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Pan-Canadian Patient Summary (PS-CA) v2.1.0 DFT

2.1.0-DFT   Canada flag
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    • PS-CA Library of Profiles
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    1. Index
    2. FHIR Artifacts
    3. Patient (PS-CA)

DFT - For a full list of available versions, see the Directory of published versions

Patient (PS-CA)

Links

Profile

patient-ca-ps

Derived from

http://hl7.org/fhir/StructureDefinition/Patient

Examples

patient1-example

Description

This profile represents the constraints applied to the Patient resource by the PS-CA project to represent the minimum expectations for the Patient resource when used in the PS-CA composition profile or in one of the referred resources. It is informed by the constraints of the Patient IPS-UV profile and the Canadian Baseline Profile

References to this resource

AllergyIntoleranceNotSupportedPSCA, ConditionNotSupportedPSCA, MedicationStatementNotSupportedPSCA, AllergyIntolerancePSCA, CompositionPSCA, ConditionPSCA, DiagnosticReportPSCA, FamilyMemberHistoryPSCA, ImagingStudyPSCA, ImmunizationPSCA, MedicationRequestPSCA, MedicationStatementPSCA, ObservationAlcoholUsePSCA, ObservationResultsPSCA, ObservationResultsLaboratoryPathologyPSCA, ObservationResultsRadiologyPSCA, ObservationSocialHistoryPSCA, ObservationTobaccoUsePSCA, ProcedurePSCA

Resource Content

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  • XML
  • JSON
PatientPSCA (Patient)CPatient
There are no (further) constraints on this element
Element id
Patient
Short description

Information about an individual or animal receiving health care services

Alternate names

SubjectOfCare Client Resident

Definition

Demographics and other administrative information about an individual or animal receiving care or other health-related services.

Data type

Patient

Constraints
  • dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.empty()
  • dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
    contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
  • dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
  • dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
    contained.meta.security.empty()
  • dom-6: A resource should have narrative for robust management
    text.`div`.exists()
Mappings
  • rim: Entity. Role, or Act
  • rim: Patient[classCode=PAT]
  • cda: ClinicalDocument.recordTarget.patientRole
idΣ0..1string
There are no (further) constraints on this element
Element id
Patient.id
Short description

Logical id of this artifact

Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Data type

string

metaΣ0..1Meta
There are no (further) constraints on this element
Element id
Patient.meta
Short description

Metadata about the resource

Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

Data type

Meta

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
implicitRulesΣ ?!0..1uri
There are no (further) constraints on this element
Element id
Patient.implicitRules
Short description

A set of rules under which this content was created

Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Data type

uri

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
language0..1codeBinding
There are no (further) constraints on this element
Element id
Patient.language
Short description

Language of the resource content

Definition

The base language in which the resource is written.

Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Data type

code

Binding

A human language.

CommonLanguages (preferred)

Binding extensions
maxValueSetAllLanguages
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
text0..1Narrative
There are no (further) constraints on this element
Element id
Patient.text
Short description

Text summary of the resource, for human interpretation

Alternate names

narrative, html, xhtml, display

Definition

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

Data type

Narrative

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: Act.text?
contained0..*Resource
There are no (further) constraints on this element
Element id
Patient.contained
Short description

Contained, inline Resources

Alternate names

inline resources, anonymous resources, contained resources

Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Data type

Resource

Mappings
  • rim: N/A
extensionC0..*ExtensionElement id
Patient.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
individual-recordedSexOrGenderC0..*Extension(Complex)Element id
Patient.extension:individual-recordedSexOrGender
Short description

Extension for representing an individuals recorded sex or gender.

Alternate names

extensions, user content

Definition

Recorded sex or gender (RSG) information includes the various sex and gender concepts that are often used in existing systems but are known NOT to represent a gender identity, sex parameter for clinical use, or attributes related to sexuality, such as sexual orientation, sexual activity, or sexual attraction. Examples of recorded sex or gender concepts include administrative gender, administrative sex, and sex assigned at birth. When exchanging this concept, refer to the guidance in the Gender Harmony Implementation Guide

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension(Complex)

Extension URL

http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
modifierExtension?! C0..*Extension
There are no (further) constraints on this element
Element id
Patient.modifierExtension
Short description

Extensions that cannot be ignored

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
identifierS Σ0..*IdentifierCABaselineElement id
Patient.identifier
Short description

An identifier intended for computation

Definition

An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.

Requirements

Patients are almost always assigned specific numerical identifiers.

Comments

This element employs the constraints on identifier put forth in the CA Baseline using a profiled data type.

Data type

IdentifierCABaseline

Slicing

Unordered, Open, by type(Pattern)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.identifier
  • v2: PID-3
  • rim: id
  • cda: .id
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
(All Slices)
The requirements in this element apply to all slices

id0..1string
There are no (further) constraints on this element
Element id
Patient.identifier.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Patient.identifier.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
useΣ ?!0..1codeBinding
There are no (further) constraints on this element
Element id
Patient.identifier.use
Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Data type

code

Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: N/A
  • rim: Role.code or implied by context
typeΣ0..1CodeableConceptBindingElement id
Patient.identifier.type
Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

The slices provided below are examples of identifier types used by jurisdictions for patient summary. These are not required, and the slicing is open meaning that other types can be provided and used in an implementation.

Data type

CodeableConcept

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Identifier Type Codes (extensible)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: CX.5
  • rim: Role.code or implied by context
systemΣ1..1uri
There are no (further) constraints on this element
Element id
Patient.identifier.system
Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Data type

uri

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General
http://www.acme.com/identifiers/patient
Mappings
  • v2: CX.4 / EI-2-4
  • rim: II.root or Role.id.root
  • servd: ./IdentifierType
valueΣ1..1stringElement id
Patient.identifier.value
Short description

The value that is unique within the system.

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General
123456
Mappings
  • v2: CX.1 / EI.1
  • rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
  • servd: ./Value
periodΣ0..1Period
There are no (further) constraints on this element
Element id
Patient.identifier.period
Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Data type

Period

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: CX.7 + CX.8
  • rim: Role.effectiveTime or implied by context
  • servd: ./StartDate and ./EndDate
assignerΣ0..1Reference(Organization)
There are no (further) constraints on this element
Element id
Patient.identifier.assigner
Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Reference(Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: CX.4 / (CX.4,CX.9,CX.10)
  • rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
  • servd: ./IdentifierIssuingAuthority
JHNΣ0..*IdentifierElement id
Patient.identifier:JHN
Short description

Jurisdictional Health Number

Definition

Federal patient and person health numbers used by all jurisdictions across Canada

Requirements

Patients are almost always assigned specific numerical identifiers.

Data type

Identifier

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.identifier
  • v2: PID-3
  • rim: id
  • cda: .id
id0..1string
There are no (further) constraints on this element
Element id
Patient.identifier:JHN.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Patient.identifier:JHN.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
versionCodeC0..1ExtensionElement id
Patient.identifier:JHN.extension:versionCode
Short description

Health Number Version Code

Alternate names

extensions, user content

Definition

A code indicating a specific version of an identifier credential

Comments

For example, a health card version number, credit card version number, etc. Used to help verify the authenticity of a credential

Data type

Extension

Extension URL

http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-identifierversion

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
useΣ ?!0..1codeBinding
There are no (further) constraints on this element
Element id
Patient.identifier:JHN.use
Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Data type

code

Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: N/A
  • rim: Role.code or implied by context
typeΣ1..1CodeableConceptBindingPatternElement id
Patient.identifier:JHN.type
Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

The slices provided below are examples of identifier types used by jurisdictions for patient summary. These are not required, and the slicing is open meaning that other types can be provided and used in an implementation.

Data type

CodeableConcept

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Identifier Type Codes (extensible)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
      "code": "JHN"
    }
  ]
}
Mappings
  • v2: CX.5
  • rim: Role.code or implied by context
systemΣ1..1uriElement id
Patient.identifier:JHN.system
Short description

A Health Number Naming System from the Canadian URI Registry

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Data type

uri

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General
http://www.acme.com/identifiers/patient
Mappings
  • v2: CX.4 / EI-2-4
  • rim: II.root or Role.id.root
  • servd: ./IdentifierType
valueΣ1..1stringElement id
Patient.identifier:JHN.value
Short description

The value that is unique within the system.

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General
123456
Mappings
  • v2: CX.1 / EI.1
  • rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
  • servd: ./Value
periodΣ0..1Period
There are no (further) constraints on this element
Element id
Patient.identifier:JHN.period
Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Data type

Period

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: CX.7 + CX.8
  • rim: Role.effectiveTime or implied by context
  • servd: ./StartDate and ./EndDate
assignerΣ0..1Reference(Organization)
There are no (further) constraints on this element
Element id
Patient.identifier:JHN.assigner
Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Reference(Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: CX.4 / (CX.4,CX.9,CX.10)
  • rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
  • servd: ./IdentifierIssuingAuthority
MRNΣ0..*IdentifierElement id
Patient.identifier:MRN
Short description

Medical Record Number

Definition

A local patient identifier from the submitting PoS System

Requirements

Patients are almost always assigned specific numerical identifiers.

Comments

Some jurisdictions may consider the MRN identifier type to be an alternative to the JHN identifier type under certain scenarios. These business rules are outside the scope of this profile, however the slice is socialized to prepare implementers for potential use of this pattern within certain jurisdictions

Data type

Identifier

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.identifier
  • v2: PID-3
  • rim: id
  • cda: .id
id0..1string
There are no (further) constraints on this element
Element id
Patient.identifier:MRN.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Patient.identifier:MRN.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
useΣ ?!0..1codeBinding
There are no (further) constraints on this element
Element id
Patient.identifier:MRN.use
Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Data type

code

Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: N/A
  • rim: Role.code or implied by context
typeΣ1..1CodeableConceptBindingPatternElement id
Patient.identifier:MRN.type
Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

The slices provided below are examples of identifier types used by jurisdictions for patient summary. These are not required, and the slicing is open meaning that other types can be provided and used in an implementation.

Data type

CodeableConcept

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Identifier Type Codes (extensible)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
      "code": "MR"
    }
  ]
}
Mappings
  • v2: CX.5
  • rim: Role.code or implied by context
systemΣ1..1uriElement id
Patient.identifier:MRN.system
Short description

An identifier for the system supplying the MRN

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Data type

uri

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General
http://www.acme.com/identifiers/patient
Mappings
  • v2: CX.4 / EI-2-4
  • rim: II.root or Role.id.root
  • servd: ./IdentifierType
valueΣ1..1stringElement id
Patient.identifier:MRN.value
Short description

The value that is unique within the system.

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General
123456
Mappings
  • v2: CX.1 / EI.1
  • rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
  • servd: ./Value
periodΣ0..1Period
There are no (further) constraints on this element
Element id
Patient.identifier:MRN.period
Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Data type

Period

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: CX.7 + CX.8
  • rim: Role.effectiveTime or implied by context
  • servd: ./StartDate and ./EndDate
assignerΣ0..1Reference(Organization)
There are no (further) constraints on this element
Element id
Patient.identifier:MRN.assigner
Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Reference(Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: CX.4 / (CX.4,CX.9,CX.10)
  • rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
  • servd: ./IdentifierIssuingAuthority
activeΣ ?!0..1boolean
There are no (further) constraints on this element
Element id
Patient.active
Short description

Whether this patient's record is in active use

Definition

Whether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules.

It is often used to filter patient lists to exclude inactive patients

Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death.

Requirements

Need to be able to mark a patient record as not to be used because it was created in error.

Comments

If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient.

Meaning when missing

This resource is generally assumed to be active if no value is provided for the active element

Data type

boolean

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.status
  • rim: statusCode
  • cda: n/a
nameS Σ C1..*HumanNameElement id
Patient.name
Short description

A name associated with the patient

Definition

A name associated with the individual.

Requirements

Need to be able to track the patient by multiple names. Examples are your official name and a partner name. The Alphabetic representation of the name SHALL be always provided

Comments

A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.

Data type

HumanName

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • core-pat-1: Either Patient.name.given and/or Patient.name.family and/or Patient.name.text SHALL be present or a Data Absent Reason Extension SHALL be present.
    (family.exists() or given.exists() or text.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()
Mappings
  • v2: PID-5, PID-9
  • rim: name
  • cda: .patient.name
id0..1string
There are no (further) constraints on this element
Element id
Patient.name.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Patient.name.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
useΣ ?!0..1codeBinding
There are no (further) constraints on this element
Element id
Patient.name.use
Short description

usual | official | temp | nickname | anonymous | old | maiden

Definition

Identifies the purpose for this name.

Requirements

Allows the appropriate name for a particular context of use to be selected from among a set of names.

Comments

Applications can assume that a name is current unless it explicitly says that it is temporary or old.

Data type

code

Binding

The use of a human name.

NameUse (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: XPN.7, but often indicated by which field contains the name
  • rim: unique(./use)
  • servd: ./NamePurpose
textS Σ0..1stringElement id
Patient.name.text
Short description

Text representation of the full name

Definition

Text representation of the full name. Due to the cultural variance around the world a consuming system may not know how to present the name correctly; moreover not all the parts of the name go in given or family. Creators are therefore strongly encouraged to provide through this element a presented version of the name. Future versions of this guide may require this element

Requirements

A renderable, unencoded form.

Comments

Some systems will not have a field for representing the full name as a string, these systems are still expected to be able to demonstrate they can construct name.text when developing the patient summary instance

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: implied by XPN.11
  • rim: ./formatted
familyS Σ0..1string
There are no (further) constraints on this element
Element id
Patient.name.family
Short description

Family name (often called 'Surname')

Alternate names

surname

Definition

The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.

Comments

Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: XPN.1/FN.1
  • rim: ./part[partType = FAM]
  • servd: ./FamilyName
givenS Σ0..*string
There are no (further) constraints on this element
Element id
Patient.name.given
Short description

Given names (not always 'first'). Includes middle names

Alternate names

first name, middle name

Definition

Given name.

Comments

If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: XPN.2 + XPN.3
  • rim: ./part[partType = GIV]
  • servd: ./GivenNames
prefixΣ0..*string
There are no (further) constraints on this element
Element id
Patient.name.prefix
Short description

Parts that come before the name

Definition

Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: XPN.5
  • rim: ./part[partType = PFX]
  • servd: ./TitleCode
suffixΣ0..*string
There are no (further) constraints on this element
Element id
Patient.name.suffix
Short description

Parts that come after the name

Definition

Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: XPN/4
  • rim: ./part[partType = SFX]
periodΣ0..1Period
There are no (further) constraints on this element
Element id
Patient.name.period
Short description

Time period when name was/is in use

Definition

Indicates the period of time when this name was valid for the named person.

Requirements

Allows names to be placed in historical context.

Data type

Period

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: XPN.13 + XPN.14
  • rim: ./usablePeriod[type="IVL<TS>"]
  • servd: ./StartDate and ./EndDate
telecomΣ0..*ContactPointElement id
Patient.telecom
Short description

A contact detail for the individual

Definition

A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted.

Requirements

People have (primary) ways to contact them in some way such as phone, email.

Comments

IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content.

Data type

ContactPoint

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: PID-13, PID-14, PID-40
  • rim: telecom
  • cda: .telecom
id0..1string
There are no (further) constraints on this element
Element id
Patient.telecom.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Patient.telecom.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
systemS Σ C0..1codeBinding
There are no (further) constraints on this element
Element id
Patient.telecom.system
Short description

phone | fax | email | pager | url | sms | other

Definition

Telecommunications form for contact point - what communications system is required to make use of the contact.

Data type

code

Binding

Telecommunications form for contact point.

ContactPointSystem (required)

Conditions

The cardinality or value of this element may be affected by these constraints: cpt-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: XTN.3
  • rim: ./scheme
  • servd: ./ContactPointType
valueS Σ0..1string
There are no (further) constraints on this element
Element id
Patient.telecom.value
Short description

The actual contact point details

Definition

The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

Requirements

Need to support legacy numbers that are not in a tightly controlled format.

Comments

Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: XTN.1 (or XTN.12)
  • rim: ./url
  • servd: ./Value
useS Σ ?!0..1codeBinding
There are no (further) constraints on this element
Element id
Patient.telecom.use
Short description

home | work | temp | old | mobile - purpose of this contact point

Definition

Identifies the purpose for the contact point.

Requirements

Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

Comments

Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

Data type

code

Binding

Use of contact point.

ContactPointUse (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: XTN.2 - but often indicated by field
  • rim: unique(./use)
  • servd: ./ContactPointPurpose
rankΣ0..1positiveInt
There are no (further) constraints on this element
Element id
Patient.telecom.rank
Short description

Specify preferred order of use (1 = highest)

Definition

Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.

Comments

Note that rank does not necessarily follow the order in which the contacts are represented in the instance.

Data type

positiveInt

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: n/a
  • rim: n/a
periodΣ0..1Period
There are no (further) constraints on this element
Element id
Patient.telecom.period
Short description

Time period when the contact point was/is in use

Definition

Time period when the contact point was/is in use.

Data type

Period

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: N/A
  • rim: ./usablePeriod[type="IVL<TS>"]
  • servd: ./StartDate and ./EndDate
genderS Σ0..1codeBinding
There are no (further) constraints on this element
Element id
Patient.gender
Short description

male | female | other | unknown

Definition

Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes.

Requirements

Needed for identification of the individual, in combination with (at least) name and birth date.

Comments

The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex.

Data type

code

Binding

The gender of a person used for administrative purposes.

AdministrativeGender (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: PID-8
  • rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender
  • cda: .patient.administrativeGenderCode
birthDateS Σ1..1dateElement id
Patient.birthDate
Short description

The date of birth for the individual

Definition

The date of birth for the individual.

Requirements

Age of the individual drives many clinical processes.

Comments

While the birthDate element requires a value, if the exact date of birth is unknown, only the known portion of the date (e.g., the year) should be provided without estimating or inferring unknown parts of the date. Use of the Data Absent Reason is appropriate when the date of birth of an individual cannot be determined.

Data type

date

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: PID-7
  • rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/birthTime
  • cda: .patient.birthTime
  • loinc: 21112-8
deceased[x]Σ ?!0..1
There are no (further) constraints on this element
Element id
Patient.deceased[x]
Short description

Indicates if the individual is deceased or not

Definition

Indicates if the individual is deceased or not.

Requirements

The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.

Comments

If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: PID-30 (bool) and PID-29 (datetime)
  • rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedTime
  • cda: n/a
deceasedBooleanboolean
There are no (further) constraints on this element
Data type

boolean

deceasedDateTimedateTime
There are no (further) constraints on this element
Data type

dateTime

addressΣ0..*AddressElement id
Patient.address
Short description

An address for the individual

Definition

An address for the individual.

Requirements

May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.

Comments

IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content.

Data type

Address

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: PID-11
  • rim: addr
  • cda: .addr
id0..1string
There are no (further) constraints on this element
Element id
Patient.address.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Patient.address.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
useΣ ?!0..1codeBinding
There are no (further) constraints on this element
Element id
Patient.address.use
Short description

home | work | temp | old | billing - purpose of this address

Definition

The purpose of this address.

Requirements

Allows an appropriate address to be chosen from a list of many.

Comments

Applications can assume that an address is current unless it explicitly says that it is temporary or old.

Data type

code

Binding

The use of an address.

AddressUse (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General
home
Mappings
  • v2: XAD.7
  • rim: unique(./use)
  • servd: ./AddressPurpose
typeΣ0..1codeBinding
There are no (further) constraints on this element
Element id
Patient.address.type
Short description

postal | physical | both

Definition

Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both.

Comments

The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource).

Data type

code

Binding

The type of an address (physical / postal).

AddressType (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General
both
Mappings
  • v2: XAD.18
  • rim: unique(./use)
  • vcard: address type parameter
textΣ0..1string
There are no (further) constraints on this element
Element id
Patient.address.text
Short description

Text representation of the address

Definition

Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts.

Requirements

A renderable, unencoded form.

Comments

Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General
137 Nowhere Street, Erewhon 9132
Mappings
  • v2: XAD.1 + XAD.2 + XAD.3 + XAD.4 + XAD.5 + XAD.6
  • rim: ./formatted
  • vcard: address label parameter
lineS Σ0..*string
There are no (further) constraints on this element
Element id
Patient.address.line
Short description

Street name, number, direction & P.O. Box etc.

Definition

This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General
137 Nowhere Street
Mappings
  • v2: XAD.1 + XAD.2 (note: XAD.1 and XAD.2 have different meanings for a company address than for a person address)
  • rim: AD.part[parttype = AL]
  • vcard: street
  • servd: ./StreetAddress (newline delimitted)
cityS Σ0..1string
There are no (further) constraints on this element
Element id
Patient.address.city
Short description

Name of city, town etc.

Alternate names

Municpality

Definition

The name of the city, town, suburb, village or other community or delivery center.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General
Erewhon
Mappings
  • v2: XAD.3
  • rim: AD.part[parttype = CTY]
  • vcard: locality
  • servd: ./Jurisdiction
districtΣ0..1string
There are no (further) constraints on this element
Element id
Patient.address.district
Short description

District name (aka county)

Alternate names

County

Definition

The name of the administrative area (county).

Comments

District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General
Madison
Mappings
  • v2: XAD.9
  • rim: AD.part[parttype = CNT | CPA]
stateΣ0..1string
There are no (further) constraints on this element
Element id
Patient.address.state
Short description

Sub-unit of country (abbreviations ok)

Alternate names

Province, Territory

Definition

Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes).

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: XAD.4
  • rim: AD.part[parttype = STA]
  • vcard: region
  • servd: ./Region
postalCodeS Σ0..1string
There are no (further) constraints on this element
Element id
Patient.address.postalCode
Short description

Postal code for area

Alternate names

Zip

Definition

A postal code designating a region defined by the postal service.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General
9132
Mappings
  • v2: XAD.5
  • rim: AD.part[parttype = ZIP]
  • vcard: code
  • servd: ./PostalIdentificationCode
countryS Σ0..1string
There are no (further) constraints on this element
Element id
Patient.address.country
Short description

Country (e.g. can be ISO 3166 2 or 3 letter code)

Definition

Country - a nation as commonly understood or generally accepted.

