Structure Definition: Patient Profile
Canonical URL: https://signalbhn.org/fhir/StructureDefinition/patient
Simplifier project page: Patient
Derived from: US Core Patient STU6 (R4)
Module: Patient Administration Module
Formal profile content
Patient | I | Patient | There are no (further) constraints on this element Element IdPatient Information about an individual or animal receiving health care services Alternate namesSubjectOfCare Client Resident Definition- -
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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race | I | 0..1 | Extension(Complex) | There are no (further) constraints on this element Element IdPatient.extension:race (USCDI) US Core Race Extension Alternate namesextensions, user content DefinitionConcepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The race codes used to represent these concepts are based upon the CDC Race and Ethnicity Code Set Version 1.0 which includes over 900 concepts for representing race and ethnicity of which 921 reference race. The race concepts are grouped by and pre-mapped to the 5 OMB race categories:
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Complex) Extension URLhttp://hl7.org/fhir/us/core/StructureDefinition/us-core-race Constraints
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ethnicity | I | 0..1 | Extension(Complex) | There are no (further) constraints on this element Element IdPatient.extension:ethnicity (USCDI) US Core ethnicity Extension Alternate namesextensions, user content DefinitionConcepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The ethnicity codes used to represent these concepts are based upon the CDC ethnicity and Ethnicity Code Set Version 1.0 which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity. The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories: - Hispanic or Latino - Not Hispanic or Latino. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Complex) Extension URLhttp://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity Constraints
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tribalAffiliation | I | 0..* | Extension(Complex) | There are no (further) constraints on this element Element IdPatient.extension:tribalAffiliation (USCDI) Tribal Affiliation Extension Alternate namesextensions, user content DefinitionA tribe or band with which a person associates whether or not they are an enrolled member. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Complex) Extension URLhttp://hl7.org/fhir/us/core/StructureDefinition/us-core-tribal-affiliation Constraints
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birthsex | I | 0..1 | Extension(code) | There are no (further) constraints on this element Element IdPatient.extension:birthsex (USCDI) Extension Alternate namesextensions, user content DefinitionA code classifying the person's sex assigned at birth as specified by the Office of the National Coordinator for Health IT (ONC). The codes required are intended to present birth sex (i.e., the sex recorded on the patient's birth certificate) and not gender identity or reassigned sex. http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex Constraints
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genderIdentity | I | 0..* | Extension(CodeableConcept) | There are no (further) constraints on this element Element IdPatient.extension:genderIdentity (USCDI) The individual's gender identity Alternate namesextensions, user content DefinitionAn individual's personal sense of being a man, woman, boy, girl, nonbinary, or something else. This represents an individual's identity, ascertained by asking them what that identity is. http://hl7.org/fhir/us/core/StructureDefinition/us-core-genderIdentity Constraints
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adoptionInfo | I | 0..1 | Extension(CodeableConcept) | Element IdPatient.extension:adoptionInfo The adoption status of the patient Alternate namesextensions, user content DefinitionCode indication the adoption status of the patient. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://hl7.org/fhir/StructureDefinition/patient-adoptionInfo Constraints
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identifier | S Σ | 1..* | Identifier | Element IdPatient.identifier (USCDI) An identifier for this patient DefinitionAn identifier for this patient. Patients are almost always assigned specific numerical identifiers. Unordered, Open, by system(Value) Constraints
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(All Slices) | There are no (further) constraints on this element | |||
use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | S Σ | 1..1 | uri | There are no (further) constraints on this element Element IdPatient.identifier.system (USCDI) The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdPatient.identifier.value (USCDI) The value that is unique within the system. DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdPatient.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
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SSN | S Σ | 0..* | Identifier | Element IdPatient.identifier:SSN SSN Identifier for this patient DefinitionSSN identifier for this patient. Patients are almost always assigned specific numerical identifiers.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.identifier:SSN.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.identifier:SSN.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element IdPatient.identifier:SSN.type.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
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system | Σ | 0..1 | uriFixed Value | Element IdPatient.identifier:SSN.type.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
https://www.hl7.org/fhir/valueset-identifier-type.html
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.identifier:SSN.type.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
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code | Σ | 0..1 | codeFixed Value | Element IdPatient.identifier:SSN.type.coding.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
SB
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display | Σ | 0..1 | stringFixed Value | Element IdPatient.identifier:SSN.type.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
Social Beneficiary Identifier
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdPatient.identifier:SSN.type.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
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text | Σ | 0..1 | stringFixed Value | Element IdPatient.identifier:SSN.type.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
Social Security Number
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system | S Σ | 1..1 | uriFixed Value | Element IdPatient.identifier:SSN.system (USCDI) The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
http://hl7.org/fhir/sid/us-ssn
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value | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdPatient.identifier:SSN.value (USCDI) The value that is unique within the system. DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.identifier:SSN.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdPatient.identifier:SSN.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
