIdentificationNumber Alternate namesPatientIdentificatienummer DefinitionThe Burgerservicenummer, as one of the possible patient identification numbers, should at least be sent unless there is a reason not to. Reasons for not sending include but are not limited to, research and apps without a contract for data processing (Dutch: bewerkingsovereenkomst). Patients are almost always assigned specific numerical identifiers. Unordered, Open, by system(Value) Constraints
|
BSN | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdPatient.identifier:BSN An identifier for this patient Alternate namesBSN DefinitionAn identifier for this patient. Patients are almost always assigned specific numerical identifiers.
|
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.
|
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.
|
coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element IdPatient.identifier:BSN.type.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.
|
system | Σ | 0..1 | uri | There are no (further) constraints on this element Element IdPatient.identifier:BSN.type.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.
|
version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.identifier:BSN.type.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.
|
code | Σ | 0..1 | code | There are no (further) constraints on this element Element IdPatient.identifier:BSN.type.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
|
display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.identifier:BSN.type.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
|
userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdPatient.identifier:BSN.type.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.
|
text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.identifier:BSN.type.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.
|
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
|
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 BSN voorbeeld 123456782 Mappings
|
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.
|
start | Σ | 0..1 | dateTime | There are no (further) constraints on this element Element IdPatient.identifier:BSN.period.start Starting time with inclusive boundary DefinitionThe start of the period. The boundary is inclusive. If the low element is missing, the meaning is that the low boundary is not known.
|
end | Σ | 0..1 | dateTime | There are no (further) constraints on this element Element IdPatient.identifier:BSN.period.end End time with inclusive boundary, if not ongoing DefinitionThe end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time. The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.
|
assigner | Σ | 0..1 | Reference(http://hl7.org/fhir/StructureDefinition/KoppeltaalOrganization) | There are no (further) constraints on this element 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
|
reference | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.identifier:BSN.assigner.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.
|
identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdPatient.identifier:BSN.assigner.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.
|
display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.identifier:BSN.assigner.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.
|
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 determine 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
|
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
|
telecom | Σ | 0..* | ContactPoint | There are no (further) constraints on this element Element IdPatient.telecom ContactInformation Alternate namesContactgegevens DefinitionA contact detail (e.g. a telephone number or an email address) by which the individual may be contacted. People have (primary) ways to contact them in some way such as phone, email. A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address 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).
|
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
|
value | Σ | 1..1 | string | There are no (further) constraints on this element Element IdPatient.telecom.value The actual contact point details 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.
|
use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.telecom.use home | work | temp | old | mobile - purpose of this contact point 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.
|
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.
|
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.
|
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
|
birthDate | Σ | 0..1 | date | There are no (further) constraints on this element Element IdPatient.birthDate Patient’s date of birth. The date of birth is mandatory for a patient. A vague date (such as only the year) 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).
|
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.
| |
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 namesadres, 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. 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 physical/postal address { "extension": [ { "url": "http://fhir.nl/fhir/StructureDefinition/nl-core-address-official", "valueBoolean": false } ], "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" } Mappings
|
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. 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. ?? (required) Constraints
| |
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).
| ||
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".
| |
contact | 0..* | BackboneElement | There are no (further) constraints on this element Element IdPatient.contact ContactPerson Alternate namesContactpersoon DefinitionA contact party (e.g. guardian, partner, friend) for the patient. Need to track people you can contact about the patient. Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.
| |
relationship | 0..* | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.contact.relationship Role or Relationship Alternate namesRol of relatie 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
| |
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. ?? (extensible) Constraints
| |
role | 0..* | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.contact.relationship:role Role Alternate namesRol 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. ?? (extensible) Constraints
| |
name | 0..* | 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
| |
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. Contact may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification.
| |
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
|
value | Σ | 1..1 | string | There are no (further) constraints on this element Element IdPatient.contact.telecom.value The actual contact point details 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.
|
use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.contact.telecom.use home | work | temp | old | mobile - purpose of this contact point 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.
|
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.
|
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.
|
address | 0..* | nl-core-address | There are no (further) constraints on this element Element IdPatient.contact.address AddressInformation Alternate namesadres, 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. 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 physical/postal address { "extension": [ { "url": "http://fhir.nl/fhir/StructureDefinition/nl-core-address-official", "valueBoolean": false } ], "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" } Mappings
| |
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
| |
organization | 0..* | KoppeltaalReference(KoppeltaalOrganization) | There are no (further) constraints on this element 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
| |
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.
|
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.
|
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
| |
reference-identifier-resource-type | 1..1 | Extension | There are no (further) constraints on this element 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
| |
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.
|
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.
|
coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element IdPatient.contact.organization.identifier.type.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.