Comments

ISO 3166 3 letter codes can be used in place of a human readable country name.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: XAD.6
  • rim: AD.part[parttype = CNT]
  • vcard: country
  • servd: ./Country
periodΣ0..1Period
There are no (further) constraints on this element
Element id
Patient.address.period
Short description

Time period when address was/is in use

Definition

Time period when address was/is in use.

Requirements

Allows addresses to be placed in historical context.

Data type

Period

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General
{
  "start": "2010-03-23",
  "end": "2010-07-01"
}
Mappings
  • v2: XAD.12 / XAD.13 + XAD.14
  • rim: ./usablePeriod[type="IVL<TS>"]
  • servd: ./StartDate and ./EndDate
maritalStatus0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Patient.maritalStatus
Short description

Marital (civil) status of a patient

Definition

This field contains a patient's most recent marital (civil) status.

Requirements

Most, if not all systems capture it.

Data type

CodeableConcept

Binding

The domestic partnership status of a person.

Marital Status Codes (extensible)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: PID-16
  • rim: player[classCode=PSN]/maritalStatusCode
  • cda: .patient.maritalStatusCode
multipleBirth[x]0..1
There are no (further) constraints on this element
Element id
Patient.multipleBirth[x]
Short description

Whether patient is part of a multiple birth

Definition

Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer).

Requirements

For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs.

Comments

Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in triplets would be valueInteger=2 and the third born would have valueInteger=3 If a boolean value was provided for this triplets example, then all 3 patient records would have valueBoolean=true (the ordering is not indicated).

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: PID-24 (bool), PID-25 (integer)
  • rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber
  • cda: n/a
multipleBirthBooleanboolean
There are no (further) constraints on this element
Data type

boolean

multipleBirthIntegerinteger
There are no (further) constraints on this element
Data type

integer

photo0..*Attachment
There are no (further) constraints on this element
Element id
Patient.photo
Short description

Image of the patient

Definition

Image of the patient.

Requirements

Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too.

Comments

Guidelines:

  • Use id photos, not clinical photos.
  • Limit dimensions to thumbnail.
  • Keep byte count low to ease resource updates.
Data type

Attachment

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: OBX-5 - needs a profile
  • rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/desc
  • cda: n/a
contactC0..*BackboneElement
There are no (further) constraints on this element
Element id
Patient.contact
Short description

A contact party (e.g. guardian, partner, friend) for the patient

Definition

A contact party (e.g. guardian, partner, friend) for the patient.

Requirements

Need to track people you can contact about the patient.

Comments

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.

Data type

BackboneElement

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • pat-1: SHALL at least contain a contact's details or a reference to an organization
    name.exists() or telecom.exists() or address.exists() or organization.exists()
Mappings
  • rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON]
  • cda: n/a
id0..1string
There are no (further) constraints on this element
Element id
Patient.contact.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Patient.contact.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Patient.contact.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
relationship0..*CodeableConceptBinding
There are no (further) constraints on this element
Element id
Patient.contact.relationship
Short description

The kind of relationship

Definition

The nature of the relationship between the patient and the contact person.

Requirements

Used to determine which contact person is the most relevant to approach, depending on circumstances.

Data type

CodeableConcept

Binding

The nature of the relationship between a patient and a contact person for that patient.

PatientContactRelationship (extensible)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: NK1-7, NK1-3
  • rim: code
  • cda: n/a
name0..1HumanName
There are no (further) constraints on this element
Element id
Patient.contact.name
Short description

A name associated with the contact person

Definition

A name associated with the contact person.

Requirements

Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person.

Data type

HumanName

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: NK1-2
  • rim: name
  • cda: n/a
telecom0..*ContactPoint
There are no (further) constraints on this element
Element id
Patient.contact.telecom
Short description

A contact detail for the person

Definition

A contact detail for the person, e.g. a telephone number or an email address.

Requirements

People have (primary) ways to contact them in some way such as phone, email.

Comments

Contact may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification.

Data type

ContactPoint

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: NK1-5, NK1-6, NK1-40
  • rim: telecom
  • cda: n/a
address0..1Address
There are no (further) constraints on this element
Element id
Patient.contact.address
Short description

Address for the contact person

Definition

Address for the contact person.

Requirements

Need to keep track where the contact person can be contacted per postal mail or visited.

Data type

Address

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: NK1-4
  • rim: addr
  • cda: n/a
gender0..1codeBinding
There are no (further) constraints on this element
Element id
Patient.contact.gender
Short description

male | female | other | unknown

Definition

Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes.

Requirements

Needed to address the person correctly.

Data type

code

Binding

The gender of a person used for administrative purposes.

AdministrativeGender (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: NK1-15
  • rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender
  • cda: n/a
organizationC0..1Reference(Organization)
There are no (further) constraints on this element
Element id
Patient.contact.organization
Short description

Organization that is associated with the contact

Definition

Organization on behalf of which the contact is acting or for which the contact is working.

Requirements

For guardians or business related contacts, the organization is relevant.

Data type

Reference(Organization)

Conditions

The cardinality or value of this element may be affected by these constraints: pat-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: NK1-13, NK1-30, NK1-31, NK1-32, NK1-41
  • rim: scoper
  • cda: n/a
period0..1Period
There are no (further) constraints on this element
Element id
Patient.contact.period
Short description

The period during which this contact person or organization is valid to be contacted relating to this patient

Definition

The period during which this contact person or organization is valid to be contacted relating to this patient.

Data type

Period

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: effectiveTime
  • cda: n/a
communication0..*BackboneElement
There are no (further) constraints on this element
Element id
Patient.communication
Short description

A language which may be used to communicate with the patient about his or her health

Definition

A language which may be used to communicate with the patient about his or her health.

Requirements

If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest.

Comments

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.

Data type

BackboneElement

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: LanguageCommunication
  • cda: patient.languageCommunication
id0..1string
There are no (further) constraints on this element
Element id
Patient.communication.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Patient.communication.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Patient.communication.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
language1..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Patient.communication.language
Short description

The language which can be used to communicate with the patient about his or her health

Definition

The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English.

Requirements

Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.

Comments

The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.

Data type

CodeableConcept

Binding

A human language.

CommonLanguages (preferred)

Binding extensions
maxValueSetAllLanguages
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: PID-15, LAN-2
  • rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/languageCommunication/code
  • cda: .languageCode
preferred0..1boolean
There are no (further) constraints on this element
Element id
Patient.communication.preferred
Short description

Language preference indicator

Definition

Indicates whether or not the patient prefers this language (over other languages he masters up a certain level).

Requirements

People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method.

Comments

This language is specifically identified for communicating healthcare information.

Data type

boolean

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: PID-15
  • rim: preferenceInd
  • cda: .preferenceInd
generalPractitioner0..*Reference(Organization | Practitioner | PractitionerRole)Element id
Patient.generalPractitioner
Short description

Patient's nominated primary care provider

Alternate names

careProvider

Definition

Patient's nominated care provider.

Comments

IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content.

Data type

Reference(Organization | Practitioner | PractitionerRole)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: PD1-4
  • rim: subjectOf.CareEvent.performer.AssignedEntity
  • cda: n/a
managingOrganizationΣ0..1Reference(Organization)
There are no (further) constraints on this element
Element id
Patient.managingOrganization
Short description

Organization that is the custodian of the patient record

Definition

Organization that is the custodian of the patient record.

Requirements

Need to know who recognizes this patient record, manages and updates it.

Comments

There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association).

Data type

Reference(Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: scoper
  • cda: .providerOrganization
linkΣ ?!0..*BackboneElement
There are no (further) constraints on this element
Element id
Patient.link
Short description

Link to another patient resource that concerns the same actual person

Definition

Link to another patient resource that concerns the same actual patient.

Requirements

There are multiple use cases:

  • Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and
  • Distribution of patient information across multiple servers.
Comments

There is no assumption that linked patient records have mutual links.

Data type

BackboneElement

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: outboundLink
  • cda: n/a
id0..1string
There are no (further) constraints on this element
Element id
Patient.link.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Patient.link.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Patient.link.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
otherΣ1..1Reference(Patient | RelatedPerson)
There are no (further) constraints on this element
Element id
Patient.link.other
Short description

The other patient or related person resource that the link refers to

Definition

The other patient resource that the link refers to.

Comments

Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.

Data type

Reference(Patient | RelatedPerson)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: PID-3, MRG-1
  • rim: id
  • cda: n/a
typeΣ1..1codeBinding
There are no (further) constraints on this element
Element id
Patient.link.type
Short description

replaced-by | replaces | refer | seealso

Definition

The type of link between this patient resource and another patient resource.

Data type

code

Binding

The type of link between this patient resource and another patient resource.

LinkType (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: typeCode
  • cda: n/a
PatientPSCA (Patient)CPatient
There are no (further) constraints on this element
Element id
Patient
Short description

Information about an individual or animal receiving health care services

Alternate names

SubjectOfCare Client Resident

Definition

Demographics and other administrative information about an individual or animal receiving care or other health-related services.

Data type

Patient

Constraints
  • dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.empty()
  • dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
    contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
  • dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
  • dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
    contained.meta.security.empty()
  • dom-6: A resource should have narrative for robust management
    text.`div`.exists()
Mappings
  • rim: Entity. Role, or Act
  • rim: Patient[classCode=PAT]
  • cda: ClinicalDocument.recordTarget.patientRole
idΣ0..1string
There are no (further) constraints on this element
Element id
Patient.id
Short description

Logical id of this artifact

Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Data type

string

metaΣ0..1Meta
There are no (further) constraints on this element
Element id
Patient.meta
Short description

Metadata about the resource

Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

Data type

Meta

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
implicitRulesΣ ?!0..1uri
There are no (further) constraints on this element
Element id
Patient.implicitRules
Short description

A set of rules under which this content was created

Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Data type

uri

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
language0..1codeBinding
There are no (further) constraints on this element
Element id
Patient.language
Short description

Language of the resource content

Definition

The base language in which the resource is written.

Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Data type

code

Binding

A human language.

CommonLanguages (preferred)

Binding extensions
maxValueSetAllLanguages
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
text0..1Narrative
There are no (further) constraints on this element
Element id
Patient.text
Short description

Text summary of the resource, for human interpretation

Alternate names

narrative, html, xhtml, display

Definition

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

Data type

Narrative

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: Act.text?
contained0..*Resource
There are no (further) constraints on this element
Element id
Patient.contained
Short description

Contained, inline Resources

Alternate names

inline resources, anonymous resources, contained resources

Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Data type

Resource

Mappings
  • rim: N/A
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Patient.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
individual-recordedSexOrGenderC0..*Extension(Complex)
There are no (further) constraints on this element
Element id
Patient.extension:individual-recordedSexOrGender
Short description

Extension for representing an individuals recorded sex or gender.

Alternate names

extensions, user content

Definition

Recorded sex or gender (RSG) information includes the various sex and gender concepts that are often used in existing systems but are known NOT to represent a gender identity, sex parameter for clinical use, or attributes related to sexuality, such as sexual orientation, sexual activity, or sexual attraction. Examples of recorded sex or gender concepts include administrative gender, administrative sex, and sex assigned at birth. When exchanging this concept, refer to the guidance in the Gender Harmony Implementation Guide

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension(Complex)

Extension URL

http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
modifierExtension?! C0..*Extension
There are no (further) constraints on this element
Element id
Patient.modifierExtension
Short description

Extensions that cannot be ignored

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
identifierS Σ0..*IdentifierCABaseline
There are no (further) constraints on this element
Element id
Patient.identifier
Short description

An identifier intended for computation

Definition

An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.

Requirements

Patients are almost always assigned specific numerical identifiers.

Comments

This element employs the constraints on identifier put forth in the CA Baseline using a profiled data type.

Data type

IdentifierCABaseline

Slicing

Unordered, Open, by type(Pattern)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.identifier
  • v2: PID-3
  • rim: id
  • cda: .id
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
(All Slices)
The requirements in this element apply to all slices

id0..1string
There are no (further) constraints on this element
Element id
Patient.identifier.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Patient.identifier.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
useΣ ?!0..1codeBinding
There are no (further) constraints on this element
Element id
Patient.identifier.use
Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Data type

code

Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: N/A
  • rim: Role.code or implied by context
typeΣ0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Patient.identifier.type
Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

The slices provided below are examples of identifier types used by jurisdictions for patient summary. These are not required, and the slicing is open meaning that other types can be provided and used in an implementation.

Data type

CodeableConcept

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Identifier Type Codes (extensible)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: CX.5
  • rim: Role.code or implied by context
systemΣ1..1uri
There are no (further) constraints on this element
Element id
Patient.identifier.system
Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Data type

uri

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General
http://www.acme.com/identifiers/patient
Mappings
  • v2: CX.4 / EI-2-4
  • rim: II.root or Role.id.root
  • servd: ./IdentifierType
valueΣ1..1string
There are no (further) constraints on this element
Element id
Patient.identifier.value
Short description

The value that is unique within the system.

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General
123456
Mappings
  • v2: CX.1 / EI.1
  • rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
  • servd: ./Value
periodΣ0..1Period
There are no (further) constraints on this element
Element id
Patient.identifier.period
Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Data type

Period

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: CX.7 + CX.8
  • rim: Role.effectiveTime or implied by context
  • servd: ./StartDate and ./EndDate
assignerΣ0..1Reference(Organization)
There are no (further) constraints on this element
Element id
Patient.identifier.assigner
Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Reference(Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: CX.4 / (CX.4,CX.9,CX.10)
  • rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
  • servd: ./IdentifierIssuingAuthority
JHNΣ0..*Identifier
There are no (further) constraints on this element
Element id
Patient.identifier:JHN
Short description

Jurisdictional Health Number

Definition

Federal patient and person health numbers used by all jurisdictions across Canada

Requirements

Patients are almost always assigned specific numerical identifiers.

Data type

Identifier

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.identifier
  • v2: PID-3
  • rim: id
  • cda: .id
id0..1string
There are no (further) constraints on this element
Element id
Patient.identifier:JHN.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Patient.identifier:JHN.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
versionCodeC0..1Extension
There are no (further) constraints on this element
Element id
Patient.identifier:JHN.extension:versionCode
Short description

Health Number Version Code

Alternate names

extensions, user content

Definition

A code indicating a specific version of an identifier credential

Comments

For example, a health card version number, credit card version number, etc. Used to help verify the authenticity of a credential

Data type

Extension

Extension URL

http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-identifierversion

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
useΣ ?!0..1codeBinding
There are no (further) constraints on this element
Element id
Patient.identifier:JHN.use
Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Data type

code

Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: N/A
  • rim: Role.code or implied by context
typeΣ1..1CodeableConceptBindingPattern
There are no (further) constraints on this element
Element id
Patient.identifier:JHN.type
Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Data type

CodeableConcept

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Identifier Type Codes (extensible)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
      "code": "JHN"
    }
  ]
}
Mappings
  • v2: CX.5
  • rim: Role.code or implied by context
systemΣ1..1uri
There are no (further) constraints on this element
Element id
Patient.identifier:JHN.system
Short description

A Health Number Naming System from the Canadian URI Registry

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Data type

uri

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General
http://www.acme.com/identifiers/patient
Mappings
  • v2: CX.4 / EI-2-4
  • rim: II.root or Role.id.root
  • servd: ./IdentifierType
valueΣ1..1string
There are no (further) constraints on this element
Element id
Patient.identifier:JHN.value
Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General
123456
Mappings
  • v2: CX.1 / EI.1
  • rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
  • servd: ./Value
periodΣ0..1Period
There are no (further) constraints on this element
Element id
Patient.identifier:JHN.period
Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Data type

Period

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: CX.7 + CX.8
  • rim: Role.effectiveTime or implied by context
  • servd: ./StartDate and ./EndDate
assignerΣ0..1Reference(Organization)
There are no (further) constraints on this element
Element id
Patient.identifier:JHN.assigner
Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Reference(Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: CX.4 / (CX.4,CX.9,CX.10)
  • rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
  • servd: ./IdentifierIssuingAuthority
MRNΣ0..*Identifier
There are no (further) constraints on this element
Element id
Patient.identifier:MRN
Short description

Medical Record Number

Definition

A local patient identifier from the submitting PoS System

Requirements

Patients are almost always assigned specific numerical identifiers.

Comments

Some jurisdictions may consider the MRN identifier type to be an alternative to the JHN identifier type under certain scenarios. These business rules are outside the scope of this profile, however the slice is socialized to prepare implementers for potential use of this pattern within certain jurisdictions

Data type

Identifier

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.identifier
  • v2: PID-3
  • rim: id
  • cda: .id
id0..1string
There are no (further) constraints on this element
Element id
Patient.identifier:MRN.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Patient.identifier:MRN.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
useΣ ?!0..1codeBinding
There are no (further) constraints on this element
Element id
Patient.identifier:MRN.use
Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Data type

code

Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: N/A
  • rim: Role.code or implied by context
typeΣ1..1CodeableConceptBindingPattern
There are no (further) constraints on this element
Element id
Patient.identifier:MRN.type
Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Data type

CodeableConcept

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Identifier Type Codes (extensible)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
{
  "coding": [
    {
      "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
      "code": "MR"
    }
  ]
}
Mappings
  • v2: CX.5
  • rim: Role.code or implied by context
systemΣ1..1uri
There are no (further) constraints on this element
Element id
Patient.identifier:MRN.system
Short description

An identifier for the system supplying the MRN

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Data type

uri

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General
http://www.acme.com/identifiers/patient
Mappings
  • v2: CX.4 / EI-2-4
  • rim: II.root or Role.id.root
  • servd: ./IdentifierType
valueΣ1..1string
There are no (further) constraints on this element
Element id
Patient.identifier:MRN.value
Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General
123456
Mappings
  • v2: CX.1 / EI.1
  • rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
  • servd: ./Value
periodΣ0..1Period
There are no (further) constraints on this element
Element id
Patient.identifier:MRN.period
Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Data type

Period

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: CX.7 + CX.8
  • rim: Role.effectiveTime or implied by context
  • servd: ./StartDate and ./EndDate
assignerΣ0..1Reference(Organization)
There are no (further) constraints on this element
Element id
Patient.identifier:MRN.assigner
Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Reference(Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: CX.4 / (CX.4,CX.9,CX.10)
  • rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
  • servd: ./IdentifierIssuingAuthority
activeΣ ?!0..1boolean
There are no (further) constraints on this element
Element id
Patient.active
Short description

Whether this patient's record is in active use

Definition

Whether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules.

It is often used to filter patient lists to exclude inactive patients

Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death.

Requirements

Need to be able to mark a patient record as not to be used because it was created in error.

Comments

If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient.

Meaning when missing

This resource is generally assumed to be active if no value is provided for the active element

Data type

boolean

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.status
  • rim: statusCode
  • cda: n/a
nameS Σ C1..*HumanName
There are no (further) constraints on this element
Element id
Patient.name
Short description

A name associated with the patient

Definition

A name associated with the individual.

Requirements

Need to be able to track the patient by multiple names. Examples are your official name and a partner name. The Alphabetic representation of the name SHALL be always provided

Comments

A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.

Data type

HumanName

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • core-pat-1: Either Patient.name.given and/or Patient.name.family and/or Patient.name.text SHALL be present or a Data Absent Reason Extension SHALL be present.
    (family.exists() or given.exists() or text.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()
Mappings
  • v2: PID-5, PID-9
  • rim: name
  • cda: .patient.name
id0..1string
There are no (further) constraints on this element
Element id
Patient.name.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Patient.name.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
useΣ ?!0..1codeBinding
There are no (further) constraints on this element
Element id
Patient.name.use
Short description

usual | official | temp | nickname | anonymous | old | maiden

Definition

Identifies the purpose for this name.

Requirements

Allows the appropriate name for a particular context of use to be selected from among a set of names.

Comments

Applications can assume that a name is current unless it explicitly says that it is temporary or old.

Data type

code

Binding

The use of a human name.

NameUse (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: XPN.7, but often indicated by which field contains the name
  • rim: unique(./use)
  • servd: ./NamePurpose
textS Σ0..1string
There are no (further) constraints on this element
Element id
Patient.name.text
Short description

Text representation of the full name

Definition

Text representation of the full name. Due to the cultural variance around the world a consuming system may not know how to present the name correctly; moreover not all the parts of the name go in given or family. Creators are therefore strongly encouraged to provide through this element a presented version of the name. Future versions of this guide may require this element

Requirements

A renderable, unencoded form.

Comments

Some systems will not have a field for representing the full name as a string, these systems are still expected to be able to demonstrate they can construct name.text when developing the patient summary instance

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: implied by XPN.11
  • rim: ./formatted
familyS Σ0..1string
There are no (further) constraints on this element
Element id
Patient.name.family
Short description

Family name (often called 'Surname')

Alternate names

surname

Definition

The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.

Comments

Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: XPN.1/FN.1
  • rim: ./part[partType = FAM]
  • servd: ./FamilyName
givenS Σ0..*string
There are no (further) constraints on this element
Element id
Patient.name.given
Short description

Given names (not always 'first'). Includes middle names

Alternate names

first name, middle name

Definition

Given name.

Comments

If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: XPN.2 + XPN.3
  • rim: ./part[partType = GIV]
  • servd: ./GivenNames
prefixΣ0..*string
There are no (further) constraints on this element
Element id
Patient.name.prefix
Short description

Parts that come before the name

Definition

Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: XPN.5
  • rim: ./part[partType = PFX]
  • servd: ./TitleCode
suffixΣ0..*string
There are no (further) constraints on this element
Element id
Patient.name.suffix
Short description

Parts that come after the name

Definition

Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: XPN/4
  • rim: ./part[partType = SFX]
periodΣ0..1Period
There are no (further) constraints on this element
Element id
Patient.name.period
Short description

Time period when name was/is in use

Definition

Indicates the period of time when this name was valid for the named person.

Requirements

Allows names to be placed in historical context.

Data type

Period

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: XPN.13 + XPN.14
  • rim: ./usablePeriod[type="IVL<TS>"]
  • servd: ./StartDate and ./EndDate
telecomΣ0..*ContactPoint
There are no (further) constraints on this element
Element id
Patient.telecom
Short description

A contact detail for the individual

Definition

A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted.

Requirements

People have (primary) ways to contact them in some way such as phone, email.

Comments

IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content.