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MedicaidID | S Σ | 0..* | Identifier | Element IdPatient.identifier:MedicaidID Medicaid identifier for this patient DefinitionMedicaid identifier for this patient. Patients are almost always assigned specific numerical identifiers.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.identifier:MedicaidID.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.identifier:MedicaidID.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element IdPatient.identifier:MedicaidID.type.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
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system | Σ | 0..1 | uriFixed Value | Element IdPatient.identifier:MedicaidID.type.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
https://www.hl7.org/fhir/valueset-identifier-type.html
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.identifier:MedicaidID.type.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
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code | Σ | 0..1 | codeFixed Value | Element IdPatient.identifier:MedicaidID.type.coding.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
SB
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display | Σ | 0..1 | stringFixed Value | Element IdPatient.identifier:MedicaidID.type.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
Social Beneficiary Identifier
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdPatient.identifier:MedicaidID.type.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
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text | Σ | 0..1 | stringFixed Value | Element IdPatient.identifier:MedicaidID.type.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
Patient Medicaid number
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system | S Σ | 1..1 | uriFixed Value | Element IdPatient.identifier:MedicaidID.system (USCDI) The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
https://signalbhn.org/fhir/sid/us-medicaidid
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value | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdPatient.identifier:MedicaidID.value (USCDI) The value that is unique within the system. DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.identifier:MedicaidID.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdPatient.identifier:MedicaidID.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
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MedicareID | S Σ | 0..* | Identifier | Element IdPatient.identifier:MedicareID Medicare identifier for this patient DefinitionMedicare identifier for this patient. Patients are almost always assigned specific numerical identifiers.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.identifier:MedicareID.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.identifier:MedicareID.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element IdPatient.identifier:MedicareID.type.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
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system | Σ | 0..1 | uriFixed Value | Element IdPatient.identifier:MedicareID.type.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
https://www.hl7.org/fhir/valueset-identifier-type.html
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.identifier:MedicareID.type.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
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code | Σ | 0..1 | codeFixed Value | Element IdPatient.identifier:MedicareID.type.coding.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
SB
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display | Σ | 0..1 | stringFixed Value | Element IdPatient.identifier:MedicareID.type.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
Social Beneficiary Identifier
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdPatient.identifier:MedicareID.type.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
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text | Σ | 0..1 | stringFixed Value | Element IdPatient.identifier:MedicareID.type.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
Patient Unique Medicare Number
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system | S Σ | 1..1 | uriFixed Value | Element IdPatient.identifier:MedicareID.system (USCDI) The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
http://hl7.org/fhir/sid/us-mbi
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value | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdPatient.identifier:MedicareID.value (USCDI) The value that is unique within the system. DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.identifier:MedicareID.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdPatient.identifier:MedicareID.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
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ProviderClientId | S Σ | 0..* | Identifier | Element IdPatient.identifier:ProviderClientId ProviderClient identifier for this patient DefinitionProviderClient identifier for this patient. Patients are almost always assigned specific numerical identifiers.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.identifier:ProviderClientId.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.identifier:ProviderClientId.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element IdPatient.identifier:ProviderClientId.type.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
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system | Σ | 0..1 | uriFixed Value | Element IdPatient.identifier:ProviderClientId.type.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
https://www.hl7.org/fhir/valueset-identifier-type.html
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.identifier:ProviderClientId.type.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
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code | Σ | 0..1 | codeFixed Value | Element IdPatient.identifier:ProviderClientId.type.coding.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
MR
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display | Σ | 0..1 | stringFixed Value | Element IdPatient.identifier:ProviderClientId.type.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
Medical Record Number
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdPatient.identifier:ProviderClientId.type.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.identifier:ProviderClientId.type.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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system | S Σ | 1..1 | uri | Element IdPatient.identifier:ProviderClientId.system (USCDI) The namespace for the identifier value DefinitionThis needs to be the URL that is specific to the Provider's domain; e.g. http://example.org There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdPatient.identifier:ProviderClientId.value (USCDI) The value that is unique within the system. DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.identifier:ProviderClientId.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdPatient.identifier:ProviderClientId.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