|
system | Σ | 0..1 | uri | There are no (further) constraints on this element Element IdPatient.contact.organization.identifier.type.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.
|
version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.contact.organization.identifier.type.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.
|
code | Σ | 0..1 | code | There are no (further) constraints on this element Element IdPatient.contact.organization.identifier.type.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
|
display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.contact.organization.identifier.type.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
|
userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdPatient.contact.organization.identifier.type.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.
|
text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.contact.organization.identifier.type.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.
|
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 or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri Mappings
|
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
|
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.
|
start | Σ | 0..1 | dateTime | There are no (further) constraints on this element Element IdPatient.contact.organization.identifier.period.start Starting time with inclusive boundary DefinitionThe start of the period. The boundary is inclusive. If the low element is missing, the meaning is that the low boundary is not known.
|
end | Σ | 0..1 | dateTime | There are no (further) constraints on this element Element IdPatient.contact.organization.identifier.period.end End time with inclusive boundary, if not ongoing DefinitionThe end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time. The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.
|
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.
|
reference | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.contact.organization.identifier.assigner.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.
|
identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdPatient.contact.organization.identifier.assigner.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.
|
display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.contact.organization.identifier.assigner.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.
|
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.
|
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.
| |
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).
|
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 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.
| |
language | 1..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.communication.language The language which can be used to communicate with the patient about his or her health DefinitionThe ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English. Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect. The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.
| |
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.
| |
generalPractitioner | 0..1 | KoppeltaalReference(KoppeltaalOrganization | KoppeltaalPractitioner) | There are no (further) constraints on this element 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
| |
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.
|
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.
|
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
| |
reference-identifier-resource-type | 1..1 | Extension | There are no (further) constraints on this element 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
| |
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.
|
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.
|
coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element IdPatient.generalPractitioner.identifier.type.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.
|
system | Σ | 0..1 | uri | There are no (further) constraints on this element Element IdPatient.generalPractitioner.identifier.type.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.
|
version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.generalPractitioner.identifier.type.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.
|
code | Σ | 0..1 | code | There are no (further) constraints on this element Element IdPatient.generalPractitioner.identifier.type.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
|
display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.generalPractitioner.identifier.type.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
|
userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdPatient.generalPractitioner.identifier.type.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.
|
text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.generalPractitioner.identifier.type.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.
|
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 or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri Mappings
|
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
|
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.
|
start | Σ | 0..1 | dateTime | There are no (further) constraints on this element Element IdPatient.generalPractitioner.identifier.period.start Starting time with inclusive boundary DefinitionThe start of the period. The boundary is inclusive. If the low element is missing, the meaning is that the low boundary is not known.
|
end | Σ | 0..1 | dateTime | There are no (further) constraints on this element Element IdPatient.generalPractitioner.identifier.period.end End time with inclusive boundary, if not ongoing DefinitionThe end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time. The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.
|
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.
|
reference | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.generalPractitioner.identifier.assigner.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.
|
identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdPatient.generalPractitioner.identifier.assigner.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.
|
display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.generalPractitioner.identifier.assigner.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.
|
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.
|
managingOrganization | Σ | 0..* | KoppeltaalReference(KoppeltaalOrganization) | There are no (further) constraints on this element 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
|
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.
|
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.
|
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
| |
reference-identifier-resource-type | 1..1 | Extension | There are no (further) constraints on this element 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
| |
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.
|
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.
|
coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element IdPatient.managingOrganization.identifier.type.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.
|
system | Σ | 0..1 | uri | There are no (further) constraints on this element Element IdPatient.managingOrganization.identifier.type.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.
|
version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.managingOrganization.identifier.type.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.
|
code | Σ | 0..1 | code | There are no (further) constraints on this element Element IdPatient.managingOrganization.identifier.type.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
|
display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.managingOrganization.identifier.type.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
|
userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdPatient.managingOrganization.identifier.type.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.
|
text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.managingOrganization.identifier.type.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.
|
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 or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri Mappings
|
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
|
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.
|
start | Σ | 0..1 | dateTime | There are no (further) constraints on this element Element IdPatient.managingOrganization.identifier.period.start Starting time with inclusive boundary DefinitionThe start of the period. The boundary is inclusive. If the low element is missing, the meaning is that the low boundary is not known.
|
end | Σ | 0..1 | dateTime | There are no (further) constraints on this element Element IdPatient.managingOrganization.identifier.period.end End time with inclusive boundary, if not ongoing DefinitionThe end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time. The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.
|
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.
|
reference | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.managingOrganization.identifier.assigner.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.
|
identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdPatient.managingOrganization.identifier.assigner.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.
|
display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.managingOrganization.identifier.assigner.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.
|