Data type

ContactPoint

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: PID-13, PID-14, PID-40
  • rim: telecom
  • cda: .telecom
id0..1string
There are no (further) constraints on this element
Element id
Patient.telecom.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Patient.telecom.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
systemS Σ C0..1codeBinding
There are no (further) constraints on this element
Element id
Patient.telecom.system
Short description

phone | fax | email | pager | url | sms | other

Definition

Telecommunications form for contact point - what communications system is required to make use of the contact.

Data type

code

Binding

Telecommunications form for contact point.

ContactPointSystem (required)

Conditions

The cardinality or value of this element may be affected by these constraints: cpt-2

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: XTN.3
  • rim: ./scheme
  • servd: ./ContactPointType
valueS Σ0..1string
There are no (further) constraints on this element
Element id
Patient.telecom.value
Short description

The actual contact point details

Definition

The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

Requirements

Need to support legacy numbers that are not in a tightly controlled format.

Comments

Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: XTN.1 (or XTN.12)
  • rim: ./url
  • servd: ./Value
useS Σ ?!0..1codeBinding
There are no (further) constraints on this element
Element id
Patient.telecom.use
Short description

home | work | temp | old | mobile - purpose of this contact point

Definition

Identifies the purpose for the contact point.

Requirements

Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

Comments

Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

Data type

code

Binding

Use of contact point.

ContactPointUse (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: XTN.2 - but often indicated by field
  • rim: unique(./use)
  • servd: ./ContactPointPurpose
rankΣ0..1positiveInt
There are no (further) constraints on this element
Element id
Patient.telecom.rank
Short description

Specify preferred order of use (1 = highest)

Definition

Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.

Comments

Note that rank does not necessarily follow the order in which the contacts are represented in the instance.

Data type

positiveInt

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: n/a
  • rim: n/a
periodΣ0..1Period
There are no (further) constraints on this element
Element id
Patient.telecom.period
Short description

Time period when the contact point was/is in use

Definition

Time period when the contact point was/is in use.

Data type

Period

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: N/A
  • rim: ./usablePeriod[type="IVL<TS>"]
  • servd: ./StartDate and ./EndDate
genderS Σ0..1codeBinding
There are no (further) constraints on this element
Element id
Patient.gender
Short description

male | female | other | unknown

Definition

Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes.

Requirements

Needed for identification of the individual, in combination with (at least) name and birth date.

Comments

The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex.

Data type

code

Binding

The gender of a person used for administrative purposes.

AdministrativeGender (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: PID-8
  • rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender
  • cda: .patient.administrativeGenderCode
birthDateS Σ1..1date
There are no (further) constraints on this element
Element id
Patient.birthDate
Short description

The date of birth for the individual

Definition

The date of birth for the individual.

Requirements

Age of the individual drives many clinical processes.

Comments

While the birthDate element requires a value, if the exact date of birth is unknown, only the known portion of the date (e.g., the year) should be provided without estimating or inferring unknown parts of the date. Use of the Data Absent Reason is appropriate when the date of birth of an individual cannot be determined.

Data type

date

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: PID-7
  • rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/birthTime
  • cda: .patient.birthTime
  • loinc: 21112-8
deceased[x]Σ ?!0..1
There are no (further) constraints on this element
Element id
Patient.deceased[x]
Short description

Indicates if the individual is deceased or not

Definition

Indicates if the individual is deceased or not.

Requirements

The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.

Comments

If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: PID-30 (bool) and PID-29 (datetime)
  • rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedTime
  • cda: n/a
deceasedBooleanboolean
There are no (further) constraints on this element
Data type

boolean

deceasedDateTimedateTime
There are no (further) constraints on this element
Data type

dateTime

addressΣ0..*Address
There are no (further) constraints on this element
Element id
Patient.address
Short description

An address for the individual

Definition

An address for the individual.

Requirements

May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.

Comments

IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content.

Data type

Address

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: PID-11
  • rim: addr
  • cda: .addr
id0..1string
There are no (further) constraints on this element
Element id
Patient.address.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Patient.address.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
useΣ ?!0..1codeBinding
There are no (further) constraints on this element
Element id
Patient.address.use
Short description

home | work | temp | old | billing - purpose of this address

Definition

The purpose of this address.

Requirements

Allows an appropriate address to be chosen from a list of many.

Comments

Applications can assume that an address is current unless it explicitly says that it is temporary or old.

Data type

code

Binding

The use of an address.

AddressUse (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General
home
Mappings
  • v2: XAD.7
  • rim: unique(./use)
  • servd: ./AddressPurpose
typeΣ0..1codeBinding
There are no (further) constraints on this element
Element id
Patient.address.type
Short description

postal | physical | both

Definition

Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both.

Comments

The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource).

Data type

code

Binding

The type of an address (physical / postal).

AddressType (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General
both
Mappings
  • v2: XAD.18
  • rim: unique(./use)
  • vcard: address type parameter
textΣ0..1string
There are no (further) constraints on this element
Element id
Patient.address.text
Short description

Text representation of the address

Definition

Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts.

Requirements

A renderable, unencoded form.

Comments

Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General
137 Nowhere Street, Erewhon 9132
Mappings
  • v2: XAD.1 + XAD.2 + XAD.3 + XAD.4 + XAD.5 + XAD.6
  • rim: ./formatted
  • vcard: address label parameter
lineS Σ0..*string
There are no (further) constraints on this element
Element id
Patient.address.line
Short description

Street name, number, direction & P.O. Box etc.

Definition

This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General
137 Nowhere Street
Mappings
  • v2: XAD.1 + XAD.2 (note: XAD.1 and XAD.2 have different meanings for a company address than for a person address)
  • rim: AD.part[parttype = AL]
  • vcard: street
  • servd: ./StreetAddress (newline delimitted)
cityS Σ0..1string
There are no (further) constraints on this element
Element id
Patient.address.city
Short description

Name of city, town etc.

Alternate names

Municpality

Definition

The name of the city, town, suburb, village or other community or delivery center.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General
Erewhon
Mappings
  • v2: XAD.3
  • rim: AD.part[parttype = CTY]
  • vcard: locality
  • servd: ./Jurisdiction
districtΣ0..1string
There are no (further) constraints on this element
Element id
Patient.address.district
Short description

District name (aka county)

Alternate names

County

Definition

The name of the administrative area (county).

Comments

District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General
Madison
Mappings
  • v2: XAD.9
  • rim: AD.part[parttype = CNT | CPA]
stateΣ0..1string
There are no (further) constraints on this element
Element id
Patient.address.state
Short description

Sub-unit of country (abbreviations ok)

Alternate names

Province, Territory

Definition

Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes).

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: XAD.4
  • rim: AD.part[parttype = STA]
  • vcard: region
  • servd: ./Region
postalCodeS Σ0..1string
There are no (further) constraints on this element
Element id
Patient.address.postalCode
Short description

Postal code for area

Alternate names

Zip

Definition

A postal code designating a region defined by the postal service.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General
9132
Mappings
  • v2: XAD.5
  • rim: AD.part[parttype = ZIP]
  • vcard: code
  • servd: ./PostalIdentificationCode
countryS Σ0..1string
There are no (further) constraints on this element
Element id
Patient.address.country
Short description

Country (e.g. can be ISO 3166 2 or 3 letter code)

Definition

Country - a nation as commonly understood or generally accepted.

Comments

ISO 3166 3 letter codes can be used in place of a human readable country name.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: XAD.6
  • rim: AD.part[parttype = CNT]
  • vcard: country
  • servd: ./Country
periodΣ0..1Period
There are no (further) constraints on this element
Element id
Patient.address.period
Short description

Time period when address was/is in use

Definition

Time period when address was/is in use.

Requirements

Allows addresses to be placed in historical context.

Data type

Period

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General
{
  "start": "2010-03-23",
  "end": "2010-07-01"
}
Mappings
  • v2: XAD.12 / XAD.13 + XAD.14
  • rim: ./usablePeriod[type="IVL<TS>"]
  • servd: ./StartDate and ./EndDate
maritalStatus0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Patient.maritalStatus
Short description

Marital (civil) status of a patient

Definition

This field contains a patient's most recent marital (civil) status.

Requirements

Most, if not all systems capture it.

Data type

CodeableConcept

Binding

The domestic partnership status of a person.

Marital Status Codes (extensible)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: PID-16
  • rim: player[classCode=PSN]/maritalStatusCode
  • cda: .patient.maritalStatusCode
multipleBirth[x]0..1
There are no (further) constraints on this element
Element id
Patient.multipleBirth[x]
Short description

Whether patient is part of a multiple birth

Definition

Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer).

Requirements

For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs.

Comments

Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in triplets would be valueInteger=2 and the third born would have valueInteger=3 If a boolean value was provided for this triplets example, then all 3 patient records would have valueBoolean=true (the ordering is not indicated).

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: PID-24 (bool), PID-25 (integer)
  • rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber
  • cda: n/a
multipleBirthBooleanboolean
There are no (further) constraints on this element
Data type

boolean

multipleBirthIntegerinteger
There are no (further) constraints on this element
Data type

integer

photo0..*Attachment
There are no (further) constraints on this element
Element id
Patient.photo
Short description

Image of the patient

Definition

Image of the patient.

Requirements

Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too.

Comments

Guidelines:

  • Use id photos, not clinical photos.
  • Limit dimensions to thumbnail.
  • Keep byte count low to ease resource updates.
Data type

Attachment

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: OBX-5 - needs a profile
  • rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/desc
  • cda: n/a
contactC0..*BackboneElement
There are no (further) constraints on this element
Element id
Patient.contact
Short description

A contact party (e.g. guardian, partner, friend) for the patient

Definition

A contact party (e.g. guardian, partner, friend) for the patient.

Requirements

Need to track people you can contact about the patient.

Comments

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.

Data type

BackboneElement

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • pat-1: SHALL at least contain a contact's details or a reference to an organization
    name.exists() or telecom.exists() or address.exists() or organization.exists()
Mappings
  • rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON]
  • cda: n/a
id0..1string
There are no (further) constraints on this element
Element id
Patient.contact.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Patient.contact.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Patient.contact.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
relationship0..*CodeableConceptBinding
There are no (further) constraints on this element
Element id
Patient.contact.relationship
Short description

The kind of relationship

Definition

The nature of the relationship between the patient and the contact person.

Requirements

Used to determine which contact person is the most relevant to approach, depending on circumstances.

Data type

CodeableConcept

Binding

The nature of the relationship between a patient and a contact person for that patient.

PatientContactRelationship (extensible)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: NK1-7, NK1-3
  • rim: code
  • cda: n/a
name0..1HumanName
There are no (further) constraints on this element
Element id
Patient.contact.name
Short description

A name associated with the contact person

Definition

A name associated with the contact person.

Requirements

Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person.

Data type

HumanName

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: NK1-2
  • rim: name
  • cda: n/a
telecom0..*ContactPoint
There are no (further) constraints on this element
Element id
Patient.contact.telecom
Short description

A contact detail for the person

Definition

A contact detail for the person, e.g. a telephone number or an email address.

Requirements

People have (primary) ways to contact them in some way such as phone, email.

Comments

Contact may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification.

Data type

ContactPoint

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: NK1-5, NK1-6, NK1-40
  • rim: telecom
  • cda: n/a
address0..1Address
There are no (further) constraints on this element
Element id
Patient.contact.address
Short description

Address for the contact person

Definition

Address for the contact person.

Requirements

Need to keep track where the contact person can be contacted per postal mail or visited.

Data type

Address

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: NK1-4
  • rim: addr
  • cda: n/a
gender0..1codeBinding
There are no (further) constraints on this element
Element id
Patient.contact.gender
Short description

male | female | other | unknown

Definition

Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes.

Requirements

Needed to address the person correctly.

Data type

code

Binding

The gender of a person used for administrative purposes.

AdministrativeGender (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: NK1-15
  • rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender
  • cda: n/a
organizationC0..1Reference(Organization)
There are no (further) constraints on this element
Element id
Patient.contact.organization
Short description

Organization that is associated with the contact

Definition

Organization on behalf of which the contact is acting or for which the contact is working.

Requirements

For guardians or business related contacts, the organization is relevant.

Data type

Reference(Organization)

Conditions

The cardinality or value of this element may be affected by these constraints: pat-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: NK1-13, NK1-30, NK1-31, NK1-32, NK1-41
  • rim: scoper
  • cda: n/a
period0..1Period
There are no (further) constraints on this element
Element id
Patient.contact.period
Short description

The period during which this contact person or organization is valid to be contacted relating to this patient

Definition

The period during which this contact person or organization is valid to be contacted relating to this patient.

Data type

Period

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: effectiveTime
  • cda: n/a
communication0..*BackboneElement
There are no (further) constraints on this element
Element id
Patient.communication
Short description

A language which may be used to communicate with the patient about his or her health

Definition

A language which may be used to communicate with the patient about his or her health.

Requirements

If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest.

Comments

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.

Data type

BackboneElement

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: LanguageCommunication
  • cda: patient.languageCommunication
id0..1string
There are no (further) constraints on this element
Element id
Patient.communication.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Patient.communication.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Patient.communication.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
language1..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Patient.communication.language
Short description

The language which can be used to communicate with the patient about his or her health

Definition

The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English.

Requirements

Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.

Comments

The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.

Data type

CodeableConcept

Binding

A human language.

CommonLanguages (preferred)

Binding extensions
maxValueSetAllLanguages
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: PID-15, LAN-2
  • rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/languageCommunication/code
  • cda: .languageCode
preferred0..1boolean
There are no (further) constraints on this element
Element id
Patient.communication.preferred
Short description

Language preference indicator

Definition

Indicates whether or not the patient prefers this language (over other languages he masters up a certain level).

Requirements

People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method.

Comments

This language is specifically identified for communicating healthcare information.

Data type

boolean

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: PID-15
  • rim: preferenceInd
  • cda: .preferenceInd
generalPractitioner0..*Reference(Organization | Practitioner | PractitionerRole)
There are no (further) constraints on this element
Element id
Patient.generalPractitioner
Short description

Patient's nominated primary care provider

Alternate names

careProvider

Definition

Patient's nominated care provider.

Comments

IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content.

Data type

Reference(Organization | Practitioner | PractitionerRole)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: PD1-4
  • rim: subjectOf.CareEvent.performer.AssignedEntity
  • cda: n/a
managingOrganizationΣ0..1Reference(Organization)
There are no (further) constraints on this element
Element id
Patient.managingOrganization
Short description

Organization that is the custodian of the patient record

Definition

Organization that is the custodian of the patient record.

Requirements

Need to know who recognizes this patient record, manages and updates it.

Comments

There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association).

Data type

Reference(Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: scoper
  • cda: .providerOrganization
linkΣ ?!0..*BackboneElement
There are no (further) constraints on this element
Element id
Patient.link
Short description

Link to another patient resource that concerns the same actual person

Definition

Link to another patient resource that concerns the same actual patient.

Requirements

There are multiple use cases:

  • Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and
  • Distribution of patient information across multiple servers.
Comments

There is no assumption that linked patient records have mutual links.

Data type

BackboneElement

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: outboundLink
  • cda: n/a
id0..1string
There are no (further) constraints on this element
Element id
Patient.link.id
Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Patient.link.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Patient.link.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
otherΣ1..1Reference(Patient | RelatedPerson)
There are no (further) constraints on this element
Element id
Patient.link.other
Short description

The other patient or related person resource that the link refers to

Definition

The other patient resource that the link refers to.

Comments

Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.

Data type

Reference(Patient | RelatedPerson)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: PID-3, MRG-1
  • rim: id
  • cda: n/a
typeΣ1..1codeBinding
There are no (further) constraints on this element
Element id
Patient.link.type
Short description

replaced-by | replaces | refer | seealso

Definition

The type of link between this patient resource and another patient resource.

Data type

code

Binding

The type of link between this patient resource and another patient resource.