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ClientId | S Σ | 0..* | Identifier | Element IdPatient.identifier:ClientId Client identifier for this patient DefinitionSignal's Beacon legacy identifier for client. Patients are almost always assigned specific numerical identifiers.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.identifier:ClientId.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.identifier:ClientId.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element IdPatient.identifier:ClientId.type.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
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system | Σ | 0..1 | uriFixed Value | Element IdPatient.identifier:ClientId.type.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
https://www.hl7.org/fhir/valueset-identifier-type.html
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.identifier:ClientId.type.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
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code | Σ | 0..1 | codeFixed Value | Element IdPatient.identifier:ClientId.type.coding.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
MR
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display | Σ | 0..1 | stringFixed Value | Element IdPatient.identifier:ClientId.type.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
Medical Record Number
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdPatient.identifier:ClientId.type.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.identifier:ClientId.type.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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system | S Σ | 1..1 | uriFixed Value | Element IdPatient.identifier:ClientId.system (USCDI) The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
https://signalbhn.org/fhir/sid/beacon-legacy
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value | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdPatient.identifier:ClientId.value (USCDI) The value that is unique within the system. DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.identifier:ClientId.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdPatient.identifier:ClientId.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
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active | Σ ?! | 0..1 | boolean | There are no (further) constraints on this element Element IdPatient.active Whether this patient's record is in active use DefinitionWhether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules. It is often used to filter patient lists to exclude inactive patients Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death. Need to be able to mark a patient record as not to be used because it was created in error. If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient. This resource is generally assumed to be active if no value is provided for the active element
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name | S Σ I | 1..* | HumanName | There are no (further) constraints on this element Element IdPatient.name (USCDI) A name associated with the patient DefinitionA name associated with the individual. Need to be able to track the patient by multiple names. Examples are your official name and a partner name. A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.name.use (USCDI) usual | official | temp | nickname | anonymous | old | maiden DefinitionIdentifies the purpose for this name. Allows the appropriate name for a particular context of use to be selected from among a set of names. Applications can assume that a name is current unless it explicitly says that it is temporary or old. The use of a human name. NameUse (required)Constraints
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.name.text Text representation of the full name DefinitionSpecifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts. A renderable, unencoded form. Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.
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family | S Σ I | 0..1 | string | There are no (further) constraints on this element Element IdPatient.name.family (USCDI) Family name (often called 'Surname') Alternate namessurname DefinitionThe part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father. Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).
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given | S Σ I | 0..* | string | There are no (further) constraints on this element Element IdPatient.name.given (USCDI) Given names (not always 'first'). Includes middle names Alternate namesfirst name, middle name DefinitionGiven name. If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first.
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prefix | Σ | 0..* | string | There are no (further) constraints on this element Element IdPatient.name.prefix Parts that come before the name DefinitionPart of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name. Note that FHIR strings SHALL NOT exceed 1MB in size
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suffix | Σ | 0..* | string | There are no (further) constraints on this element Element IdPatient.name.suffix (USCDI) Parts that come after the name DefinitionPart of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name. Note that FHIR strings SHALL NOT exceed 1MB in size
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.name.period (USCDI) Time period when name was/is in use DefinitionIndicates the period of time when this name was valid for the named person. Allows names to be placed in historical context. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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telecom | Σ I | 0..* | ContactPoint | There are no (further) constraints on this element Element IdPatient.telecom (USCDI) A contact detail for the individual DefinitionA contact detail (e.g. a telephone number or an email address) by which the individual may be contacted. People have (primary) ways to contact them in some way such as phone, email. A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).
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system | S Σ I | 1..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.telecom.system (USCDI) phone | fax | email | pager | url | sms | other DefinitionTelecommunications form for contact point - what communications system is required to make use of the contact. Note that FHIR strings SHALL NOT exceed 1MB in size Telecommunications form for contact point. ContactPointSystem (required)Constraints
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value | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdPatient.telecom.value (USCDI) The actual contact point details DefinitionThe actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address). Need to support legacy numbers that are not in a tightly controlled format. Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.
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use | S Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.telecom.use (USCDI) home | work | temp | old | mobile - purpose of this contact point DefinitionIdentifies the purpose for the contact point. Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose. Applications can assume that a contact is current unless it explicitly says that it is temporary or old. Use of contact point. ContactPointUse (required)Constraints
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rank | Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element IdPatient.telecom.rank Specify preferred order of use (1 = highest) DefinitionSpecifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values. Note that rank does not necessarily follow the order in which the contacts are represented in the instance.
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.telecom.period Time period when the contact point was/is in use DefinitionTime period when the contact point was/is in use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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gender | S Σ | 1..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.gender (USCDI) male | female | other | unknown DefinitionAdministrative Gender - the gender that the patient is considered to have for administration and record keeping purposes. Needed for identification of the individual, in combination with (at least) name and birth date. The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex. The gender of a person used for administrative purposes. AdministrativeGender (required)Constraints
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birthDate | S Σ | 0..1 | date | There are no (further) constraints on this element Element IdPatient.birthDate (USCDI) The date of birth for the individual DefinitionThe date of birth for the individual. Age of the individual drives many clinical processes. At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternity/infant care systems).
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deceased[x] | Σ ?! | 0..1 | There are no (further) constraints on this element Element IdPatient.deceased[x] (USCDI) Indicates if the individual is deceased or not DefinitionIndicates if the individual is deceased or not. The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive. If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.
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deceasedBoolean | boolean | There are no (further) constraints on this element Data Type | ||
deceasedDateTime | dateTime | There are no (further) constraints on this element Data Type | ||
address | S Σ | 0..* | Address | There are no (further) constraints on this element Element IdPatient.address (USCDI) An address for the individual DefinitionAn address for the individual. May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification. Patient may have multiple addresses with different uses or applicable periods.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.address.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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noFixedAddress | I | 0..1 | Extension(boolean) | Element IdPatient.address.extension:noFixedAddress No fixed address indicator Alternate namesextensions, user content DefinitionNo fixed address indicator. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://hl7.org/fhir/StructureDefinition/no-fixed-address Constraints
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.address.use (USCDI) home | work | temp | old | billing - purpose of this address DefinitionThe purpose of this address. Allows an appropriate address to be chosen from a list of many. Applications can assume that an address is current unless it explicitly says that it is temporary or old. The use of an address. AddressUse (required)Constraints
General home Mappings
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type | Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.address.type postal | physical | both DefinitionDistinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both. The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource). The type of an address (physical / postal). AddressType (required)Constraints
General both Mappings
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.address.text Text representation of the address DefinitionSpecifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts. A renderable, unencoded form. Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.
General 137 Nowhere Street, Erewhon 9132 Mappings
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line | S Σ | 0..* | string | There are no (further) constraints on this element Element IdPatient.address.line (USCDI) Street name, number, direction & P.O. Box etc. DefinitionThis component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information. Note that FHIR strings SHALL NOT exceed 1MB in size
General 137 Nowhere Street Mappings
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city | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.address.city (USCDI) Name of city, town etc. Alternate namesMunicpality DefinitionThe name of the city, town, suburb, village or other community or delivery center. Note that FHIR strings SHALL NOT exceed 1MB in size
General Erewhon Mappings
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district | Σ | 0..1 | stringBinding | Element IdPatient.address.district District name (aka county) Alternate namesCounty DefinitionThe name of the administrative area (county). District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead. Colorado counties codes (required) Constraints
General Madison Mappings
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state | S Σ | 0..1 | stringBinding | There are no (further) constraints on this element Element IdPatient.address.state (USCDI) Sub-unit of country (abbreviations ok) Alternate namesProvince, Territory DefinitionSub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes). Note that FHIR strings SHALL NOT exceed 1MB in size Two Letter USPS alphabetic codes. UspsTwoLetterAlphabeticCodes (extensible)Constraints
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postalCode | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.address.postalCode (USCDI) US Zip Codes Alternate namesZip, Zip Code DefinitionA postal code designating a region defined by the postal service. Note that FHIR strings SHALL NOT exceed 1MB in size
General 9132 Mappings
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country | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.address.country Country (e.g. can be ISO 3166 2 or 3 letter code) DefinitionCountry - a nation as commonly understood or generally accepted. ISO 3166 3 letter codes can be used in place of a human readable country name.