LinkType (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: typeCode
  • cda: n/a
<StructureDefinition xmlns="http://hl7.org/fhir">
<id value="patient-ca-ps" />
<url value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/patient-ca-ps" />
<name value="PatientPSCA" />
<title value="Patient (PS-CA)" />
<status value="draft" />
<experimental value="false" />
<date value="2024-04-09T00:00:00-08:00" />
<description value="This profile represents the constraints applied to the Patient resource by the PS-CA project to represent the minimum expectations for the Patient resource when used in the PS-CA composition profile or in one of the referred resources. It is informed by the constraints of the [Patient IPS-UV profile](http://hl7.org/fhir/uv/ips/StructureDefinition-Patient-uv-ips.html) and the [Canadian Baseline Profile](http://build.fhir.org/ig/HL7-Canada/ca-baseline/branches/master/StructureDefinition-profile-patient.html)" />
<copyright value="Copyright © 2024+ Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy)." />
<fhirVersion value="4.0.1" />
<kind value="resource" />
<abstract value="false" />
<type value="Patient" />
<baseDefinition value="http://hl7.org/fhir/StructureDefinition/Patient" />
<derivation value="constraint" />
<snapshot>
<element id="Patient">
<path value="Patient" />
<short value="Information about an individual or animal receiving health care services" />
<definition value="Demographics and other administrative information about an individual or animal receiving care or other health-related services." />
<alias value="SubjectOfCare Client Resident" />
<min value="0" />
<max value="*" />
<base>
<path value="Patient" />
<min value="0" />
<max value="*" />
</base>
<constraint>
<key value="dom-2" />
<severity value="error" />
<human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources" />
<expression value="contained.contained.empty()" />
<xpath value="not(parent::f:contained and f:contained)" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<constraint>
<key value="dom-3" />
<severity value="error" />
<human value="If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource" />
<expression value="contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()" />
<xpath value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<constraint>
<key value="dom-4" />
<severity value="error" />
<human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" />
<expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()" />
<xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<constraint>
<key value="dom-5" />
<severity value="error" />
<human value="If a resource is contained in another resource, it SHALL NOT have a security label" />
<expression value="contained.meta.security.empty()" />
<xpath value="not(exists(f:contained/*/f:meta/f:security))" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<constraint>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
<valueBoolean value="true" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
<valueMarkdown value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time." />
</extension>
<key value="dom-6" />
<severity value="warning" />
<human value="A resource should have narrative for robust management" />
<expression value="text.`div`.exists()" />
<xpath value="exists(f:text/h:div)" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="Entity. Role, or Act" />
</mapping>
<mapping>
<identity value="rim" />
<map value="Patient[classCode=PAT]" />
</mapping>
<mapping>
<identity value="cda" />
<map value="ClinicalDocument.recordTarget.patientRole" />
</mapping>
</element>
<element id="Patient.id">
<path value="Patient.id" />
<short value="Logical id of this artifact" />
<definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes." />
<comment value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation." />
<min value="0" />
<max value="1" />
<base>
<path value="Resource.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="true" />
</element>
<element id="Patient.meta">
<path value="Patient.meta" />
<short value="Metadata about the resource" />
<definition value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource." />
<min value="0" />
<max value="1" />
<base>
<path value="Resource.meta" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Meta" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
</element>
<element id="Patient.implicitRules">
<path value="Patient.implicitRules" />
<short value="A set of rules under which this content was created" />
<definition value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc." />
<comment value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc." />
<min value="0" />
<max value="1" />
<base>
<path value="Resource.implicitRules" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="uri" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="true" />
<isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation" />
<isSummary value="true" />
</element>
<element id="Patient.language">
<path value="Patient.language" />
<short value="Language of the resource content" />
<definition value="The base language in which the resource is written." />
<comment value="Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)." />
<min value="0" />
<max value="1" />
<base>
<path value="Resource.language" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
<valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="Language" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
<valueBoolean value="true" />
</extension>
<strength value="preferred" />
<description value="A human language." />
<valueSet value="http://hl7.org/fhir/ValueSet/languages" />
</binding>
</element>
<element id="Patient.text">
<path value="Patient.text" />
<short value="Text summary of the resource, for human interpretation" />
<definition value="A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety." />
<comment value="Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later." />
<alias value="narrative" />
<alias value="html" />
<alias value="xhtml" />
<alias value="display" />
<min value="0" />
<max value="1" />
<base>
<path value="DomainResource.text" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Narrative" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="Act.text?" />
</mapping>
</element>
<element id="Patient.contained">
<path value="Patient.contained" />
<short value="Contained, inline Resources" />
<definition value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope." />
<comment value="This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels." />
<alias value="inline resources" />
<alias value="anonymous resources" />
<alias value="contained resources" />
<min value="0" />
<max value="*" />
<base>
<path value="DomainResource.contained" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Resource" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Patient.extension">
<path value="Patient.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="DomainResource.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Patient.extension:individual-recordedSexOrGender">
<path value="Patient.extension" />
<sliceName value="individual-recordedSexOrGender" />
<short value="Extension for representing an individuals recorded sex or gender." />
<definition value="Recorded sex or gender (RSG) information includes the various sex and gender concepts that are often used in existing systems but are known NOT to represent a gender identity, sex parameter for clinical use, or attributes related to sexuality, such as sexual orientation, sexual activity, or sexual attraction. Examples of recorded sex or gender concepts include administrative gender, administrative sex, and sex assigned at birth. When exchanging this concept, refer to the guidance in the Gender Harmony Implementation Guide" />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="DomainResource.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Patient.modifierExtension">
<path value="Patient.modifierExtension" />
<short value="Extensions that cannot be ignored" />
<definition value="May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="DomainResource.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Patient.identifier">
<path value="Patient.identifier" />
<slicing>
<discriminator>
<type value="pattern" />
<path value="type" />
</discriminator>
<rules value="open" />
</slicing>
<short value="An identifier intended for computation" />
<definition value="An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers." />
<comment value="This element employs the constraints on identifier put forth in the CA Baseline using a profiled data type." />
<requirements value="Patients are almost always assigned specific numerical identifiers." />
<min value="0" />
<max value="*" />
<base>
<path value="Patient.identifier" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Identifier" />
<profile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-identifier" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="w5" />
<map value="FiveWs.identifier" />
</mapping>
<mapping>
<identity value="v2" />
<map value="PID-3" />
</mapping>
<mapping>
<identity value="rim" />
<map value="id" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".id" />
</mapping>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
</mapping>
<mapping>
<identity value="rim" />
<map value="II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]" />
</mapping>
<mapping>
<identity value="servd" />
<map value="Identifier" />
</mapping>
</element>
<element id="Patient.identifier.id">
<path value="Patient.identifier.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Patient.identifier.extension">
<path value="Patient.identifier.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Patient.identifier.use">
<path value="Patient.identifier.use" />
<short value="usual | official | temp | secondary | old (If known)" />
<definition value="The purpose of this identifier." />
<comment value="Applications can assume that an identifier is permanent unless it explicitly says that it is temporary." />
<requirements value="Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers." />
<min value="0" />
<max value="1" />
<base>
<path value="Identifier.use" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="true" />
<isModifierReason value="This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one." />
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="IdentifierUse" />
</extension>
<strength value="required" />
<description value="Identifies the purpose for this identifier, if known ." />
<valueSet value="http://hl7.org/fhir/ValueSet/identifier-use|4.0.1" />
</binding>
<mapping>
<identity value="v2" />
<map value="N/A" />
</mapping>
<mapping>
<identity value="rim" />
<map value="Role.code or implied by context" />
</mapping>
</element>
<element id="Patient.identifier.type">
<path value="Patient.identifier.type" />
<short value="Description of identifier" />
<definition value="A coded type for the identifier that can be used to determine which identifier to use for a specific purpose." />
<comment value="The slices provided below are examples of identifier types used by jurisdictions for patient summary. These are not required, and the slicing is open meaning that other types can be provided and used in an implementation." />
<requirements value="Allows users to make use of identifiers when the identifier system is not known." />
<min value="0" />
<max value="1" />
<base>
<path value="Identifier.type" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="IdentifierType" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
<valueBoolean value="true" />
</extension>
<strength value="extensible" />
<description value="A coded type for an identifier that can be used to determine which identifier to use for a specific purpose." />
<valueSet value="http://hl7.org/fhir/ValueSet/identifier-type" />
</binding>
<mapping>
<identity value="v2" />
<map value="CX.5" />
</mapping>
<mapping>
<identity value="rim" />
<map value="Role.code or implied by context" />
</mapping>
</element>
<element id="Patient.identifier.system">
<path value="Patient.identifier.system" />
<short value="The namespace for the identifier value" />
<definition value="Establishes the namespace for the value - that is, a URL that describes a set values that are unique." />
<comment value="Identifier.system is always case sensitive." />
<requirements value="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." />
<min value="1" />
<max value="1" />
<base>
<path value="Identifier.system" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="uri" />
</type>
<example>
<label value="General" />
<valueUri value="http://www.acme.com/identifiers/patient" />
</example>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="CX.4 / EI-2-4" />
</mapping>
<mapping>
<identity value="rim" />
<map value="II.root or Role.id.root" />
</mapping>
<mapping>
<identity value="servd" />
<map value="./IdentifierType" />
</mapping>
</element>
<element id="Patient.identifier.value">
<path value="Patient.identifier.value" />
<short value="The value that is unique within the system." />
<definition value="The portion of the identifier typically relevant to the user and which is unique within the context of the system." />
<comment value="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](http://hl7.org/fhir/R4/extension-rendered-value.html). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe." />
<min value="1" />
<max value="1" />
<base>
<path value="Identifier.value" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<example>
<label value="General" />
<valueString value="123456" />
</example>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="CX.1 / EI.1" />
</mapping>
<mapping>
<identity value="rim" />
<map value="II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)" />
</mapping>
<mapping>
<identity value="servd" />
<map value="./Value" />
</mapping>
</element>
<element id="Patient.identifier.period">
<path value="Patient.identifier.period" />
<short value="Time period when id is/was valid for use" />
<definition value="Time period during which identifier is/was valid for use." />
<min value="0" />
<max value="1" />
<base>
<path value="Identifier.period" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Period" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="CX.7 + CX.8" />
</mapping>
<mapping>
<identity value="rim" />
<map value="Role.effectiveTime or implied by context" />
</mapping>
<mapping>
<identity value="servd" />
<map value="./StartDate and ./EndDate" />
</mapping>
</element>
<element id="Patient.identifier.assigner">
<path value="Patient.identifier.assigner" />
<short value="Organization that issued id (may be just text)" />
<definition value="Organization that issued/manages the identifier." />
<comment value="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." />
<min value="0" />
<max value="1" />
<base>
<path value="Identifier.assigner" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="CX.4 / (CX.4,CX.9,CX.10)" />
</mapping>
<mapping>
<identity value="rim" />
<map value="II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper" />
</mapping>
<mapping>
<identity value="servd" />
<map value="./IdentifierIssuingAuthority" />
</mapping>
</element>
<element id="Patient.identifier:JHN">
<path value="Patient.identifier" />
<sliceName value="JHN" />
<short value="Jurisdictional Health Number" />
<definition value="Federal patient and person health numbers used by all jurisdictions across Canada" />
<requirements value="Patients are almost always assigned specific numerical identifiers." />
<min value="0" />
<max value="*" />
<base>
<path value="Patient.identifier" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Identifier" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="w5" />
<map value="FiveWs.identifier" />
</mapping>
<mapping>
<identity value="v2" />
<map value="PID-3" />
</mapping>
<mapping>
<identity value="rim" />
<map value="id" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".id" />
</mapping>
</element>
<element id="Patient.identifier:JHN.id">
<path value="Patient.identifier.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Patient.identifier:JHN.extension">
<path value="Patient.identifier.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Patient.identifier:JHN.extension:versionCode">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
<valueCode value="normative" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
<valueCode value="4.0.0" />
</extension>
<path value="Patient.identifier.extension" />
<sliceName value="versionCode" />
<short value="Health Number Version Code" />
<definition value="A code indicating a specific version of an identifier credential" />
<comment value="For example, a health card version number, credit card version number, etc. Used to help verify the authenticity of a credential" />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="1" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-identifierversion" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mustSupport value="false" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Patient.identifier:JHN.use">
<path value="Patient.identifier.use" />
<short value="usual | official | temp | secondary | old (If known)" />
<definition value="The purpose of this identifier." />
<comment value="Applications can assume that an identifier is permanent unless it explicitly says that it is temporary." />
<requirements value="Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers." />
<min value="0" />
<max value="1" />
<base>
<path value="Identifier.use" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="true" />
<isModifierReason value="This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one." />
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="IdentifierUse" />
</extension>
<strength value="required" />
<description value="Identifies the purpose for this identifier, if known ." />
<valueSet value="http://hl7.org/fhir/ValueSet/identifier-use|4.0.1" />
</binding>
<mapping>
<identity value="v2" />
<map value="N/A" />
</mapping>
<mapping>
<identity value="rim" />
<map value="Role.code or implied by context" />
</mapping>
</element>
<element id="Patient.identifier:JHN.type">
<path value="Patient.identifier.type" />
<short value="Description of identifier" />
<definition value="A coded type for the identifier that can be used to determine which identifier to use for a specific purpose." />
<comment value="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." />
<requirements value="Allows users to make use of identifiers when the identifier system is not known." />
<min value="1" />
<max value="1" />
<base>
<path value="Identifier.type" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<patternCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203" />
<code value="JHN" />
</coding>
</patternCodeableConcept>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="IdentifierType" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
<valueBoolean value="true" />
</extension>
<strength value="extensible" />
<description value="A coded type for an identifier that can be used to determine which identifier to use for a specific purpose." />
<valueSet value="http://hl7.org/fhir/ValueSet/identifier-type" />
</binding>
<mapping>
<identity value="v2" />
<map value="CX.5" />
</mapping>
<mapping>
<identity value="rim" />
<map value="Role.code or implied by context" />
</mapping>
</element>
<element id="Patient.identifier:JHN.system">
<path value="Patient.identifier.system" />
<short value="A Health Number Naming System from the Canadian URI Registry" />
<definition value="Establishes the namespace for the value - that is, a URL that describes a set values that are unique." />
<comment value="Identifier.system is always case sensitive." />
<requirements value="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." />
<min value="1" />
<max value="1" />
<base>
<path value="Identifier.system" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="uri" />
</type>
<example>
<label value="General" />
<valueUri value="http://www.acme.com/identifiers/patient" />
</example>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="CX.4 / EI-2-4" />
</mapping>
<mapping>
<identity value="rim" />
<map value="II.root or Role.id.root" />
</mapping>
<mapping>
<identity value="servd" />
<map value="./IdentifierType" />
</mapping>
</element>
<element id="Patient.identifier:JHN.value">
<path value="Patient.identifier.value" />
<short value="The value that is unique" />
<definition value="The portion of the identifier typically relevant to the user and which is unique within the context of the system." />
<comment value="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](extension-rendered-value.html). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe." />
<min value="1" />
<max value="1" />
<base>
<path value="Identifier.value" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<example>
<label value="General" />
<valueString value="123456" />
</example>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="CX.1 / EI.1" />
</mapping>
<mapping>
<identity value="rim" />
<map value="II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)" />
</mapping>
<mapping>
<identity value="servd" />
<map value="./Value" />
</mapping>
</element>
<element id="Patient.identifier:JHN.period">
<path value="Patient.identifier.period" />
<short value="Time period when id is/was valid for use" />
<definition value="Time period during which identifier is/was valid for use." />
<min value="0" />
<max value="1" />
<base>
<path value="Identifier.period" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Period" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="CX.7 + CX.8" />
</mapping>
<mapping>
<identity value="rim" />
<map value="Role.effectiveTime or implied by context" />
</mapping>
<mapping>
<identity value="servd" />
<map value="./StartDate and ./EndDate" />
</mapping>
</element>
<element id="Patient.identifier:JHN.assigner">
<path value="Patient.identifier.assigner" />
<short value="Organization that issued id (may be just text)" />
<definition value="Organization that issued/manages the identifier." />
<comment value="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." />
<min value="0" />
<max value="1" />
<base>
<path value="Identifier.assigner" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="CX.4 / (CX.4,CX.9,CX.10)" />
</mapping>
<mapping>
<identity value="rim" />
<map value="II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper" />
</mapping>
<mapping>
<identity value="servd" />
<map value="./IdentifierIssuingAuthority" />
</mapping>
</element>
<element id="Patient.identifier:MRN">
<path value="Patient.identifier" />
<sliceName value="MRN" />
<short value="Medical Record Number" />
<definition value="A local patient identifier from the submitting PoS System" />
<comment value="Some jurisdictions may consider the MRN identifier type to be an alternative to the JHN identifier type under certain scenarios. These business rules are outside the scope of this profile, however the slice is socialized to prepare implementers for potential use of this pattern within certain jurisdictions" />
<requirements value="Patients are almost always assigned specific numerical identifiers." />
<min value="0" />
<max value="*" />
<base>
<path value="Patient.identifier" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Identifier" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="w5" />
<map value="FiveWs.identifier" />
</mapping>
<mapping>
<identity value="v2" />
<map value="PID-3" />
</mapping>
<mapping>
<identity value="rim" />
<map value="id" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".id" />
</mapping>
</element>
<element id="Patient.identifier:MRN.id">
<path value="Patient.identifier.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Patient.identifier:MRN.extension">
<path value="Patient.identifier.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Patient.identifier:MRN.use">
<path value="Patient.identifier.use" />
<short value="usual | official | temp | secondary | old (If known)" />
<definition value="The purpose of this identifier." />
<comment value="Applications can assume that an identifier is permanent unless it explicitly says that it is temporary." />
<requirements value="Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers." />
<min value="0" />
<max value="1" />
<base>
<path value="Identifier.use" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="true" />
<isModifierReason value="This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one." />
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="IdentifierUse" />
</extension>
<strength value="required" />
<description value="Identifies the purpose for this identifier, if known ." />
<valueSet value="http://hl7.org/fhir/ValueSet/identifier-use|4.0.1" />
</binding>
<mapping>
<identity value="v2" />
<map value="N/A" />
</mapping>
<mapping>
<identity value="rim" />
<map value="Role.code or implied by context" />
</mapping>
</element>
<element id="Patient.identifier:MRN.type">
<path value="Patient.identifier.type" />
<short value="Description of identifier" />
<definition value="A coded type for the identifier that can be used to determine which identifier to use for a specific purpose." />
<comment value="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." />
<requirements value="Allows users to make use of identifiers when the identifier system is not known." />
<min value="1" />
<max value="1" />
<base>
<path value="Identifier.type" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<patternCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203" />
<code value="MR" />
</coding>
</patternCodeableConcept>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="IdentifierType" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
<valueBoolean value="true" />
</extension>
<strength value="extensible" />
<description value="A coded type for an identifier that can be used to determine which identifier to use for a specific purpose." />
<valueSet value="http://hl7.org/fhir/ValueSet/identifier-type" />
</binding>
<mapping>
<identity value="v2" />
<map value="CX.5" />
</mapping>
<mapping>
<identity value="rim" />
<map value="Role.code or implied by context" />
</mapping>
</element>
<element id="Patient.identifier:MRN.system">
<path value="Patient.identifier.system" />
<short value="An identifier for the system supplying the MRN" />
<definition value="Establishes the namespace for the value - that is, a URL that describes a set values that are unique." />
<comment value="Identifier.system is always case sensitive." />
<requirements value="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." />
<min value="1" />
<max value="1" />
<base>
<path value="Identifier.system" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="uri" />
</type>
<example>
<label value="General" />
<valueUri value="http://www.acme.com/identifiers/patient" />
</example>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="CX.4 / EI-2-4" />
</mapping>
<mapping>
<identity value="rim" />
<map value="II.root or Role.id.root" />
</mapping>
<mapping>
<identity value="servd" />
<map value="./IdentifierType" />
</mapping>
</element>
<element id="Patient.identifier:MRN.value">
<path value="Patient.identifier.value" />
<short value="The value that is unique" />
<definition value="The portion of the identifier typically relevant to the user and which is unique within the context of the system." />
<comment value="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](extension-rendered-value.html). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe." />
<min value="1" />
<max value="1" />
<base>
<path value="Identifier.value" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<example>
<label value="General" />
<valueString value="123456" />
</example>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="CX.1 / EI.1" />
</mapping>
<mapping>
<identity value="rim" />
<map value="II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)" />
</mapping>
<mapping>
<identity value="servd" />
<map value="./Value" />
</mapping>
</element>
<element id="Patient.identifier:MRN.period">
<path value="Patient.identifier.period" />
<short value="Time period when id is/was valid for use" />
<definition value="Time period during which identifier is/was valid for use." />
<min value="0" />
<max value="1" />
<base>
<path value="Identifier.period" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Period" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="CX.7 + CX.8" />
</mapping>
<mapping>
<identity value="rim" />
<map value="Role.effectiveTime or implied by context" />
</mapping>
<mapping>
<identity value="servd" />
<map value="./StartDate and ./EndDate" />
</mapping>
</element>
<element id="Patient.identifier:MRN.assigner">
<path value="Patient.identifier.assigner" />
<short value="Organization that issued id (may be just text)" />
<definition value="Organization that issued/manages the identifier." />
<comment value="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." />
<min value="0" />
<max value="1" />
<base>
<path value="Identifier.assigner" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="CX.4 / (CX.4,CX.9,CX.10)" />
</mapping>
<mapping>
<identity value="rim" />
<map value="II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper" />
</mapping>
<mapping>
<identity value="servd" />
<map value="./IdentifierIssuingAuthority" />
</mapping>
</element>
<element id="Patient.active">
<path value="Patient.active" />
<short value="Whether this patient's record is in active use" />
<definition value="Whether this patient record is in active use. \nMany systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules.\n\nIt is often used to filter patient lists to exclude inactive patients\n\nDeceased patients may also be marked as inactive for the same reasons, but may be active for some time after death." />
<comment value="If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient." />
<requirements value="Need to be able to mark a patient record as not to be used because it was created in error." />
<min value="0" />
<max value="1" />
<base>
<path value="Patient.active" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="boolean" />
</type>
<meaningWhenMissing value="This resource is generally assumed to be active if no value is provided for the active element" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="true" />
<isModifierReason value="This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid" />
<isSummary value="true" />
<mapping>
<identity value="w5" />
<map value="FiveWs.status" />
</mapping>
<mapping>
<identity value="rim" />
<map value="statusCode" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Patient.name">
<path value="Patient.name" />
<short value="A name associated with the patient" />
<definition value="A name associated with the individual." />
<comment value="A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns." />
<requirements value="Need to be able to track the patient by multiple names. Examples are your official name and a partner name.\nThe Alphabetic representation of the name SHALL be always provided" />
<min value="1" />
<max value="*" />
<base>
<path value="Patient.name" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="HumanName" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="core-pat-1" />
<severity value="error" />
<human value="Either Patient.name.given and/or Patient.name.family and/or Patient.name.text SHALL be present or a Data Absent Reason Extension SHALL be present." />
<expression value="(family.exists() or given.exists() or text.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()" />
<xpath value="(/f:name/f:extension/@url='http://hl7.org/fhir/StructureDefinition/data-absent-reason' and not(/f:name/f:family or /f:name/f:given or /f:name/f:text)) or (not(/f:name/f:extension/@url='http://hl7.org/fhir/StructureDefinition/data-absent-reason') and (/f:name/f:family or /f:name/f:given or /f:name/f:text))" />
<source value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/patient-ca-ps" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="PID-5, PID-9" />
</mapping>
<mapping>
<identity value="rim" />
<map value="name" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".patient.name" />
</mapping>
</element>
<element id="Patient.name.id">
<path value="Patient.name.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Patient.name.extension">
<path value="Patient.name.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Patient.name.use">
<path value="Patient.name.use" />
<short value="usual | official | temp | nickname | anonymous | old | maiden" />
<definition value="Identifies the purpose for this name." />
<comment value="Applications can assume that a name is current unless it explicitly says that it is temporary or old." />
<requirements value="Allows the appropriate name for a particular context of use to be selected from among a set of names." />
<min value="0" />
<max value="1" />
<base>
<path value="HumanName.use" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="true" />
<isModifierReason value="This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one" />
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="NameUse" />
</extension>
<strength value="required" />
<description value="The use of a human name." />
<valueSet value="http://hl7.org/fhir/ValueSet/name-use|4.0.1" />
</binding>
<mapping>
<identity value="v2" />
<map value="XPN.7, but often indicated by which field contains the name" />
</mapping>
<mapping>
<identity value="rim" />
<map value="unique(./use)" />
</mapping>
<mapping>
<identity value="servd" />
<map value="./NamePurpose" />
</mapping>
</element>
<element id="Patient.name.text">
<path value="Patient.name.text" />
<short value="Text representation of the full name" />
<definition value="Text representation of the full name. Due to the cultural variance around the world a consuming system may not know how to present the name correctly; moreover not all the parts of the name go in given or family. Creators are therefore strongly encouraged to provide through this element a presented version of the name. Future versions of this guide may require this element" />
<comment value="Some systems will not have a field for representing the full name as a string, these systems are still expected to be able to demonstrate they can construct name.text when developing the patient summary instance" />
<requirements value="A renderable, unencoded form." />
<min value="0" />
<max value="1" />
<base>
<path value="HumanName.text" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="implied by XPN.11" />
</mapping>
<mapping>
<identity value="rim" />
<map value="./formatted" />
</mapping>
</element>
<element id="Patient.name.family">
<path value="Patient.name.family" />
<short value="Family name (often called 'Surname')" />
<definition value="The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father." />
<comment value="Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures)." />
<alias value="surname" />
<min value="0" />
<max value="1" />
<base>
<path value="HumanName.family" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="XPN.1/FN.1" />
</mapping>
<mapping>
<identity value="rim" />
<map value="./part[partType = FAM]" />
</mapping>
<mapping>
<identity value="servd" />
<map value="./FamilyName" />
</mapping>
</element>
<element id="Patient.name.given">
<path value="Patient.name.given" />
<short value="Given names (not always 'first'). Includes middle names" />
<definition value="Given name." />
<comment value="If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first." />
<alias value="first name" />
<alias value="middle name" />
<min value="0" />
<max value="*" />
<base>
<path value="HumanName.given" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="string" />
</type>
<orderMeaning value="Given Names appear in the correct order for presenting the name" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="XPN.2 + XPN.3" />
</mapping>
<mapping>
<identity value="rim" />
<map value="./part[partType = GIV]" />
</mapping>
<mapping>
<identity value="servd" />
<map value="./GivenNames" />
</mapping>
</element>
<element id="Patient.name.prefix">
<path value="Patient.name.prefix" />
<short value="Parts that come before the name" />
<definition value="Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name." />
<min value="0" />
<max value="*" />
<base>
<path value="HumanName.prefix" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="string" />
</type>
<orderMeaning value="Prefixes appear in the correct order for presenting the name" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="XPN.5" />
</mapping>
<mapping>
<identity value="rim" />
<map value="./part[partType = PFX]" />
</mapping>
<mapping>
<identity value="servd" />
<map value="./TitleCode" />
</mapping>
</element>
<element id="Patient.name.suffix">
<path value="Patient.name.suffix" />
<short value="Parts that come after the name" />
<definition value="Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name." />
<min value="0" />
<max value="*" />
<base>
<path value="HumanName.suffix" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="string" />
</type>
<orderMeaning value="Suffixes appear in the correct order for presenting the name" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="XPN/4" />