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.address.period (USCDI) Time period when address was/is in use DefinitionTime period when address was/is in use. Allows addresses to be placed in historical context. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
General { "start": "2010-03-23", "end": "2010-07-01" } Mappings
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maritalStatus | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.maritalStatus Marital (civil) status of a patient DefinitionThis field contains a patient's most recent marital (civil) status. Most, if not all systems capture it. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The domestic partnership status of a person. Marital Status Codes (extensible)Constraints
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multipleBirth[x] | 0..1 | There are no (further) constraints on this element Element IdPatient.multipleBirth[x] Whether patient is part of a multiple birth DefinitionIndicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer). For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs. 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).
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multipleBirthBoolean | boolean | There are no (further) constraints on this element Data Type | ||
multipleBirthInteger | integer | There are no (further) constraints on this element Data Type | ||
photo | I | 0..* | Attachment | There are no (further) constraints on this element Element IdPatient.photo Image of the patient DefinitionImage of the patient. Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too. Guidelines:
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contact | I | 0..* | BackboneElement | There are no (further) constraints on this element Element IdPatient.contact A contact party (e.g. guardian, partner, friend) for the patient DefinitionA contact party (e.g. guardian, partner, friend) for the patient. Need to track people you can contact about the patient. Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.
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relationship | 0..* | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.contact.relationship The kind of relationship DefinitionThe nature of the relationship between the patient and the contact person. Used to determine which contact person is the most relevant to approach, depending on circumstances. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The nature of the relationship between a patient and a contact person for that patient. PatientContactRelationship (extensible)Constraints
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name | 0..1 | HumanName | There are no (further) constraints on this element Element IdPatient.contact.name A name associated with the contact person DefinitionA name associated with the contact person. Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person. Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts might or might not be imbued with some implicit meaning; various cultures associate different importance with the name parts and the degree to which systems must care about name parts around the world varies widely.
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telecom | I | 0..* | ContactPoint | There are no (further) constraints on this element Element IdPatient.contact.telecom A contact detail for the person DefinitionA contact detail for the person, e.g. a telephone number or an email address. People have (primary) ways to contact them in some way such as phone, email. Contact may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification.
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address | 0..1 | Address | There are no (further) constraints on this element Element IdPatient.contact.address Address for the contact person DefinitionAddress for the contact person. Need to keep track where the contact person can be contacted per postal mail or visited. Note: address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource).
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gender | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.contact.gender male | female | other | unknown DefinitionAdministrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes. Needed to address the person correctly. Note that FHIR strings SHALL NOT exceed 1MB in size The gender of a person used for administrative purposes. AdministrativeGender (required)Constraints
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organization | I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdPatient.contact.organization Organization that is associated with the contact DefinitionOrganization on behalf of which the contact is acting or for which the contact is working. For guardians or business related contacts, the organization is relevant. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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period | I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.contact.period The period during which this contact person or organization is valid to be contacted relating to this patient DefinitionThe period during which this contact person or organization is valid to be contacted relating to this patient. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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communication | 0..* | BackboneElement | There are no (further) constraints on this element Element IdPatient.communication (USCDI) A language which may be used to communicate with the patient about his or her health DefinitionA language which may be used to communicate with the patient about his or her health. If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest. If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.
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language | S | 1..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.communication.language (USCDI) The language which can be used to communicate with the patient about his or her health DefinitionThe ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English. Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect. The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type. A human language. LanguageCodesWithLanguageAndOptionallyARegionModifier (extensible)Constraints
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preferred | 0..1 | boolean | There are no (further) constraints on this element Element IdPatient.communication.preferred Language preference indicator DefinitionIndicates whether or not the patient prefers this language (over other languages he masters up a certain level). People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method. This language is specifically identified for communicating healthcare information.
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generalPractitioner | I | 0..* | Reference(Organization | Practitioner | PractitionerRole) | There are no (further) constraints on this element Element IdPatient.generalPractitioner Patient's nominated primary care provider Alternate namescareProvider DefinitionPatient's nominated care provider. This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues. Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type. Reference(Organization | Practitioner | PractitionerRole) Constraints
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managingOrganization | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdPatient.managingOrganization Organization that is the custodian of the patient record DefinitionOrganization that is the custodian of the patient record. Need to know who recognizes this patient record, manages and updates it. There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association).
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link | Σ ?! | 0..* | BackboneElement | There are no (further) constraints on this element Element IdPatient.link Link to another patient resource that concerns the same actual person DefinitionLink to another patient resource that concerns the same actual patient. There are multiple use cases:
There is no assumption that linked patient records have mutual links.
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other | Σ I | 1..1 | Reference(Patient | RelatedPerson) | There are no (further) constraints on this element Element IdPatient.link.other The other patient or related person resource that the link refers to DefinitionThe other patient resource that the link refers to. Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual. Reference(Patient | RelatedPerson) Constraints
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type | Σ | 1..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.link.type replaced-by | replaces | refer | seealso DefinitionThe type of link between this patient resource and another patient resource. Note that FHIR strings SHALL NOT exceed 1MB in size The type of link between this patient resource and another patient resource. LinkType (required)Constraints
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Patient | I | Patient | There are no (further) constraints on this element Element IdPatient Information about an individual or animal receiving health care services Alternate namesSubjectOfCare Client Resident Definition- -
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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race | I | 0..1 | Extension(Complex) | There are no (further) constraints on this element Element IdPatient.extension:race (USCDI) US Core Race Extension Alternate namesextensions, user content DefinitionConcepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The race codes used to represent these concepts are based upon the CDC Race and Ethnicity Code Set Version 1.0 which includes over 900 concepts for representing race and ethnicity of which 921 reference race. The race concepts are grouped by and pre-mapped to the 5 OMB race categories:
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Complex) Extension URLhttp://hl7.org/fhir/us/core/StructureDefinition/us-core-race Constraints
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ethnicity | I | 0..1 | Extension(Complex) | There are no (further) constraints on this element Element IdPatient.extension:ethnicity (USCDI) US Core ethnicity Extension Alternate namesextensions, user content DefinitionConcepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The ethnicity codes used to represent these concepts are based upon the CDC ethnicity and Ethnicity Code Set Version 1.0 which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity. The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories: - Hispanic or Latino - Not Hispanic or Latino. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Complex) Extension URLhttp://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity Constraints
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tribalAffiliation | I | 0..* | Extension(Complex) | There are no (further) constraints on this element Element IdPatient.extension:tribalAffiliation (USCDI) Tribal Affiliation Extension Alternate namesextensions, user content DefinitionA tribe or band with which a person associates whether or not they are an enrolled member. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Complex) Extension URLhttp://hl7.org/fhir/us/core/StructureDefinition/us-core-tribal-affiliation Constraints
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birthsex | I | 0..1 | Extension(code) | There are no (further) constraints on this element Element IdPatient.extension:birthsex (USCDI) Extension Alternate namesextensions, user content DefinitionA code classifying the person's sex assigned at birth as specified by the Office of the National Coordinator for Health IT (ONC). The codes required are intended to present birth sex (i.e., the sex recorded on the patient's birth certificate) and not gender identity or reassigned sex. http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex Constraints
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genderIdentity | I | 0..* | Extension(CodeableConcept) | There are no (further) constraints on this element Element IdPatient.extension:genderIdentity (USCDI) The individual's gender identity Alternate namesextensions, user content DefinitionAn individual's personal sense of being a man, woman, boy, girl, nonbinary, or something else. This represents an individual's identity, ascertained by asking them what that identity is. http://hl7.org/fhir/us/core/StructureDefinition/us-core-genderIdentity Constraints
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adoptionInfo | I | 0..1 | Extension(CodeableConcept) | Element IdPatient.extension:adoptionInfo The adoption status of the patient Alternate namesextensions, user content DefinitionCode indication the adoption status of the patient. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://hl7.org/fhir/StructureDefinition/patient-adoptionInfo Constraints
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identifier | S Σ | 1..* | Identifier | Element IdPatient.identifier (USCDI) An identifier for this patient DefinitionAn identifier for this patient. Patients are almost always assigned specific numerical identifiers. Unordered, Open, by system(Value) Constraints
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(All Slices) | There are no (further) constraints on this element | |||
use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | S Σ | 1..1 | uri | There are no (further) constraints on this element Element IdPatient.identifier.system (USCDI) The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdPatient.identifier.value (USCDI) The value that is unique within the system. DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdPatient.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
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SSN | S Σ | 0..* | Identifier | Element IdPatient.identifier:SSN SSN Identifier for this patient DefinitionSSN identifier for this patient. Patients are almost always assigned specific numerical identifiers.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.identifier:SSN.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.identifier:SSN.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element IdPatient.identifier:SSN.type.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
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system | Σ | 0..1 | uriFixed Value | Element IdPatient.identifier:SSN.type.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
https://www.hl7.org/fhir/valueset-identifier-type.html
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.identifier:SSN.type.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
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code | Σ | 0..1 | codeFixed Value | Element IdPatient.identifier:SSN.type.coding.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
SB
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display | Σ | 0..1 | stringFixed Value | Element IdPatient.identifier:SSN.type.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
Social Beneficiary Identifier
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdPatient.identifier:SSN.type.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