</mapping>
<mapping>
<identity value="rim" />
<map value="./part[partType = SFX]" />
</mapping>
</element>
<element id="Patient.name.period">
<path value="Patient.name.period" />
<short value="Time period when name was/is in use" />
<definition value="Indicates the period of time when this name was valid for the named person." />
<requirements value="Allows names to be placed in historical context." />
<min value="0" />
<max value="1" />
<base>
<path value="HumanName.period" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Period" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="XPN.13 + XPN.14" />
</mapping>
<mapping>
<identity value="rim" />
<map value="./usablePeriod[type="IVL<TS>"]" />
</mapping>
<mapping>
<identity value="servd" />
<map value="./StartDate and ./EndDate" />
</mapping>
</element>
<element id="Patient.telecom">
<path value="Patient.telecom" />
<short value="A contact detail for the individual" />
<definition value="A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted." />
<comment value="IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content." />
<requirements value="People have (primary) ways to contact them in some way such as phone, email." />
<min value="0" />
<max value="*" />
<base>
<path value="Patient.telecom" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="ContactPoint" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="PID-13, PID-14, PID-40" />
</mapping>
<mapping>
<identity value="rim" />
<map value="telecom" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".telecom" />
</mapping>
</element>
<element id="Patient.telecom.id">
<path value="Patient.telecom.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Patient.telecom.extension">
<path value="Patient.telecom.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Patient.telecom.system">
<path value="Patient.telecom.system" />
<short value="phone | fax | email | pager | url | sms | other" />
<definition value="Telecommunications form for contact point - what communications system is required to make use of the contact." />
<min value="0" />
<max value="1" />
<base>
<path value="ContactPoint.system" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<condition value="cpt-2" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ContactPointSystem" />
</extension>
<strength value="required" />
<description value="Telecommunications form for contact point." />
<valueSet value="http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1" />
</binding>
<mapping>
<identity value="v2" />
<map value="XTN.3" />
</mapping>
<mapping>
<identity value="rim" />
<map value="./scheme" />
</mapping>
<mapping>
<identity value="servd" />
<map value="./ContactPointType" />
</mapping>
</element>
<element id="Patient.telecom.value">
<path value="Patient.telecom.value" />
<short value="The actual contact point details" />
<definition value="The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address)." />
<comment value="Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value." />
<requirements value="Need to support legacy numbers that are not in a tightly controlled format." />
<min value="0" />
<max value="1" />
<base>
<path value="ContactPoint.value" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="XTN.1 (or XTN.12)" />
</mapping>
<mapping>
<identity value="rim" />
<map value="./url" />
</mapping>
<mapping>
<identity value="servd" />
<map value="./Value" />
</mapping>
</element>
<element id="Patient.telecom.use">
<path value="Patient.telecom.use" />
<short value="home | work | temp | old | mobile - purpose of this contact point" />
<definition value="Identifies the purpose for the contact point." />
<comment value="Applications can assume that a contact is current unless it explicitly says that it is temporary or old." />
<requirements value="Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose." />
<min value="0" />
<max value="1" />
<base>
<path value="ContactPoint.use" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="true" />
<isModifierReason value="This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one" />
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ContactPointUse" />
</extension>
<strength value="required" />
<description value="Use of contact point." />
<valueSet value="http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1" />
</binding>
<mapping>
<identity value="v2" />
<map value="XTN.2 - but often indicated by field" />
</mapping>
<mapping>
<identity value="rim" />
<map value="unique(./use)" />
</mapping>
<mapping>
<identity value="servd" />
<map value="./ContactPointPurpose" />
</mapping>
</element>
<element id="Patient.telecom.rank">
<path value="Patient.telecom.rank" />
<short value="Specify preferred order of use (1 = highest)" />
<definition value="Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values." />
<comment value="Note that rank does not necessarily follow the order in which the contacts are represented in the instance." />
<min value="0" />
<max value="1" />
<base>
<path value="ContactPoint.rank" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="positiveInt" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Patient.telecom.period">
<path value="Patient.telecom.period" />
<short value="Time period when the contact point was/is in use" />
<definition value="Time period when the contact point was/is in use." />
<min value="0" />
<max value="1" />
<base>
<path value="ContactPoint.period" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Period" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="N/A" />
</mapping>
<mapping>
<identity value="rim" />
<map value="./usablePeriod[type="IVL<TS>"]" />
</mapping>
<mapping>
<identity value="servd" />
<map value="./StartDate and ./EndDate" />
</mapping>
</element>
<element id="Patient.gender">
<path value="Patient.gender" />
<short value="male | female | other | unknown" />
<definition value="Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes." />
<comment value="The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex." />
<requirements value="Needed for identification of the individual, in combination with (at least) name and birth date." />
<min value="0" />
<max value="1" />
<base>
<path value="Patient.gender" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="AdministrativeGender" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
<valueBoolean value="true" />
</extension>
<strength value="required" />
<description value="The gender of a person used for administrative purposes." />
<valueSet value="http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1" />
</binding>
<mapping>
<identity value="v2" />
<map value="PID-8" />
</mapping>
<mapping>
<identity value="rim" />
<map value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".patient.administrativeGenderCode" />
</mapping>
</element>
<element id="Patient.birthDate">
<path value="Patient.birthDate" />
<short value="The date of birth for the individual" />
<definition value="The date of birth for the individual." />
<comment value="While the birthDate element requires a value, if the exact date of birth is unknown, only the known portion of the date (e.g., the year) should be provided without estimating or inferring unknown parts of the date. Use of the Data Absent Reason is appropriate when the date of birth of an individual cannot be determined." />
<requirements value="Age of the individual drives many clinical processes." />
<min value="1" />
<max value="1" />
<base>
<path value="Patient.birthDate" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="date" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="PID-7" />
</mapping>
<mapping>
<identity value="rim" />
<map value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/birthTime" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".patient.birthTime" />
</mapping>
<mapping>
<identity value="loinc" />
<map value="21112-8" />
</mapping>
</element>
<element id="Patient.deceased[x]">
<path value="Patient.deceased[x]" />
<short value="Indicates if the individual is deceased or not" />
<definition value="Indicates if the individual is deceased or not." />
<comment value="If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive." />
<requirements value="The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive." />
<min value="0" />
<max value="1" />
<base>
<path value="Patient.deceased[x]" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="boolean" />
</type>
<type>
<code value="dateTime" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="true" />
<isModifierReason value="This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different." />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="PID-30 (bool) and PID-29 (datetime)" />
</mapping>
<mapping>
<identity value="rim" />
<map value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedTime" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Patient.address">
<path value="Patient.address" />
<short value="An address for the individual" />
<definition value="An address for the individual." />
<comment value="IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content." />
<requirements value="May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification." />
<min value="0" />
<max value="*" />
<base>
<path value="Patient.address" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Address" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="PID-11" />
</mapping>
<mapping>
<identity value="rim" />
<map value="addr" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".addr" />
</mapping>
</element>
<element id="Patient.address.id">
<path value="Patient.address.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Patient.address.extension">
<path value="Patient.address.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Patient.address.use">
<path value="Patient.address.use" />
<short value="home | work | temp | old | billing - purpose of this address" />
<definition value="The purpose of this address." />
<comment value="Applications can assume that an address is current unless it explicitly says that it is temporary or old." />
<requirements value="Allows an appropriate address to be chosen from a list of many." />
<min value="0" />
<max value="1" />
<base>
<path value="Address.use" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<example>
<label value="General" />
<valueCode value="home" />
</example>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="true" />
<isModifierReason value="This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one" />
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="AddressUse" />
</extension>
<strength value="required" />
<description value="The use of an address." />
<valueSet value="http://hl7.org/fhir/ValueSet/address-use|4.0.1" />
</binding>
<mapping>
<identity value="v2" />
<map value="XAD.7" />
</mapping>
<mapping>
<identity value="rim" />
<map value="unique(./use)" />
</mapping>
<mapping>
<identity value="servd" />
<map value="./AddressPurpose" />
</mapping>
</element>
<element id="Patient.address.type">
<path value="Patient.address.type" />
<short value="postal | physical | both" />
<definition value="Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both." />
<comment value="The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the [Location](location.html#) resource)." />
<min value="0" />
<max value="1" />
<base>
<path value="Address.type" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<example>
<label value="General" />
<valueCode value="both" />
</example>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="AddressType" />
</extension>
<strength value="required" />
<description value="The type of an address (physical / postal)." />
<valueSet value="http://hl7.org/fhir/ValueSet/address-type|4.0.1" />
</binding>
<mapping>
<identity value="v2" />
<map value="XAD.18" />
</mapping>
<mapping>
<identity value="rim" />
<map value="unique(./use)" />
</mapping>
<mapping>
<identity value="vcard" />
<map value="address type parameter" />
</mapping>
</element>
<element id="Patient.address.text">
<path value="Patient.address.text" />
<short value="Text representation of the address" />
<definition value="Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts." />
<comment value="Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part." />
<requirements value="A renderable, unencoded form." />
<min value="0" />
<max value="1" />
<base>
<path value="Address.text" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<example>
<label value="General" />
<valueString value="137 Nowhere Street, Erewhon 9132" />
</example>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="XAD.1 + XAD.2 + XAD.3 + XAD.4 + XAD.5 + XAD.6" />
</mapping>
<mapping>
<identity value="rim" />
<map value="./formatted" />
</mapping>
<mapping>
<identity value="vcard" />
<map value="address label parameter" />
</mapping>
</element>
<element id="Patient.address.line">
<path value="Patient.address.line" />
<short value="Street name, number, direction & P.O. Box etc." />
<definition value="This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information." />
<min value="0" />
<max value="*" />
<base>
<path value="Address.line" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="string" />
</type>
<orderMeaning value="The order in which lines should appear in an address label" />
<example>
<label value="General" />
<valueString value="137 Nowhere Street" />
</example>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="XAD.1 + XAD.2 (note: XAD.1 and XAD.2 have different meanings for a company address than for a person address)" />
</mapping>
<mapping>
<identity value="rim" />
<map value="AD.part[parttype = AL]" />
</mapping>
<mapping>
<identity value="vcard" />
<map value="street" />
</mapping>
<mapping>
<identity value="servd" />
<map value="./StreetAddress (newline delimitted)" />
</mapping>
</element>
<element id="Patient.address.city">
<path value="Patient.address.city" />
<short value="Name of city, town etc." />
<definition value="The name of the city, town, suburb, village or other community or delivery center." />
<alias value="Municpality" />
<min value="0" />
<max value="1" />
<base>
<path value="Address.city" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<example>
<label value="General" />
<valueString value="Erewhon" />
</example>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="XAD.3" />
</mapping>
<mapping>
<identity value="rim" />
<map value="AD.part[parttype = CTY]" />
</mapping>
<mapping>
<identity value="vcard" />
<map value="locality" />
</mapping>
<mapping>
<identity value="servd" />
<map value="./Jurisdiction" />
</mapping>
</element>
<element id="Patient.address.district">
<path value="Patient.address.district" />
<short value="District name (aka county)" />
<definition value="The name of the administrative area (county)." />
<comment value="District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead." />
<alias value="County" />
<min value="0" />
<max value="1" />
<base>
<path value="Address.district" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<example>
<label value="General" />
<valueString value="Madison" />
</example>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="XAD.9" />
</mapping>
<mapping>
<identity value="rim" />
<map value="AD.part[parttype = CNT | CPA]" />
</mapping>
</element>
<element id="Patient.address.state">
<path value="Patient.address.state" />
<short value="Sub-unit of country (abbreviations ok)" />
<definition value="Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes)." />
<alias value="Province" />
<alias value="Territory" />
<min value="0" />
<max value="1" />
<base>
<path value="Address.state" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="XAD.4" />
</mapping>
<mapping>
<identity value="rim" />
<map value="AD.part[parttype = STA]" />
</mapping>
<mapping>
<identity value="vcard" />
<map value="region" />
</mapping>
<mapping>
<identity value="servd" />
<map value="./Region" />
</mapping>
</element>
<element id="Patient.address.postalCode">
<path value="Patient.address.postalCode" />
<short value="Postal code for area" />
<definition value="A postal code designating a region defined by the postal service." />
<alias value="Zip" />
<min value="0" />
<max value="1" />
<base>
<path value="Address.postalCode" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<example>
<label value="General" />
<valueString value="9132" />
</example>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="XAD.5" />
</mapping>
<mapping>
<identity value="rim" />
<map value="AD.part[parttype = ZIP]" />
</mapping>
<mapping>
<identity value="vcard" />
<map value="code" />
</mapping>
<mapping>
<identity value="servd" />
<map value="./PostalIdentificationCode" />
</mapping>
</element>
<element id="Patient.address.country">
<path value="Patient.address.country" />
<short value="Country (e.g. can be ISO 3166 2 or 3 letter code)" />
<definition value="Country - a nation as commonly understood or generally accepted." />
<comment value="ISO 3166 3 letter codes can be used in place of a human readable country name." />
<min value="0" />
<max value="1" />
<base>
<path value="Address.country" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="XAD.6" />
</mapping>
<mapping>
<identity value="rim" />
<map value="AD.part[parttype = CNT]" />
</mapping>
<mapping>
<identity value="vcard" />
<map value="country" />
</mapping>
<mapping>
<identity value="servd" />
<map value="./Country" />
</mapping>
</element>
<element id="Patient.address.period">
<path value="Patient.address.period" />
<short value="Time period when address was/is in use" />
<definition value="Time period when address was/is in use." />
<requirements value="Allows addresses to be placed in historical context." />
<min value="0" />
<max value="1" />
<base>
<path value="Address.period" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Period" />
</type>
<example>
<label value="General" />
<valuePeriod>
<start value="2010-03-23" />
<end value="2010-07-01" />
</valuePeriod>
</example>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="XAD.12 / XAD.13 + XAD.14" />
</mapping>
<mapping>
<identity value="rim" />
<map value="./usablePeriod[type="IVL<TS>"]" />
</mapping>
<mapping>
<identity value="servd" />
<map value="./StartDate and ./EndDate" />
</mapping>
</element>
<element id="Patient.maritalStatus">
<path value="Patient.maritalStatus" />
<short value="Marital (civil) status of a patient" />
<definition value="This field contains a patient's most recent marital (civil) status." />
<requirements value="Most, if not all systems capture it." />
<min value="0" />
<max value="1" />
<base>
<path value="Patient.maritalStatus" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="MaritalStatus" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
<valueBoolean value="true" />
</extension>
<strength value="extensible" />
<description value="The domestic partnership status of a person." />
<valueSet value="http://hl7.org/fhir/ValueSet/marital-status" />
</binding>
<mapping>
<identity value="v2" />
<map value="PID-16" />
</mapping>
<mapping>
<identity value="rim" />
<map value="player[classCode=PSN]/maritalStatusCode" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".patient.maritalStatusCode" />
</mapping>
</element>
<element id="Patient.multipleBirth[x]">
<path value="Patient.multipleBirth[x]" />
<short value="Whether patient is part of a multiple birth" />
<definition value="Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer)." />
<comment value="Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in triplets would be valueInteger=2 and the third born would have valueInteger=3 If a boolean value was provided for this triplets example, then all 3 patient records would have valueBoolean=true (the ordering is not indicated)." />
<requirements value="For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs." />
<min value="0" />
<max value="1" />
<base>
<path value="Patient.multipleBirth[x]" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="boolean" />
</type>
<type>
<code value="integer" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="v2" />
<map value="PID-24 (bool), PID-25 (integer)" />
</mapping>
<mapping>
<identity value="rim" />
<map value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Patient.photo">
<path value="Patient.photo" />
<short value="Image of the patient" />
<definition value="Image of the patient." />
<comment value="Guidelines:\n* Use id photos, not clinical photos.\n* Limit dimensions to thumbnail.\n* Keep byte count low to ease resource updates." />
<requirements value="Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too." />
<min value="0" />
<max value="*" />
<base>
<path value="Patient.photo" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Attachment" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="v2" />
<map value="OBX-5 - needs a profile" />
</mapping>
<mapping>
<identity value="rim" />
<map value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/desc" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Patient.contact">
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
<valueString value="Contact" />
</extension>
<path value="Patient.contact" />
<short value="A contact party (e.g. guardian, partner, friend) for the patient" />
<definition value="A contact party (e.g. guardian, partner, friend) for the patient." />
<comment value="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." />
<requirements value="Need to track people you can contact about the patient." />
<min value="0" />
<max value="*" />
<base>
<path value="Patient.contact" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="BackboneElement" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="pat-1" />
<severity value="error" />
<human value="SHALL at least contain a contact's details or a reference to an organization" />
<expression value="name.exists() or telecom.exists() or address.exists() or organization.exists()" />
<xpath value="exists(f:name) or exists(f:telecom) or exists(f:address) or exists(f:organization)" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON]" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Patient.contact.id">
<path value="Patient.contact.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Patient.contact.extension">
<path value="Patient.contact.extension" />
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Patient.contact.modifierExtension">
<path value="Patient.contact.modifierExtension" />
<short value="Extensions that cannot be ignored even if unrecognized" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<alias value="modifiers" />
<min value="0" />
<max value="*" />
<base>
<path value="BackboneElement.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Patient.contact.relationship">
<path value="Patient.contact.relationship" />
<short value="The kind of relationship" />
<definition value="The nature of the relationship between the patient and the contact person." />
<requirements value="Used to determine which contact person is the most relevant to approach, depending on circumstances." />
<min value="0" />
<max value="*" />
<base>
<path value="Patient.contact.relationship" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ContactRelationship" />
</extension>
<strength value="extensible" />
<description value="The nature of the relationship between a patient and a contact person for that patient." />
<valueSet value="http://hl7.org/fhir/ValueSet/patient-contactrelationship" />
</binding>
<mapping>
<identity value="v2" />
<map value="NK1-7, NK1-3" />
</mapping>
<mapping>
<identity value="rim" />
<map value="code" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Patient.contact.name">
<path value="Patient.contact.name" />
<short value="A name associated with the contact person" />
<definition value="A name associated with the contact person." />
<requirements value="Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person." />
<min value="0" />
<max value="1" />
<base>
<path value="Patient.contact.name" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="HumanName" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="v2" />
<map value="NK1-2" />
</mapping>
<mapping>
<identity value="rim" />
<map value="name" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Patient.contact.telecom">
<path value="Patient.contact.telecom" />
<short value="A contact detail for the person" />
<definition value="A contact detail for the person, e.g. a telephone number or an email address." />
<comment value="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." />
<requirements value="People have (primary) ways to contact them in some way such as phone, email." />
<min value="0" />
<max value="*" />
<base>
<path value="Patient.contact.telecom" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="ContactPoint" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="v2" />
<map value="NK1-5, NK1-6, NK1-40" />
</mapping>
<mapping>
<identity value="rim" />
<map value="telecom" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Patient.contact.address">
<path value="Patient.contact.address" />
<short value="Address for the contact person" />
<definition value="Address for the contact person." />
<requirements value="Need to keep track where the contact person can be contacted per postal mail or visited." />
<min value="0" />
<max value="1" />
<base>
<path value="Patient.contact.address" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Address" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="v2" />
<map value="NK1-4" />
</mapping>
<mapping>
<identity value="rim" />
<map value="addr" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Patient.contact.gender">
<path value="Patient.contact.gender" />
<short value="male | female | other | unknown" />
<definition value="Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes." />
<requirements value="Needed to address the person correctly." />
<min value="0" />
<max value="1" />
<base>
<path value="Patient.contact.gender" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="AdministrativeGender" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
<valueBoolean value="true" />
</extension>
<strength value="required" />
<description value="The gender of a person used for administrative purposes." />
<valueSet value="http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1" />
</binding>
<mapping>
<identity value="v2" />
<map value="NK1-15" />
</mapping>
<mapping>
<identity value="rim" />
<map value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Patient.contact.organization">
<path value="Patient.contact.organization" />
<short value="Organization that is associated with the contact" />
<definition value="Organization on behalf of which the contact is acting or for which the contact is working." />
<requirements value="For guardians or business related contacts, the organization is relevant." />
<min value="0" />
<max value="1" />
<base>
<path value="Patient.contact.organization" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
</type>
<condition value="pat-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="v2" />
<map value="NK1-13, NK1-30, NK1-31, NK1-32, NK1-41" />
</mapping>
<mapping>
<identity value="rim" />
<map value="scoper" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Patient.contact.period">
<path value="Patient.contact.period" />
<short value="The period during which this contact person or organization is valid to be contacted relating to this patient" />
<definition value="The period during which this contact person or organization is valid to be contacted relating to this patient." />
<min value="0" />
<max value="1" />
<base>
<path value="Patient.contact.period" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Period" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="effectiveTime" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Patient.communication">
<path value="Patient.communication" />
<short value="A language which may be used to communicate with the patient about his or her health" />
<definition value="A language which may be used to communicate with the patient about his or her health." />
<comment value="If no language is specified, this *implies* that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required." />
<requirements value="If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest." />
<min value="0" />
<max value="*" />
<base>
<path value="Patient.communication" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="BackboneElement" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="LanguageCommunication" />
</mapping>
<mapping>
<identity value="cda" />
<map value="patient.languageCommunication" />
</mapping>
</element>
<element id="Patient.communication.id">
<path value="Patient.communication.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Patient.communication.extension">
<path value="Patient.communication.extension" />
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Patient.communication.modifierExtension">
<path value="Patient.communication.modifierExtension" />
<short value="Extensions that cannot be ignored even if unrecognized" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<alias value="modifiers" />
<min value="0" />
<max value="*" />
<base>
<path value="BackboneElement.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Patient.communication.language">
<path value="Patient.communication.language" />
<short value="The language which can be used to communicate with the patient about his or her health" />
<definition value="The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English." />
<comment value="The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type." />
<requirements value="Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect." />
<min value="1" />
<max value="1" />
<base>
<path value="Patient.communication.language" />
<min value="1" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
<valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="Language" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
<valueBoolean value="true" />
</extension>
<strength value="preferred" />
<description value="A human language." />
<valueSet value="http://hl7.org/fhir/ValueSet/languages" />
</binding>
<mapping>
<identity value="v2" />
<map value="PID-15, LAN-2" />
</mapping>
<mapping>
<identity value="rim" />
<map value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/languageCommunication/code" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".languageCode" />
</mapping>
</element>
<element id="Patient.communication.preferred">
<path value="Patient.communication.preferred" />
<short value="Language preference indicator" />
<definition value="Indicates whether or not the patient prefers this language (over other languages he masters up a certain level)." />
<comment value="This language is specifically identified for communicating healthcare information." />
<requirements value="People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method." />
<min value="0" />
<max value="1" />
<base>
<path value="Patient.communication.preferred" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="boolean" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="v2" />
<map value="PID-15" />
</mapping>
<mapping>
<identity value="rim" />
<map value="preferenceInd" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".preferenceInd" />
</mapping>
</element>
<element id="Patient.generalPractitioner">
<path value="Patient.generalPractitioner" />
<short value="Patient's nominated primary care provider" />
<definition value="Patient's nominated care provider." />
<comment value="IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content." />
<alias value="careProvider" />
<min value="0" />
<max value="*" />
<base>
<path value="Patient.generalPractitioner" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="v2" />
<map value="PD1-4" />
</mapping>
<mapping>
<identity value="rim" />
<map value="subjectOf.CareEvent.performer.AssignedEntity" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Patient.managingOrganization">
<path value="Patient.managingOrganization" />
<short value="Organization that is the custodian of the patient record" />
<definition value="Organization that is the custodian of the patient record." />
<comment value="There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association)." />
<requirements value="Need to know who recognizes this patient record, manages and updates it." />
<min value="0" />
<max value="1" />
<base>
<path value="Patient.managingOrganization" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="scoper" />
</mapping>
<mapping>
<identity value="cda" />
<map value=".providerOrganization" />
</mapping>
</element>
<element id="Patient.link">
<path value="Patient.link" />
<short value="Link to another patient resource that concerns the same actual person" />
<definition value="Link to another patient resource that concerns the same actual patient." />
<comment value="There is no assumption that linked patient records have mutual links." />
<requirements value="There are multiple use cases: \n\n* Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and \n* Distribution of patient information across multiple servers." />
<min value="0" />
<max value="*" />
<base>
<path value="Patient.link" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="BackboneElement" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="true" />
<isModifierReason value="This element is labeled as a modifier because it might not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="outboundLink" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Patient.link.id">
<path value="Patient.link.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Patient.link.extension">
<path value="Patient.link.extension" />
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Patient.link.modifierExtension">
<path value="Patient.link.modifierExtension" />
<short value="Extensions that cannot be ignored even if unrecognized" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<alias value="modifiers" />
<min value="0" />
<max value="*" />
<base>
<path value="BackboneElement.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Patient.link.other">
<path value="Patient.link.other" />
<short value="The other patient or related person resource that the link refers to" />
<definition value="The other patient resource that the link refers to." />
<comment value="Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual." />
<min value="1" />
<max value="1" />
<base>
<path value="Patient.link.other" />
<min value="1" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-hierarchy">
<valueBoolean value="false" />
</extension>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<mapping>
<identity value="v2" />
<map value="PID-3, MRG-1" />
</mapping>
<mapping>
<identity value="rim" />
<map value="id" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
<element id="Patient.link.type">
<path value="Patient.link.type" />
<short value="replaced-by | replaces | refer | seealso" />
<definition value="The type of link between this patient resource and another patient resource." />
<min value="1" />
<max value="1" />
<base>
<path value="Patient.link.type" />
<min value="1" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="false" />
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="LinkType" />
</extension>
<strength value="required" />
<description value="The type of link between this patient resource and another patient resource." />
<valueSet value="http://hl7.org/fhir/ValueSet/link-type|4.0.1" />
</binding>
<mapping>
<identity value="rim" />
<map value="typeCode" />
</mapping>
<mapping>
<identity value="cda" />
<map value="n/a" />
</mapping>
</element>
</snapshot>
<differential>
<element id="Patient.extension:individual-recordedSexOrGender">
<path value="Patient.extension" />
<sliceName value="individual-recordedSexOrGender" />
<short value="Extension for representing an individuals recorded sex or gender." />
<definition value="Recorded sex or gender (RSG) information includes the various sex and gender concepts that are often used in existing systems but are known NOT to represent a gender identity, sex parameter for clinical use, or attributes related to sexuality, such as sexual orientation, sexual activity, or sexual attraction. Examples of recorded sex or gender concepts include administrative gender, administrative sex, and sex assigned at birth. When exchanging this concept, refer to the guidance in the Gender Harmony Implementation Guide" />
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender" />
</type>
</element>
<element id="Patient.identifier">
<path value="Patient.identifier" />
<slicing>
<discriminator>
<type value="pattern" />
<path value="type" />
</discriminator>
<rules value="open" />
</slicing>
<comment value="This element employs the constraints on identifier put forth in the CA Baseline using a profiled data type." />
<type>
<code value="Identifier" />
<profile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-identifier" />
</type>
<mustSupport value="true" />
</element>
<element id="Patient.identifier.type">
<path value="Patient.identifier.type" />
<comment value="The slices provided below are examples of identifier types used by jurisdictions for patient summary. These are not required, and the slicing is open meaning that other types can be provided and used in an implementation." />