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text | Σ | 0..1 | stringFixed Value | Element IdPatient.identifier:SSN.type.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
Social Security Number
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system | S Σ | 1..1 | uriFixed Value | Element IdPatient.identifier:SSN.system (USCDI) The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
http://hl7.org/fhir/sid/us-ssn
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value | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdPatient.identifier:SSN.value (USCDI) The value that is unique within the system. DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.identifier:SSN.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdPatient.identifier:SSN.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
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MedicaidID | S Σ | 0..* | Identifier | Element IdPatient.identifier:MedicaidID Medicaid identifier for this patient DefinitionMedicaid identifier for this patient. Patients are almost always assigned specific numerical identifiers.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.identifier:MedicaidID.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.identifier:MedicaidID.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element IdPatient.identifier:MedicaidID.type.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
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system | Σ | 0..1 | uriFixed Value | Element IdPatient.identifier:MedicaidID.type.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
https://www.hl7.org/fhir/valueset-identifier-type.html
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.identifier:MedicaidID.type.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
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code | Σ | 0..1 | codeFixed Value | Element IdPatient.identifier:MedicaidID.type.coding.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
SB
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display | Σ | 0..1 | stringFixed Value | Element IdPatient.identifier:MedicaidID.type.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
Social Beneficiary Identifier
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdPatient.identifier:MedicaidID.type.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
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text | Σ | 0..1 | stringFixed Value | Element IdPatient.identifier:MedicaidID.type.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
Patient Medicaid number
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system | S Σ | 1..1 | uriFixed Value | Element IdPatient.identifier:MedicaidID.system (USCDI) The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
https://signalbhn.org/fhir/sid/us-medicaidid
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value | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdPatient.identifier:MedicaidID.value (USCDI) The value that is unique within the system. DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.identifier:MedicaidID.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdPatient.identifier:MedicaidID.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
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MedicareID | S Σ | 0..* | Identifier | Element IdPatient.identifier:MedicareID Medicare identifier for this patient DefinitionMedicare identifier for this patient. Patients are almost always assigned specific numerical identifiers.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.identifier:MedicareID.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.identifier:MedicareID.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element IdPatient.identifier:MedicareID.type.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
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system | Σ | 0..1 | uriFixed Value | Element IdPatient.identifier:MedicareID.type.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
https://www.hl7.org/fhir/valueset-identifier-type.html
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.identifier:MedicareID.type.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
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code | Σ | 0..1 | codeFixed Value | Element IdPatient.identifier:MedicareID.type.coding.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
SB
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display | Σ | 0..1 | stringFixed Value | Element IdPatient.identifier:MedicareID.type.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
Social Beneficiary Identifier
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdPatient.identifier:MedicareID.type.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
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text | Σ | 0..1 | stringFixed Value | Element IdPatient.identifier:MedicareID.type.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
Patient Unique Medicare Number
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system | S Σ | 1..1 | uriFixed Value | Element IdPatient.identifier:MedicareID.system (USCDI) The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
http://hl7.org/fhir/sid/us-mbi
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value | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdPatient.identifier:MedicareID.value (USCDI) The value that is unique within the system. DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.identifier:MedicareID.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdPatient.identifier:MedicareID.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
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ProviderClientId | S Σ | 0..* | Identifier | Element IdPatient.identifier:ProviderClientId ProviderClient identifier for this patient DefinitionProviderClient identifier for this patient. Patients are almost always assigned specific numerical identifiers.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.identifier:ProviderClientId.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.identifier:ProviderClientId.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element IdPatient.identifier:ProviderClientId.type.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
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system | Σ | 0..1 | uriFixed Value | Element IdPatient.identifier:ProviderClientId.type.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
https://www.hl7.org/fhir/valueset-identifier-type.html
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.identifier:ProviderClientId.type.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
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code | Σ | 0..1 | codeFixed Value | Element IdPatient.identifier:ProviderClientId.type.coding.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
MR
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display | Σ | 0..1 | stringFixed Value | Element IdPatient.identifier:ProviderClientId.type.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
Medical Record Number