</element>
<element id="Patient.identifier.system">
<path value="Patient.identifier.system" />
<min value="1" />
</element>
<element id="Patient.identifier.value">
<path value="Patient.identifier.value" />
<short value="The value that is unique within the system." />
<min value="1" />
</element>
<element id="Patient.identifier:JHN">
<path value="Patient.identifier" />
<sliceName value="JHN" />
<short value="Jurisdictional Health Number" />
<definition value="Federal patient and person health numbers used by all jurisdictions across Canada" />
</element>
<element id="Patient.identifier:JHN.extension">
<path value="Patient.identifier.extension" />
</element>
<element id="Patient.identifier:JHN.extension:versionCode">
<path value="Patient.identifier.extension" />
<sliceName value="versionCode" />
<short value="Health Number Version Code" />
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-identifierversion" />
</type>
</element>
<element id="Patient.identifier:JHN.type">
<path value="Patient.identifier.type" />
<min value="1" />
<patternCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203" />
<code value="JHN" />
</coding>
</patternCodeableConcept>
</element>
<element id="Patient.identifier:JHN.system">
<path value="Patient.identifier.system" />
<short value="A Health Number Naming System from the Canadian URI Registry" />
<min value="1" />
</element>
<element id="Patient.identifier:JHN.value">
<path value="Patient.identifier.value" />
<min value="1" />
</element>
<element id="Patient.identifier:MRN">
<path value="Patient.identifier" />
<sliceName value="MRN" />
<short value="Medical Record Number" />
<definition value="A local patient identifier from the submitting PoS System" />
<comment value="Some jurisdictions may consider the MRN identifier type to be an alternative to the JHN identifier type under certain scenarios. These business rules are outside the scope of this profile, however the slice is socialized to prepare implementers for potential use of this pattern within certain jurisdictions" />
</element>
<element id="Patient.identifier:MRN.type">
<path value="Patient.identifier.type" />
<min value="1" />
<patternCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203" />
<code value="MR" />
</coding>
</patternCodeableConcept>
</element>
<element id="Patient.identifier:MRN.system">
<path value="Patient.identifier.system" />
<short value="An identifier for the system supplying the MRN" />
<min value="1" />
</element>
<element id="Patient.identifier:MRN.value">
<path value="Patient.identifier.value" />
<min value="1" />
</element>
<element id="Patient.name">
<path value="Patient.name" />
<requirements value="Need to be able to track the patient by multiple names. Examples are your official name and a partner name.\nThe Alphabetic representation of the name SHALL be always provided" />
<min value="1" />
<constraint>
<key value="core-pat-1" />
<severity value="error" />
<human value="Either Patient.name.given and/or Patient.name.family and/or Patient.name.text SHALL be present or a Data Absent Reason Extension SHALL be present." />
<expression value="(family.exists() or given.exists() or text.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()" />
<xpath value="(/f:name/f:extension/@url='http://hl7.org/fhir/StructureDefinition/data-absent-reason' and not(/f:name/f:family or /f:name/f:given or /f:name/f:text)) or (not(/f:name/f:extension/@url='http://hl7.org/fhir/StructureDefinition/data-absent-reason') and (/f:name/f:family or /f:name/f:given or /f:name/f:text))" />
</constraint>
<mustSupport value="true" />
</element>
<element id="Patient.name.text">
<path value="Patient.name.text" />
<definition value="Text representation of the full name. Due to the cultural variance around the world a consuming system may not know how to present the name correctly; moreover not all the parts of the name go in given or family. Creators are therefore strongly encouraged to provide through this element a presented version of the name. Future versions of this guide may require this element" />
<comment value="Some systems will not have a field for representing the full name as a string, these systems are still expected to be able to demonstrate they can construct name.text when developing the patient summary instance" />
<mustSupport value="true" />
</element>
<element id="Patient.name.family">
<path value="Patient.name.family" />
<mustSupport value="true" />
</element>
<element id="Patient.name.given">
<path value="Patient.name.given" />
<mustSupport value="true" />
</element>
<element id="Patient.telecom">
<path value="Patient.telecom" />
<comment value="IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content." />
</element>
<element id="Patient.telecom.system">
<path value="Patient.telecom.system" />
<mustSupport value="true" />
</element>
<element id="Patient.telecom.value">
<path value="Patient.telecom.value" />
<mustSupport value="true" />
</element>
<element id="Patient.telecom.use">
<path value="Patient.telecom.use" />
<mustSupport value="true" />
</element>
<element id="Patient.gender">
<path value="Patient.gender" />
<mustSupport value="true" />
</element>
<element id="Patient.birthDate">
<path value="Patient.birthDate" />
<comment value="While the birthDate element requires a value, if the exact date of birth is unknown, only the known portion of the date (e.g., the year) should be provided without estimating or inferring unknown parts of the date. Use of the Data Absent Reason is appropriate when the date of birth of an individual cannot be determined." />
<min value="1" />
<mustSupport value="true" />
</element>
<element id="Patient.address">
<path value="Patient.address" />
<comment value="IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content." />
</element>
<element id="Patient.address.line">
<path value="Patient.address.line" />
<mustSupport value="true" />
</element>
<element id="Patient.address.city">
<path value="Patient.address.city" />
<mustSupport value="true" />
</element>
<element id="Patient.address.postalCode">
<path value="Patient.address.postalCode" />
<mustSupport value="true" />
</element>
<element id="Patient.address.country">
<path value="Patient.address.country" />
<mustSupport value="true" />
</element>
<element id="Patient.generalPractitioner">
<path value="Patient.generalPractitioner" />
<comment value="IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content." />
</element>
</differential>
</StructureDefinition>
{
"resourceType": "StructureDefinition",
"id": "patient-ca-ps",
"url": "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/patient-ca-ps",
"name": "PatientPSCA",
"title": "Patient (PS-CA)",
"status": "draft",
"experimental": false,
"date": "2024-04-09T00:00:00-08:00",
"description": "This profile represents the constraints applied to the Patient resource by the PS-CA project to represent the minimum expectations for the Patient resource when used in the PS-CA composition profile or in one of the referred resources. It is informed by the constraints of the [Patient IPS-UV profile](http://hl7.org/fhir/uv/ips/StructureDefinition-Patient-uv-ips.html) and the [Canadian Baseline Profile](http://build.fhir.org/ig/HL7-Canada/ca-baseline/branches/master/StructureDefinition-profile-patient.html)",
"copyright": "Copyright © 2024+ Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy).",
"fhirVersion": "4.0.1",
"kind": "resource",
"abstract": false,
"type": "Patient",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Patient",
"derivation": "constraint",
"snapshot": {
"element": [
{
"id": "Patient",
"path": "Patient",
"short": "Information about an individual or animal receiving health care services",
"definition": "Demographics and other administrative information about an individual or animal receiving care or other health-related services.",
"alias": [
"SubjectOfCare Client Resident"
],
"min": 0,
"max": "*",
"base": {
"path": "Patient",
"min": 0,
"max": "*"
},
"constraint": [
{
"key": "dom-2",
"severity": "error",
"human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
"expression": "contained.contained.empty()",
"xpath": "not(parent::f:contained and f:contained)",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key": "dom-3",
"severity": "error",
"human": "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource",
"expression": "contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()",
"xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key": "dom-4",
"severity": "error",
"human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()",
"xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key": "dom-5",
"severity": "error",
"human": "If a resource is contained in another resource, it SHALL NOT have a security label",
"expression": "contained.meta.security.empty()",
"xpath": "not(exists(f:contained/*/f:meta/f:security))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
"valueBoolean": true
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation",
"valueMarkdown": "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
}
],
"key": "dom-6",
"severity": "warning",
"human": "A resource should have narrative for robust management",
"expression": "text.`div`.exists()",
"xpath": "exists(f:text/h:div)",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "Entity. Role, or Act"
},
{
"identity": "rim",
"map": "Patient[classCode=PAT]"
},
{
"identity": "cda",
"map": "ClinicalDocument.recordTarget.patientRole"
}
]
},
{
"id": "Patient.id",
"path": "Patient.id",
"short": "Logical id of this artifact",
"definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
"comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": true
},
{
"id": "Patient.meta",
"path": "Patient.meta",
"short": "Metadata about the resource",
"definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.meta",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Meta"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true
},
{
"id": "Patient.implicitRules",
"path": "Patient.implicitRules",
"short": "A set of rules under which this content was created",
"definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.",
"comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.implicitRules",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": true,
"isModifierReason": "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation",
"isSummary": true
},
{
"id": "Patient.language",
"path": "Patient.language",
"short": "Language of the resource content",
"definition": "The base language in which the resource is written.",
"comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
"min": 0,
"max": "1",
"base": {
"path": "Resource.language",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
"valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "Language"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
"valueBoolean": true
}
],
"strength": "preferred",
"description": "A human language.",
"valueSet": "http://hl7.org/fhir/ValueSet/languages"
}
},
{
"id": "Patient.text",
"path": "Patient.text",
"short": "Text summary of the resource, for human interpretation",
"definition": "A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
"comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded information is added later.",
"alias": [
"narrative",
"html",
"xhtml",
"display"
],
"min": 0,
"max": "1",
"base": {
"path": "DomainResource.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Narrative"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "Act.text?"
}
]
},
{
"id": "Patient.contained",
"path": "Patient.contained",
"short": "Contained, inline Resources",
"definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
"comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.",
"alias": [
"inline resources",
"anonymous resources",
"contained resources"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.contained",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Resource"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Patient.extension",
"path": "Patient.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"ordered": false,
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Patient.extension:individual-recordedSexOrGender",
"path": "Patient.extension",
"sliceName": "individual-recordedSexOrGender",
"short": "Extension for representing an individuals recorded sex or gender.",
"definition": "Recorded sex or gender (RSG) information includes the various sex and gender concepts that are often used in existing systems but are known NOT to represent a gender identity, sex parameter for clinical use, or attributes related to sexuality, such as sexual orientation, sexual activity, or sexual attraction. Examples of recorded sex or gender concepts include administrative gender, administrative sex, and sex assigned at birth. When exchanging this concept, refer to the guidance in the Gender Harmony Implementation Guide",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Patient.modifierExtension",
"path": "Patient.modifierExtension",
"short": "Extensions that cannot be ignored",
"definition": "May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Patient.identifier",
"path": "Patient.identifier",
"slicing": {
"discriminator": [
{
"type": "pattern",
"path": "type"
}
],
"rules": "open"
},
"short": "An identifier intended for computation",
"definition": "An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.",
"comment": "This element employs the constraints on identifier put forth in the CA Baseline using a profiled data type.",
"requirements": "Patients are almost always assigned specific numerical identifiers.",
"min": 0,
"max": "*",
"base": {
"path": "Patient.identifier",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Identifier",
"profile": [
"http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-identifier"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "w5",
"map": "FiveWs.identifier"
},
{
"identity": "v2",
"map": "PID-3"
},
{
"identity": "rim",
"map": "id"
},
{
"identity": "cda",
"map": ".id"
},
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)"
},
{
"identity": "rim",
"map": "II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]"
},
{
"identity": "servd",
"map": "Identifier"
}
]
},
{
"id": "Patient.identifier.id",
"path": "Patient.identifier.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Patient.identifier.extension",
"path": "Patient.identifier.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Patient.identifier.use",
"path": "Patient.identifier.use",
"short": "usual | official | temp | secondary | old (If known)",
"definition": "The purpose of this identifier.",
"comment": "Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.",
"requirements": "Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.use",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": true,
"isModifierReason": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one.",
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "IdentifierUse"
}
],
"strength": "required",
"description": "Identifies the purpose for this identifier, if known .",
"valueSet": "http://hl7.org/fhir/ValueSet/identifier-use|4.0.1"
},
"mapping": [
{
"identity": "v2",
"map": "N/A"
},
{
"identity": "rim",
"map": "Role.code or implied by context"
}
]
},
{
"id": "Patient.identifier.type",
"path": "Patient.identifier.type",
"short": "Description of identifier",
"definition": "A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.",
"comment": "The slices provided below are examples of identifier types used by jurisdictions for patient summary. These are not required, and the slicing is open meaning that other types can be provided and used in an implementation.",
"requirements": "Allows users to make use of identifiers when the identifier system is not known.",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.type",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "IdentifierType"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
"valueBoolean": true
}
],
"strength": "extensible",
"description": "A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.",
"valueSet": "http://hl7.org/fhir/ValueSet/identifier-type"
},
"mapping": [
{
"identity": "v2",
"map": "CX.5"
},
{
"identity": "rim",
"map": "Role.code or implied by context"
}
]
},
{
"id": "Patient.identifier.system",
"path": "Patient.identifier.system",
"short": "The namespace for the identifier value",
"definition": "Establishes the namespace for the value - that is, a URL that describes a set values that are unique.",
"comment": "Identifier.system is always case sensitive.",
"requirements": "There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.",
"min": 1,
"max": "1",
"base": {
"path": "Identifier.system",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"example": [
{
"label": "General",
"valueUri": "http://www.acme.com/identifiers/patient"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "CX.4 / EI-2-4"
},
{
"identity": "rim",
"map": "II.root or Role.id.root"
},
{
"identity": "servd",
"map": "./IdentifierType"
}
]
},
{
"id": "Patient.identifier.value",
"path": "Patient.identifier.value",
"short": "The value that is unique within the system.",
"definition": "The portion of the identifier typically relevant to the user and which is unique within the context of the system.",
"comment": "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](http://hl7.org/fhir/R4/extension-rendered-value.html). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.",
"min": 1,
"max": "1",
"base": {
"path": "Identifier.value",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"example": [
{
"label": "General",
"valueString": "123456"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "CX.1 / EI.1"
},
{
"identity": "rim",
"map": "II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)"
},
{
"identity": "servd",
"map": "./Value"
}
]
},
{
"id": "Patient.identifier.period",
"path": "Patient.identifier.period",
"short": "Time period when id is/was valid for use",
"definition": "Time period during which identifier is/was valid for use.",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.period",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Period"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "CX.7 + CX.8"
},
{
"identity": "rim",
"map": "Role.effectiveTime or implied by context"
},
{
"identity": "servd",
"map": "./StartDate and ./EndDate"
}
]
},
{
"id": "Patient.identifier.assigner",
"path": "Patient.identifier.assigner",
"short": "Organization that issued id (may be just text)",
"definition": "Organization that issued/manages the identifier.",
"comment": "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.",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.assigner",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "CX.4 / (CX.4,CX.9,CX.10)"
},
{
"identity": "rim",
"map": "II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper"
},
{
"identity": "servd",
"map": "./IdentifierIssuingAuthority"
}
]
},
{
"id": "Patient.identifier:JHN",
"path": "Patient.identifier",
"sliceName": "JHN",
"short": "Jurisdictional Health Number",
"definition": "Federal patient and person health numbers used by all jurisdictions across Canada",
"requirements": "Patients are almost always assigned specific numerical identifiers.",
"min": 0,
"max": "*",
"base": {
"path": "Patient.identifier",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Identifier"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "w5",
"map": "FiveWs.identifier"
},
{
"identity": "v2",
"map": "PID-3"
},
{
"identity": "rim",
"map": "id"
},
{
"identity": "cda",
"map": ".id"
}
]
},
{
"id": "Patient.identifier:JHN.id",
"path": "Patient.identifier.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Patient.identifier:JHN.extension",
"path": "Patient.identifier.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Patient.identifier:JHN.extension:versionCode",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
}
],
"path": "Patient.identifier.extension",
"sliceName": "versionCode",
"short": "Health Number Version Code",
"definition": "A code indicating a specific version of an identifier credential",
"comment": "For example, a health card version number, credit card version number, etc. Used to help verify the authenticity of a credential",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "1",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-identifierversion"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mustSupport": false,
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Patient.identifier:JHN.use",
"path": "Patient.identifier.use",
"short": "usual | official | temp | secondary | old (If known)",
"definition": "The purpose of this identifier.",
"comment": "Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.",
"requirements": "Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.use",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": true,
"isModifierReason": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one.",
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "IdentifierUse"
}
],
"strength": "required",
"description": "Identifies the purpose for this identifier, if known .",
"valueSet": "http://hl7.org/fhir/ValueSet/identifier-use|4.0.1"
},
"mapping": [
{
"identity": "v2",
"map": "N/A"
},
{
"identity": "rim",
"map": "Role.code or implied by context"
}
]
},
{
"id": "Patient.identifier:JHN.type",
"path": "Patient.identifier.type",
"short": "Description of identifier",
"definition": "A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.",
"comment": "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.",
"requirements": "Allows users to make use of identifiers when the identifier system is not known.",
"min": 1,
"max": "1",
"base": {
"path": "Identifier.type",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"patternCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "JHN"
}
]
},
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "IdentifierType"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
"valueBoolean": true
}
],
"strength": "extensible",
"description": "A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.",
"valueSet": "http://hl7.org/fhir/ValueSet/identifier-type"
},
"mapping": [
{
"identity": "v2",
"map": "CX.5"
},
{
"identity": "rim",
"map": "Role.code or implied by context"
}
]
},
{
"id": "Patient.identifier:JHN.system",
"path": "Patient.identifier.system",
"short": "A Health Number Naming System from the Canadian URI Registry",
"definition": "Establishes the namespace for the value - that is, a URL that describes a set values that are unique.",
"comment": "Identifier.system is always case sensitive.",
"requirements": "There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.",
"min": 1,
"max": "1",
"base": {
"path": "Identifier.system",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"example": [
{
"label": "General",
"valueUri": "http://www.acme.com/identifiers/patient"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "CX.4 / EI-2-4"
},
{
"identity": "rim",
"map": "II.root or Role.id.root"
},
{
"identity": "servd",
"map": "./IdentifierType"
}
]
},
{
"id": "Patient.identifier:JHN.value",
"path": "Patient.identifier.value",
"short": "The value that is unique",
"definition": "The portion of the identifier typically relevant to the user and which is unique within the context of the system.",
"comment": "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](extension-rendered-value.html). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.",
"min": 1,
"max": "1",
"base": {
"path": "Identifier.value",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"example": [
{
"label": "General",
"valueString": "123456"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "CX.1 / EI.1"
},
{
"identity": "rim",
"map": "II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)"
},
{
"identity": "servd",
"map": "./Value"
}
]
},
{
"id": "Patient.identifier:JHN.period",
"path": "Patient.identifier.period",
"short": "Time period when id is/was valid for use",
"definition": "Time period during which identifier is/was valid for use.",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.period",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Period"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "CX.7 + CX.8"
},
{
"identity": "rim",
"map": "Role.effectiveTime or implied by context"
},
{
"identity": "servd",
"map": "./StartDate and ./EndDate"
}
]
},
{
"id": "Patient.identifier:JHN.assigner",
"path": "Patient.identifier.assigner",
"short": "Organization that issued id (may be just text)",
"definition": "Organization that issued/manages the identifier.",
"comment": "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.",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.assigner",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "CX.4 / (CX.4,CX.9,CX.10)"
},
{
"identity": "rim",
"map": "II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper"
},
{
"identity": "servd",
"map": "./IdentifierIssuingAuthority"
}
]
},
{
"id": "Patient.identifier:MRN",
"path": "Patient.identifier",
"sliceName": "MRN",
"short": "Medical Record Number",
"definition": "A local patient identifier from the submitting PoS System",
"comment": "Some jurisdictions may consider the MRN identifier type to be an alternative to the JHN identifier type under certain scenarios. These business rules are outside the scope of this profile, however the slice is socialized to prepare implementers for potential use of this pattern within certain jurisdictions",
"requirements": "Patients are almost always assigned specific numerical identifiers.",
"min": 0,
"max": "*",
"base": {
"path": "Patient.identifier",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Identifier"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "w5",
"map": "FiveWs.identifier"
},
{
"identity": "v2",
"map": "PID-3"
},
{
"identity": "rim",
"map": "id"
},
{
"identity": "cda",
"map": ".id"
}
]
},
{
"id": "Patient.identifier:MRN.id",
"path": "Patient.identifier.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Patient.identifier:MRN.extension",
"path": "Patient.identifier.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Patient.identifier:MRN.use",
"path": "Patient.identifier.use",
"short": "usual | official | temp | secondary | old (If known)",
"definition": "The purpose of this identifier.",
"comment": "Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.",
"requirements": "Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.use",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": true,
"isModifierReason": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one.",
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "IdentifierUse"
}
],
"strength": "required",
"description": "Identifies the purpose for this identifier, if known .",
"valueSet": "http://hl7.org/fhir/ValueSet/identifier-use|4.0.1"
},
"mapping": [
{
"identity": "v2",
"map": "N/A"
},
{
"identity": "rim",
"map": "Role.code or implied by context"
}
]
},
{
"id": "Patient.identifier:MRN.type",
"path": "Patient.identifier.type",
"short": "Description of identifier",
"definition": "A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.",
"comment": "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.",
"requirements": "Allows users to make use of identifiers when the identifier system is not known.",
"min": 1,
"max": "1",
"base": {
"path": "Identifier.type",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"patternCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "MR"
}
]
},
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "IdentifierType"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
"valueBoolean": true
}
],
"strength": "extensible",
"description": "A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.",
"valueSet": "http://hl7.org/fhir/ValueSet/identifier-type"
},
"mapping": [
{
"identity": "v2",
"map": "CX.5"
},
{
"identity": "rim",
"map": "Role.code or implied by context"
}
]
},
{
"id": "Patient.identifier:MRN.system",
"path": "Patient.identifier.system",
"short": "An identifier for the system supplying the MRN",
"definition": "Establishes the namespace for the value - that is, a URL that describes a set values that are unique.",
"comment": "Identifier.system is always case sensitive.",
"requirements": "There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.",
"min": 1,
"max": "1",
"base": {
"path": "Identifier.system",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"example": [
{
"label": "General",
"valueUri": "http://www.acme.com/identifiers/patient"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "CX.4 / EI-2-4"
},
{
"identity": "rim",
"map": "II.root or Role.id.root"
},
{
"identity": "servd",
"map": "./IdentifierType"
}
]
},
{
"id": "Patient.identifier:MRN.value",
"path": "Patient.identifier.value",
"short": "The value that is unique",
"definition": "The portion of the identifier typically relevant to the user and which is unique within the context of the system.",
"comment": "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](extension-rendered-value.html). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.",
"min": 1,
"max": "1",
"base": {
"path": "Identifier.value",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"example": [
{
"label": "General",
"valueString": "123456"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "CX.1 / EI.1"
},
{
"identity": "rim",
"map": "II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)"
},
{
"identity": "servd",
"map": "./Value"
}
]
},
{
"id": "Patient.identifier:MRN.period",
"path": "Patient.identifier.period",
"short": "Time period when id is/was valid for use",
"definition": "Time period during which identifier is/was valid for use.",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.period",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Period"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "CX.7 + CX.8"
},
{
"identity": "rim",
"map": "Role.effectiveTime or implied by context"
},
{
"identity": "servd",
"map": "./StartDate and ./EndDate"
}
]
},
{
"id": "Patient.identifier:MRN.assigner",
"path": "Patient.identifier.assigner",
"short": "Organization that issued id (may be just text)",
"definition": "Organization that issued/manages the identifier.",
"comment": "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.",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.assigner",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "CX.4 / (CX.4,CX.9,CX.10)"
},
{
"identity": "rim",
"map": "II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper"
},
{
"identity": "servd",
"map": "./IdentifierIssuingAuthority"
}
]
},
{
"id": "Patient.active",
"path": "Patient.active",
"short": "Whether this patient's record is in active use",
"definition": "Whether this patient record is in active use. \nMany systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules.\n\nIt is often used to filter patient lists to exclude inactive patients\n\nDeceased patients may also be marked as inactive for the same reasons, but may be active for some time after death.",
"comment": "If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient.",
"requirements": "Need to be able to mark a patient record as not to be used because it was created in error.",
"min": 0,
"max": "1",
"base": {
"path": "Patient.active",
"min": 0,
"max": "1"
},
"type": [
{
"code": "boolean"
}
],
"meaningWhenMissing": "This resource is generally assumed to be active if no value is provided for the active element",
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": true,
"isModifierReason": "This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid",
"isSummary": true,
"mapping": [
{
"identity": "w5",
"map": "FiveWs.status"
},
{
"identity": "rim",
"map": "statusCode"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Patient.name",
"path": "Patient.name",
"short": "A name associated with the patient",
"definition": "A name associated with the individual.",
"comment": "A patient may have multiple names with different uses or applicable periods. For animals, the name is a \"HumanName\" in the sense that is assigned and used by humans and has the same patterns.",
"requirements": "Need to be able to track the patient by multiple names. Examples are your official name and a partner name.\nThe Alphabetic representation of the name SHALL be always provided",
"min": 1,
"max": "*",
"base": {
"path": "Patient.name",
"min": 0,
"max": "*"
},
"type": [
{
"code": "HumanName"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "core-pat-1",
"severity": "error",
"human": "Either Patient.name.given and/or Patient.name.family and/or Patient.name.text SHALL be present or a Data Absent Reason Extension SHALL be present.",
"expression": "(family.exists() or given.exists() or text.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()",
"xpath": "(/f:name/f:extension/@url='http://hl7.org/fhir/StructureDefinition/data-absent-reason' and not(/f:name/f:family or /f:name/f:given or /f:name/f:text)) or (not(/f:name/f:extension/@url='http://hl7.org/fhir/StructureDefinition/data-absent-reason') and (/f:name/f:family or /f:name/f:given or /f:name/f:text))",
"source": "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/patient-ca-ps"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "PID-5, PID-9"
},
{
"identity": "rim",
"map": "name"
},
{
"identity": "cda",
"map": ".patient.name"
}
]
},
{
"id": "Patient.name.id",
"path": "Patient.name.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Patient.name.extension",
"path": "Patient.name.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Patient.name.use",
"path": "Patient.name.use",
"short": "usual | official | temp | nickname | anonymous | old | maiden",
"definition": "Identifies the purpose for this name.",
"comment": "Applications can assume that a name is current unless it explicitly says that it is temporary or old.",
"requirements": "Allows the appropriate name for a particular context of use to be selected from among a set of names.",
"min": 0,
"max": "1",
"base": {
"path": "HumanName.use",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": true,
"isModifierReason": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old name etc.for a current/permanent one",
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "NameUse"
}
],
"strength": "required",
"description": "The use of a human name.",
"valueSet": "http://hl7.org/fhir/ValueSet/name-use|4.0.1"
},
"mapping": [
{
"identity": "v2",
"map": "XPN.7, but often indicated by which field contains the name"
},
{
"identity": "rim",
"map": "unique(./use)"
},
{
"identity": "servd",
"map": "./NamePurpose"
}
]
},
{
"id": "Patient.name.text",
"path": "Patient.name.text",
"short": "Text representation of the full name",
"definition": "Text representation of the full name. Due to the cultural variance around the world a consuming system may not know how to present the name correctly; moreover not all the parts of the name go in given or family. Creators are therefore strongly encouraged to provide through this element a presented version of the name. Future versions of this guide may require this element",
"comment": "Some systems will not have a field for representing the full name as a string, these systems are still expected to be able to demonstrate they can construct name.text when developing the patient summary instance",
"requirements": "A renderable, unencoded form.",
"min": 0,
"max": "1",
"base": {
"path": "HumanName.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "implied by XPN.11"
},
{
"identity": "rim",
"map": "./formatted"
}
]
},
{
"id": "Patient.name.family",
"path": "Patient.name.family",
"short": "Family name (often called 'Surname')",
"definition": "The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.",
"comment": "Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).",
"alias": [
"surname"
],
"min": 0,
"max": "1",
"base": {
"path": "HumanName.family",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "XPN.1/FN.1"
},
{
"identity": "rim",
"map": "./part[partType = FAM]"
},
{
"identity": "servd",
"map": "./FamilyName"
}
]
},
{
"id": "Patient.name.given",
"path": "Patient.name.given",
"short": "Given names (not always 'first'). Includes middle names",
"definition": "Given name.",
"comment": "If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called \"first name\" since given names do not always come first.",
"alias": [
"first name",
"middle name"
],
"min": 0,
"max": "*",
"base": {
"path": "HumanName.given",
"min": 0,
"max": "*"
},
"type": [
{
"code": "string"
}
],
"orderMeaning": "Given Names appear in the correct order for presenting the name",
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "XPN.2 + XPN.3"
},
{
"identity": "rim",
"map": "./part[partType = GIV]"
},
{
"identity": "servd",
"map": "./GivenNames"
}
]
},
{
"id": "Patient.name.prefix",
"path": "Patient.name.prefix",
"short": "Parts that come before the name",
"definition": "Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name.",
"min": 0,
"max": "*",
"base": {
"path": "HumanName.prefix",
"min": 0,
"max": "*"
},
"type": [
{
"code": "string"
}
],
"orderMeaning": "Prefixes appear in the correct order for presenting the name",
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "XPN.5"
},
{
"identity": "rim",
"map": "./part[partType = PFX]"
},
{
"identity": "servd",
"map": "./TitleCode"
}
]
},
{
"id": "Patient.name.suffix",
"path": "Patient.name.suffix",
"short": "Parts that come after the name",
"definition": "Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name.",
"min": 0,
"max": "*",
"base": {
"path": "HumanName.suffix",
"min": 0,
"max": "*"
},
"type": [
{
"code": "string"
}
],
"orderMeaning": "Suffixes appear in the correct order for presenting the name",
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "XPN/4"
},
{
"identity": "rim",
"map": "./part[partType = SFX]"
}
]
},
{
"id": "Patient.name.period",
"path": "Patient.name.period",
"short": "Time period when name was/is in use",
"definition": "Indicates the period of time when this name was valid for the named person.",
"requirements": "Allows names to be placed in historical context.",
"min": 0,
"max": "1",
"base": {
"path": "HumanName.period",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Period"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "XPN.13 + XPN.14"
},
{
"identity": "rim",
"map": "./usablePeriod[type=\"IVL<TS>\"]"
},
{
"identity": "servd",
"map": "./StartDate and ./EndDate"
}
]
},
{
"id": "Patient.telecom",
"path": "Patient.telecom",
"short": "A contact detail for the individual",
"definition": "A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted.",
"comment": "IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content.",
"requirements": "People have (primary) ways to contact them in some way such as phone, email.",
"min": 0,
"max": "*",
"base": {
"path": "Patient.telecom",
"min": 0,
"max": "*"
},
"type": [
{
"code": "ContactPoint"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "PID-13, PID-14, PID-40"
},
{
"identity": "rim",
"map": "telecom"
},
{
"identity": "cda",
"map": ".telecom"
}
]
},
{
"id": "Patient.telecom.id",
"path": "Patient.telecom.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Patient.telecom.extension",
"path": "Patient.telecom.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Patient.telecom.system",
"path": "Patient.telecom.system",
"short": "phone | fax | email | pager | url | sms | other",
"definition": "Telecommunications form for contact point - what communications system is required to make use of the contact.",
"min": 0,
"max": "1",
"base": {
"path": "ContactPoint.system",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"condition": [
"cpt-2"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ContactPointSystem"
}
],
"strength": "required",
"description": "Telecommunications form for contact point.",
"valueSet": "http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1"
},
"mapping": [
{
"identity": "v2",
"map": "XTN.3"
},
{
"identity": "rim",
"map": "./scheme"
},
{
"identity": "servd",
"map": "./ContactPointType"
}
]
},
{
"id": "Patient.telecom.value",
"path": "Patient.telecom.value",
"short": "The actual contact point details",
"definition": "The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).",
"comment": "Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.",
"requirements": "Need to support legacy numbers that are not in a tightly controlled format.",
"min": 0,
"max": "1",
"base": {
"path": "ContactPoint.value",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "XTN.1 (or XTN.12)"
},
{
"identity": "rim",
"map": "./url"
},
{
"identity": "servd",
"map": "./Value"
}
]
},
{
"id": "Patient.telecom.use",
"path": "Patient.telecom.use",
"short": "home | work | temp | old | mobile - purpose of this contact point",
"definition": "Identifies the purpose for the contact point.",
"comment": "Applications can assume that a contact is current unless it explicitly says that it is temporary or old.",
"requirements": "Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.",
"min": 0,
"max": "1",
"base": {
"path": "ContactPoint.use",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": true,
"isModifierReason": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old contact etc.for a current/permanent one",
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ContactPointUse"
}
],
"strength": "required",
"description": "Use of contact point.",
"valueSet": "http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1"
},
"mapping": [
{
"identity": "v2",
"map": "XTN.2 - but often indicated by field"
},
{
"identity": "rim",
"map": "unique(./use)"
},
{
"identity": "servd",
"map": "./ContactPointPurpose"
}
]
},
{
"id": "Patient.telecom.rank",
"path": "Patient.telecom.rank",
"short": "Specify preferred order of use (1 = highest)",
"definition": "Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.",
"comment": "Note that rank does not necessarily follow the order in which the contacts are represented in the instance.",
"min": 0,
"max": "1",
"base": {
"path": "ContactPoint.rank",
"min": 0,
"max": "1"
},
"type": [
{
"code": "positiveInt"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "n/a"
},
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Patient.telecom.period",
"path": "Patient.telecom.period",
"short": "Time period when the contact point was/is in use",
"definition": "Time period when the contact point was/is in use.",
"min": 0,
"max": "1",
"base": {
"path": "ContactPoint.period",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Period"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "N/A"
},
{
"identity": "rim",
"map": "./usablePeriod[type=\"IVL<TS>\"]"
},
{
"identity": "servd",
"map": "./StartDate and ./EndDate"
}
]
},
{
"id": "Patient.gender",
"path": "Patient.gender",
"short": "male | female | other | unknown",
"definition": "Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes.",
"comment": "The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a \"hard\" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex.",
"requirements": "Needed for identification of the individual, in combination with (at least) name and birth date.",
"min": 0,
"max": "1",
"base": {
"path": "Patient.gender",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "AdministrativeGender"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
"valueBoolean": true
}
],
"strength": "required",
"description": "The gender of a person used for administrative purposes.",
"valueSet": "http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1"
},
"mapping": [
{
"identity": "v2",
"map": "PID-8"
},
{
"identity": "rim",
"map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender"
},
{
"identity": "cda",
"map": ".patient.administrativeGenderCode"
}
]
},
{
"id": "Patient.birthDate",
"path": "Patient.birthDate",
"short": "The date of birth for the individual",
"definition": "The date of birth for the individual.",
"comment": "While the birthDate element requires a value, if the exact date of birth is unknown, only the known portion of the date (e.g., the year) should be provided without estimating or inferring unknown parts of the date. Use of the Data Absent Reason is appropriate when the date of birth of an individual cannot be determined.",
"requirements": "Age of the individual drives many clinical processes.",
"min": 1,
"max": "1",
"base": {
"path": "Patient.birthDate",
"min": 0,
"max": "1"
},
"type": [
{
"code": "date"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "PID-7"
},
{
"identity": "rim",
"map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/birthTime"
},
{
"identity": "cda",
"map": ".patient.birthTime"
},
{
"identity": "loinc",
"map": "21112-8"
}
]
},
{
"id": "Patient.deceased[x]",
"path": "Patient.deceased[x]",
"short": "Indicates if the individual is deceased or not",
"definition": "Indicates if the individual is deceased or not.",
"comment": "If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.",
"requirements": "The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.",
"min": 0,
"max": "1",
"base": {
"path": "Patient.deceased[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "boolean"
},
{
"code": "dateTime"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": true,
"isModifierReason": "This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.",
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "PID-30 (bool) and PID-29 (datetime)"
},
{
"identity": "rim",
"map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedTime"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Patient.address",
"path": "Patient.address",
"short": "An address for the individual",
"definition": "An address for the individual.",
"comment": "IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content.",
"requirements": "May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.",
"min": 0,
"max": "*",
"base": {
"path": "Patient.address",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Address"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "PID-11"
},
{
"identity": "rim",
"map": "addr"
},
{
"identity": "cda",
"map": ".addr"
}
]
},
{
"id": "Patient.address.id",
"path": "Patient.address.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Patient.address.extension",
"path": "Patient.address.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Patient.address.use",
"path": "Patient.address.use",
"short": "home | work | temp | old | billing - purpose of this address",
"definition": "The purpose of this address.",
"comment": "Applications can assume that an address is current unless it explicitly says that it is temporary or old.",
"requirements": "Allows an appropriate address to be chosen from a list of many.",
"min": 0,
"max": "1",
"base": {
"path": "Address.use",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"example": [
{
"label": "General",
"valueCode": "home"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": true,
"isModifierReason": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old address etc.for a current/permanent one",
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "AddressUse"
}
],
"strength": "required",
"description": "The use of an address.",
"valueSet": "http://hl7.org/fhir/ValueSet/address-use|4.0.1"
},
"mapping": [
{
"identity": "v2",
"map": "XAD.7"
},
{
"identity": "rim",
"map": "unique(./use)"
},
{
"identity": "servd",
"map": "./AddressPurpose"
}
]
},
{
"id": "Patient.address.type",
"path": "Patient.address.type",
"short": "postal | physical | both",
"definition": "Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both.",
"comment": "The definition of Address states that \"address is intended to describe postal addresses, not physical locations\". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the [Location](location.html#) resource).",
"min": 0,
"max": "1",
"base": {
"path": "Address.type",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"example": [
{
"label": "General",
"valueCode": "both"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "AddressType"
}
],
"strength": "required",
"description": "The type of an address (physical / postal).",
"valueSet": "http://hl7.org/fhir/ValueSet/address-type|4.0.1"
},
"mapping": [
{
"identity": "v2",
"map": "XAD.18"
},
{
"identity": "rim",
"map": "unique(./use)"
},
{
"identity": "vcard",
"map": "address type parameter"
}
]
},
{
"id": "Patient.address.text",
"path": "Patient.address.text",
"short": "Text representation of the address",
"definition": "Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts.",
"comment": "Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.",
"requirements": "A renderable, unencoded form.",
"min": 0,
"max": "1",
"base": {
"path": "Address.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"example": [
{
"label": "General",
"valueString": "137 Nowhere Street, Erewhon 9132"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "XAD.1 + XAD.2 + XAD.3 + XAD.4 + XAD.5 + XAD.6"
},
{
"identity": "rim",
"map": "./formatted"
},
{
"identity": "vcard",
"map": "address label parameter"
}
]
},
{
"id": "Patient.address.line",
"path": "Patient.address.line",
"short": "Street name, number, direction & P.O. Box etc.",
"definition": "This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.",
"min": 0,
"max": "*",
"base": {
"path": "Address.line",
"min": 0,
"max": "*"
},
"type": [
{
"code": "string"
}
],
"orderMeaning": "The order in which lines should appear in an address label",
"example": [
{
"label": "General",
"valueString": "137 Nowhere Street"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "XAD.1 + XAD.2 (note: XAD.1 and XAD.2 have different meanings for a company address than for a person address)"
},
{
"identity": "rim",
"map": "AD.part[parttype = AL]"
},
{
"identity": "vcard",
"map": "street"
},
{
"identity": "servd",
"map": "./StreetAddress (newline delimitted)"
}
]
},
{
"id": "Patient.address.city",
"path": "Patient.address.city",
"short": "Name of city, town etc.",
"definition": "The name of the city, town, suburb, village or other community or delivery center.",
"alias": [
"Municpality"
],
"min": 0,
"max": "1",
"base": {
"path": "Address.city",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"example": [
{
"label": "General",
"valueString": "Erewhon"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "XAD.3"
},
{
"identity": "rim",
"map": "AD.part[parttype = CTY]"
},
{
"identity": "vcard",
"map": "locality"
},
{
"identity": "servd",
"map": "./Jurisdiction"
}
]
},
{
"id": "Patient.address.district",
"path": "Patient.address.district",
"short": "District name (aka county)",
"definition": "The name of the administrative area (county).",
"comment": "District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.",
"alias": [
"County"
],
"min": 0,
"max": "1",
"base": {
"path": "Address.district",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"example": [
{
"label": "General",
"valueString": "Madison"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "XAD.9"
},
{
"identity": "rim",
"map": "AD.part[parttype = CNT | CPA]"
}
]
},
{
"id": "Patient.address.state",
"path": "Patient.address.state",
"short": "Sub-unit of country (abbreviations ok)",
"definition": "Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes).",
"alias": [
"Province",
"Territory"
],
"min": 0,
"max": "1",
"base": {
"path": "Address.state",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "XAD.4"
},
{
"identity": "rim",
"map": "AD.part[parttype = STA]"
},
{
"identity": "vcard",
"map": "region"
},
{
"identity": "servd",
"map": "./Region"
}
]
},
{
"id": "Patient.address.postalCode",
"path": "Patient.address.postalCode",
"short": "Postal code for area",
"definition": "A postal code designating a region defined by the postal service.",
"alias": [
"Zip"
],
"min": 0,
"max": "1",
"base": {
"path": "Address.postalCode",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"example": [
{
"label": "General",
"valueString": "9132"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "XAD.5"
},
{
"identity": "rim",
"map": "AD.part[parttype = ZIP]"
},
{
"identity": "vcard",
"map": "code"
},
{
"identity": "servd",
"map": "./PostalIdentificationCode"
}
]
},
{
"id": "Patient.address.country",
"path": "Patient.address.country",
"short": "Country (e.g. can be ISO 3166 2 or 3 letter code)",
"definition": "Country - a nation as commonly understood or generally accepted.",
"comment": "ISO 3166 3 letter codes can be used in place of a human readable country name.",
"min": 0,
"max": "1",
"base": {
"path": "Address.country",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "XAD.6"
},
{
"identity": "rim",
"map": "AD.part[parttype = CNT]"
},
{
"identity": "vcard",
"map": "country"
},
{
"identity": "servd",
"map": "./Country"
}
]
},
{
"id": "Patient.address.period",
"path": "Patient.address.period",
"short": "Time period when address was/is in use",
"definition": "Time period when address was/is in use.",
"requirements": "Allows addresses to be placed in historical context.",
"min": 0,
"max": "1",
"base": {
"path": "Address.period",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Period"
}
],
"example": [
{
"label": "General",
"valuePeriod": {
"start": "2010-03-23",
"end": "2010-07-01"
}
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "XAD.12 / XAD.13 + XAD.14"
},
{
"identity": "rim",
"map": "./usablePeriod[type=\"IVL<TS>\"]"
},
{
"identity": "servd",
"map": "./StartDate and ./EndDate"
}
]
},
{
"id": "Patient.maritalStatus",
"path": "Patient.maritalStatus",
"short": "Marital (civil) status of a patient",
"definition": "This field contains a patient's most recent marital (civil) status.",
"requirements": "Most, if not all systems capture it.",
"min": 0,
"max": "1",
"base": {
"path": "Patient.maritalStatus",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MaritalStatus"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
"valueBoolean": true
}
],
"strength": "extensible",
"description": "The domestic partnership status of a person.",
"valueSet": "http://hl7.org/fhir/ValueSet/marital-status"
},
"mapping": [
{
"identity": "v2",
"map": "PID-16"
},
{
"identity": "rim",
"map": "player[classCode=PSN]/maritalStatusCode"
},
{
"identity": "cda",
"map": ".patient.maritalStatusCode"
}
]
},
{
"id": "Patient.multipleBirth[x]",
"path": "Patient.multipleBirth[x]",
"short": "Whether patient is part of a multiple birth",
"definition": "Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer).",
"comment": "Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in triplets would be valueInteger=2 and the third born would have valueInteger=3 If a boolean value was provided for this triplets example, then all 3 patient records would have valueBoolean=true (the ordering is not indicated).",
"requirements": "For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs.",
"min": 0,
"max": "1",
"base": {
"path": "Patient.multipleBirth[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "boolean"
},
{
"code": "integer"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "v2",
"map": "PID-24 (bool), PID-25 (integer)"
},
{
"identity": "rim",
"map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Patient.photo",
"path": "Patient.photo",
"short": "Image of the patient",
"definition": "Image of the patient.",
"comment": "Guidelines:\n* Use id photos, not clinical photos.\n* Limit dimensions to thumbnail.\n* Keep byte count low to ease resource updates.",
"requirements": "Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too.",
"min": 0,
"max": "*",
"base": {
"path": "Patient.photo",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Attachment"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "v2",
"map": "OBX-5 - needs a profile"
},
{
"identity": "rim",
"map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/desc"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Patient.contact",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
"valueString": "Contact"
}
],
"path": "Patient.contact",
"short": "A contact party (e.g. guardian, partner, friend) for the patient",
"definition": "A contact party (e.g. guardian, partner, friend) for the patient.",
"comment": "Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.",
"requirements": "Need to track people you can contact about the patient.",
"min": 0,
"max": "*",
"base": {
"path": "Patient.contact",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "pat-1",
"severity": "error",
"human": "SHALL at least contain a contact's details or a reference to an organization",
"expression": "name.exists() or telecom.exists() or address.exists() or organization.exists()",
"xpath": "exists(f:name) or exists(f:telecom) or exists(f:address) or exists(f:organization)"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON]"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Patient.contact.id",
"path": "Patient.contact.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Patient.contact.extension",
"path": "Patient.contact.extension",
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Patient.contact.modifierExtension",
"path": "Patient.contact.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Patient.contact.relationship",
"path": "Patient.contact.relationship",
"short": "The kind of relationship",
"definition": "The nature of the relationship between the patient and the contact person.",
"requirements": "Used to determine which contact person is the most relevant to approach, depending on circumstances.",
"min": 0,
"max": "*",
"base": {
"path": "Patient.contact.relationship",
"min": 0,
"max": "*"
},
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ContactRelationship"
}
],
"strength": "extensible",
"description": "The nature of the relationship between a patient and a contact person for that patient.",
"valueSet": "http://hl7.org/fhir/ValueSet/patient-contactrelationship"
},
"mapping": [
{
"identity": "v2",
"map": "NK1-7, NK1-3"
},
{
"identity": "rim",
"map": "code"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Patient.contact.name",
"path": "Patient.contact.name",
"short": "A name associated with the contact person",
"definition": "A name associated with the contact person.",
"requirements": "Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person.",
"min": 0,
"max": "1",
"base": {
"path": "Patient.contact.name",
"min": 0,
"max": "1"
},
"type": [
{
"code": "HumanName"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "v2",
"map": "NK1-2"
},
{
"identity": "rim",
"map": "name"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Patient.contact.telecom",
"path": "Patient.contact.telecom",
"short": "A contact detail for the person",
"definition": "A contact detail for the person, e.g. a telephone number or an email address.",
"comment": "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.",
"requirements": "People have (primary) ways to contact them in some way such as phone, email.",
"min": 0,
"max": "*",
"base": {
"path": "Patient.contact.telecom",
"min": 0,
"max": "*"
},
"type": [
{
"code": "ContactPoint"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "v2",
"map": "NK1-5, NK1-6, NK1-40"
},
{
"identity": "rim",
"map": "telecom"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Patient.contact.address",
"path": "Patient.contact.address",
"short": "Address for the contact person",
"definition": "Address for the contact person.",
"requirements": "Need to keep track where the contact person can be contacted per postal mail or visited.",
"min": 0,
"max": "1",
"base": {
"path": "Patient.contact.address",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Address"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "v2",
"map": "NK1-4"
},
{
"identity": "rim",
"map": "addr"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Patient.contact.gender",
"path": "Patient.contact.gender",
"short": "male | female | other | unknown",
"definition": "Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes.",
"requirements": "Needed to address the person correctly.",
"min": 0,
"max": "1",
"base": {
"path": "Patient.contact.gender",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "AdministrativeGender"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
"valueBoolean": true
}
],
"strength": "required",
"description": "The gender of a person used for administrative purposes.",
"valueSet": "http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1"
},
"mapping": [
{
"identity": "v2",
"map": "NK1-15"
},
{
"identity": "rim",
"map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Patient.contact.organization",
"path": "Patient.contact.organization",
"short": "Organization that is associated with the contact",
"definition": "Organization on behalf of which the contact is acting or for which the contact is working.",
"requirements": "For guardians or business related contacts, the organization is relevant.",
"min": 0,
"max": "1",
"base": {
"path": "Patient.contact.organization",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
"condition": [
"pat-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "v2",
"map": "NK1-13, NK1-30, NK1-31, NK1-32, NK1-41"
},
{
"identity": "rim",
"map": "scoper"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Patient.contact.period",
"path": "Patient.contact.period",
"short": "The period during which this contact person or organization is valid to be contacted relating to this patient",
"definition": "The period during which this contact person or organization is valid to be contacted relating to this patient.",
"min": 0,
"max": "1",
"base": {
"path": "Patient.contact.period",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Period"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "effectiveTime"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Patient.communication",
"path": "Patient.communication",
"short": "A language which may be used to communicate with the patient about his or her health",
"definition": "A language which may be used to communicate with the patient about his or her health.",
"comment": "If no language is specified, this *implies* that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.",
"requirements": "If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest.",
"min": 0,
"max": "*",
"base": {
"path": "Patient.communication",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "LanguageCommunication"
},
{
"identity": "cda",
"map": "patient.languageCommunication"
}
]
},
{
"id": "Patient.communication.id",
"path": "Patient.communication.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Patient.communication.extension",
"path": "Patient.communication.extension",
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Patient.communication.modifierExtension",
"path": "Patient.communication.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Patient.communication.language",
"path": "Patient.communication.language",
"short": "The language which can be used to communicate with the patient about his or her health",
"definition": "The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. \"en\" for English, or \"en-US\" for American English versus \"en-EN\" for England English.",
"comment": "The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.",
"requirements": "Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.",
"min": 1,
"max": "1",
"base": {
"path": "Patient.communication.language",
"min": 1,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
"valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "Language"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
"valueBoolean": true
}
],
"strength": "preferred",
"description": "A human language.",
"valueSet": "http://hl7.org/fhir/ValueSet/languages"
},
"mapping": [
{
"identity": "v2",
"map": "PID-15, LAN-2"
},
{
"identity": "rim",
"map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/languageCommunication/code"
},
{
"identity": "cda",
"map": ".languageCode"
}
]
},
{
"id": "Patient.communication.preferred",
"path": "Patient.communication.preferred",
"short": "Language preference indicator",
"definition": "Indicates whether or not the patient prefers this language (over other languages he masters up a certain level).",
"comment": "This language is specifically identified for communicating healthcare information.",
"requirements": "People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method.",
"min": 0,
"max": "1",
"base": {
"path": "Patient.communication.preferred",
"min": 0,
"max": "1"
},
"type": [
{
"code": "boolean"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "v2",
"map": "PID-15"
},
{
"identity": "rim",
"map": "preferenceInd"
},
{
"identity": "cda",
"map": ".preferenceInd"
}
]
},
{
"id": "Patient.generalPractitioner",
"path": "Patient.generalPractitioner",
"short": "Patient's nominated primary care provider",
"definition": "Patient's nominated care provider.",
"comment": "IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content.",
"alias": [
"careProvider"
],
"min": 0,
"max": "*",
"base": {
"path": "Patient.generalPractitioner",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Organization",
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "v2",
"map": "PD1-4"
},
{
"identity": "rim",
"map": "subjectOf.CareEvent.performer.AssignedEntity"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Patient.managingOrganization",
"path": "Patient.managingOrganization",
"short": "Organization that is the custodian of the patient record",
"definition": "Organization that is the custodian of the patient record.",
"comment": "There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association).",
"requirements": "Need to know who recognizes this patient record, manages and updates it.",
"min": 0,
"max": "1",
"base": {
"path": "Patient.managingOrganization",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "scoper"
},
{
"identity": "cda",
"map": ".providerOrganization"
}
]
},
{
"id": "Patient.link",
"path": "Patient.link",
"short": "Link to another patient resource that concerns the same actual person",
"definition": "Link to another patient resource that concerns the same actual patient.",
"comment": "There is no assumption that linked patient records have mutual links.",
"requirements": "There are multiple use cases: \n\n* Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and \n* Distribution of patient information across multiple servers.",
"min": 0,
"max": "*",
"base": {
"path": "Patient.link",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": true,
"isModifierReason": "This element is labeled as a modifier because it might not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "outboundLink"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Patient.link.id",
"path": "Patient.link.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Patient.link.extension",
"path": "Patient.link.extension",
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Patient.link.modifierExtension",
"path": "Patient.link.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Patient.link.other",
"path": "Patient.link.other",
"short": "The other patient or related person resource that the link refers to",
"definition": "The other patient resource that the link refers to.",
"comment": "Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.",
"min": 1,
"max": "1",
"base": {
"path": "Patient.link.other",
"min": 1,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-hierarchy",
"valueBoolean": false
}
],
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "v2",
"map": "PID-3, MRG-1"
},
{
"identity": "rim",
"map": "id"
},
{
"identity": "cda",
"map": "n/a"
}
]
},
{
"id": "Patient.link.type",
"path": "Patient.link.type",
"short": "replaced-by | replaces | refer | seealso",
"definition": "The type of link between this patient resource and another patient resource.",
"min": 1,
"max": "1",
"base": {
"path": "Patient.link.type",
"min": 1,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "LinkType"
}
],
"strength": "required",
"description": "The type of link between this patient resource and another patient resource.",
"valueSet": "http://hl7.org/fhir/ValueSet/link-type|4.0.1"
},
"mapping": [
{
"identity": "rim",
"map": "typeCode"
},
{
"identity": "cda",
"map": "n/a"
}
]
}
]
},
"differential": {
"element": [
{
"id": "Patient.extension:individual-recordedSexOrGender",
"path": "Patient.extension",
"sliceName": "individual-recordedSexOrGender",
"short": "Extension for representing an individuals recorded sex or gender.",
"definition": "Recorded sex or gender (RSG) information includes the various sex and gender concepts that are often used in existing systems but are known NOT to represent a gender identity, sex parameter for clinical use, or attributes related to sexuality, such as sexual orientation, sexual activity, or sexual attraction. Examples of recorded sex or gender concepts include administrative gender, administrative sex, and sex assigned at birth. When exchanging this concept, refer to the guidance in the Gender Harmony Implementation Guide",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender"
]
}
]
},
{
"id": "Patient.identifier",
"path": "Patient.identifier",
"slicing": {
"discriminator": [
{
"type": "pattern",
"path": "type"
}
],
"rules": "open"
},
"comment": "This element employs the constraints on identifier put forth in the CA Baseline using a profiled data type.",
"type": [
{
"code": "Identifier",
"profile": [
"http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-identifier"
]
}
],
"mustSupport": true
},
{
"id": "Patient.identifier.type",
"path": "Patient.identifier.type",
"comment": "The slices provided below are examples of identifier types used by jurisdictions for patient summary. These are not required, and the slicing is open meaning that other types can be provided and used in an implementation."
},
{
"id": "Patient.identifier.system",
"path": "Patient.identifier.system",
"min": 1
},
{
"id": "Patient.identifier.value",
"path": "Patient.identifier.value",
"short": "The value that is unique within the system.",
"min": 1
},
{
"id": "Patient.identifier:JHN",
"path": "Patient.identifier",
"sliceName": "JHN",
"short": "Jurisdictional Health Number",
"definition": "Federal patient and person health numbers used by all jurisdictions across Canada"
},
{
"id": "Patient.identifier:JHN.extension",
"path": "Patient.identifier.extension"
},
{
"id": "Patient.identifier:JHN.extension:versionCode",
"path": "Patient.identifier.extension",
"sliceName": "versionCode",
"short": "Health Number Version Code",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-identifierversion"
]
}
]
},
{
"id": "Patient.identifier:JHN.type",
"path": "Patient.identifier.type",
"min": 1,
"patternCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "JHN"
}
]
}
},
{
"id": "Patient.identifier:JHN.system",
"path": "Patient.identifier.system",
"short": "A Health Number Naming System from the Canadian URI Registry",
"min": 1
},
{
"id": "Patient.identifier:JHN.value",
"path": "Patient.identifier.value",
"min": 1
},
{
"id": "Patient.identifier:MRN",
"path": "Patient.identifier",
"sliceName": "MRN",
"short": "Medical Record Number",
"definition": "A local patient identifier from the submitting PoS System",
"comment": "Some jurisdictions may consider the MRN identifier type to be an alternative to the JHN identifier type under certain scenarios. These business rules are outside the scope of this profile, however the slice is socialized to prepare implementers for potential use of this pattern within certain jurisdictions"
},
{
"id": "Patient.identifier:MRN.type",
"path": "Patient.identifier.type",
"min": 1,
"patternCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "MR"
}
]
}
},
{
"id": "Patient.identifier:MRN.system",
"path": "Patient.identifier.system",
"short": "An identifier for the system supplying the MRN",
"min": 1
},
{
"id": "Patient.identifier:MRN.value",
"path": "Patient.identifier.value",
"min": 1
},
{
"id": "Patient.name",
"path": "Patient.name",
"requirements": "Need to be able to track the patient by multiple names. Examples are your official name and a partner name.\nThe Alphabetic representation of the name SHALL be always provided",
"min": 1,
"constraint": [
{
"key": "core-pat-1",
"severity": "error",
"human": "Either Patient.name.given and/or Patient.name.family and/or Patient.name.text SHALL be present or a Data Absent Reason Extension SHALL be present.",
"expression": "(family.exists() or given.exists() or text.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()",
"xpath": "(/f:name/f:extension/@url='http://hl7.org/fhir/StructureDefinition/data-absent-reason' and not(/f:name/f:family or /f:name/f:given or /f:name/f:text)) or (not(/f:name/f:extension/@url='http://hl7.org/fhir/StructureDefinition/data-absent-reason') and (/f:name/f:family or /f:name/f:given or /f:name/f:text))"
}
],
"mustSupport": true
},
{
"id": "Patient.name.text",
"path": "Patient.name.text",
"definition": "Text representation of the full name. Due to the cultural variance around the world a consuming system may not know how to present the name correctly; moreover not all the parts of the name go in given or family. Creators are therefore strongly encouraged to provide through this element a presented version of the name. Future versions of this guide may require this element",
"comment": "Some systems will not have a field for representing the full name as a string, these systems are still expected to be able to demonstrate they can construct name.text when developing the patient summary instance",
"mustSupport": true
},
{
"id": "Patient.name.family",
"path": "Patient.name.family",
"mustSupport": true
},
{
"id": "Patient.name.given",
"path": "Patient.name.given",
"mustSupport": true
},
{
"id": "Patient.telecom",
"path": "Patient.telecom",
"comment": "IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content."
},
{
"id": "Patient.telecom.system",
"path": "Patient.telecom.system",
"mustSupport": true
},
{
"id": "Patient.telecom.value",
"path": "Patient.telecom.value",
"mustSupport": true
},
{
"id": "Patient.telecom.use",
"path": "Patient.telecom.use",
"mustSupport": true
},
{
"id": "Patient.gender",
"path": "Patient.gender",
"mustSupport": true
},
{
"id": "Patient.birthDate",
"path": "Patient.birthDate",
"comment": "While the birthDate element requires a value, if the exact date of birth is unknown, only the known portion of the date (e.g., the year) should be provided without estimating or inferring unknown parts of the date. Use of the Data Absent Reason is appropriate when the date of birth of an individual cannot be determined.",
"min": 1,
"mustSupport": true
},
{
"id": "Patient.address",
"path": "Patient.address",
"comment": "IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content."
},
{
"id": "Patient.address.line",
"path": "Patient.address.line",
"mustSupport": true
},
{
"id": "Patient.address.city",
"path": "Patient.address.city",
"mustSupport": true
},
{
"id": "Patient.address.postalCode",
"path": "Patient.address.postalCode",
"mustSupport": true
},
{
"id": "Patient.address.country",
"path": "Patient.address.country",
"mustSupport": true
},
{
"id": "Patient.generalPractitioner",
"path": "Patient.generalPractitioner",
"comment": "IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content."
}
]
}
}

Terminology bindings (Differential)

Terminology bindings (Snapshot)

PathConformanceValueSet
Patient.languagepreferredhttp://hl7.org/fhir/ValueSet/languages
Patient.identifier.userequiredhttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
Patient.identifier.typeextensiblehttp://hl7.org/fhir/ValueSet/identifier-type
Patient.identifier:JHN.userequiredhttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
Patient.identifier:JHN.typeextensiblehttp://hl7.org/fhir/ValueSet/identifier-type
Patient.identifier:MRN.userequiredhttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
Patient.identifier:MRN.typeextensiblehttp://hl7.org/fhir/ValueSet/identifier-type
Patient.name.userequiredhttp://hl7.org/fhir/ValueSet/name-use|4.0.1
Patient.telecom.systemrequiredhttp://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
Patient.telecom.userequiredhttp://hl7.org/fhir/ValueSet/contact-point-use|4.0.1
Patient.genderrequiredhttp://hl7.org/fhir/ValueSet/administrative-gender|4.0.1
Patient.address.userequiredhttp://hl7.org/fhir/ValueSet/address-use|4.0.1
Patient.address.typerequiredhttp://hl7.org/fhir/ValueSet/address-type|4.0.1
Patient.maritalStatusextensiblehttp://hl7.org/fhir/ValueSet/marital-status
Patient.contact.relationshipextensiblehttp://hl7.org/fhir/ValueSet/patient-contactrelationship
Patient.contact.genderrequiredhttp://hl7.org/fhir/ValueSet/administrative-gender|4.0.1
Patient.communication.languagepreferredhttp://hl7.org/fhir/ValueSet/languages
Patient.link.typerequiredhttp://hl7.org/fhir/ValueSet/link-type|4.0.1

Constraints

PathIdGradeDetailsExpression
Patient.namecore-pat-1errorEither Patient.name.given and/or Patient.name.family and/or Patient.name.text SHALL be present or a Data Absent Reason Extension SHALL be present.(family.exists() or given.exists() or text.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()

Obligations

Key Differences between the IPS-UV and PS-CA

Must Support Differences:

The following elements are considered Must Support in the IPS-UV specification that are relaxed in this version of the PS-CA profile:

  • Patient.telecom

  • Patient.address

  • Patient.generalPractitioner

    Note: Systems that support these elements are encouraged to send them in patient summaries

Cardinality Differences:

There are no cardinality differences between this profile and IPS-UV

Vocabulary Differences:

  • Patient.identifier
    • slices added for JPID & MRN identifier types anticipated to be used by early implementers

Other differences between the IPS and PS-CA Include:

  • Patient.name.text: comment added

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