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdPatient.identifier:ProviderClientId.type.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.identifier:ProviderClientId.type.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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system | S Σ | 1..1 | uri | Element IdPatient.identifier:ProviderClientId.system (USCDI) The namespace for the identifier value DefinitionThis needs to be the URL that is specific to the Provider's domain; e.g. http://example.org There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdPatient.identifier:ProviderClientId.value (USCDI) The value that is unique within the system. DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.identifier:ProviderClientId.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdPatient.identifier:ProviderClientId.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
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ClientId | S Σ | 0..* | Identifier | Element IdPatient.identifier:ClientId Client identifier for this patient DefinitionSignal's Beacon legacy identifier for client. Patients are almost always assigned specific numerical identifiers.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.identifier:ClientId.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.identifier:ClientId.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element IdPatient.identifier:ClientId.type.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
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system | Σ | 0..1 | uriFixed Value | Element IdPatient.identifier:ClientId.type.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
https://www.hl7.org/fhir/valueset-identifier-type.html
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.identifier:ClientId.type.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
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code | Σ | 0..1 | codeFixed Value | Element IdPatient.identifier:ClientId.type.coding.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
MR
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display | Σ | 0..1 | stringFixed Value | Element IdPatient.identifier:ClientId.type.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
Medical Record Number
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdPatient.identifier:ClientId.type.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.identifier:ClientId.type.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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system | S Σ | 1..1 | uriFixed Value | Element IdPatient.identifier:ClientId.system (USCDI) The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
https://signalbhn.org/fhir/sid/beacon-legacy
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value | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdPatient.identifier:ClientId.value (USCDI) The value that is unique within the system. DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.identifier:ClientId.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdPatient.identifier:ClientId.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
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active | Σ ?! | 0..1 | boolean | There are no (further) constraints on this element Element IdPatient.active Whether this patient's record is in active use DefinitionWhether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules. It is often used to filter patient lists to exclude inactive patients Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death. Need to be able to mark a patient record as not to be used because it was created in error. If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient. This resource is generally assumed to be active if no value is provided for the active element
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name | S Σ I | 1..* | HumanName | There are no (further) constraints on this element Element IdPatient.name (USCDI) A name associated with the patient DefinitionA name associated with the individual. Need to be able to track the patient by multiple names. Examples are your official name and a partner name. A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.name.use (USCDI) usual | official | temp | nickname | anonymous | old | maiden DefinitionIdentifies the purpose for this name. Allows the appropriate name for a particular context of use to be selected from among a set of names. Applications can assume that a name is current unless it explicitly says that it is temporary or old. The use of a human name. NameUse (required)Constraints
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.name.text Text representation of the full name DefinitionSpecifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts. A renderable, unencoded form. Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.
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family | S Σ I | 0..1 | string | There are no (further) constraints on this element Element IdPatient.name.family (USCDI) Family name (often called 'Surname') Alternate namessurname DefinitionThe part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father. Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).
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given | S Σ I | 0..* | string | There are no (further) constraints on this element Element IdPatient.name.given (USCDI) Given names (not always 'first'). Includes middle names Alternate namesfirst name, middle name DefinitionGiven name. If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first.
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prefix | Σ | 0..* | string | There are no (further) constraints on this element Element IdPatient.name.prefix Parts that come before the name DefinitionPart of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name. Note that FHIR strings SHALL NOT exceed 1MB in size
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suffix | Σ | 0..* | string | There are no (further) constraints on this element Element IdPatient.name.suffix (USCDI) Parts that come after the name DefinitionPart of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name. Note that FHIR strings SHALL NOT exceed 1MB in size
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.name.period (USCDI) Time period when name was/is in use DefinitionIndicates the period of time when this name was valid for the named person. Allows names to be placed in historical context. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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telecom | Σ I | 0..* | ContactPoint | There are no (further) constraints on this element Element IdPatient.telecom (USCDI) A contact detail for the individual DefinitionA contact detail (e.g. a telephone number or an email address) by which the individual may be contacted. People have (primary) ways to contact them in some way such as phone, email. A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).
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system | S Σ I | 1..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.telecom.system (USCDI) phone | fax | email | pager | url | sms | other DefinitionTelecommunications form for contact point - what communications system is required to make use of the contact. Note that FHIR strings SHALL NOT exceed 1MB in size Telecommunications form for contact point. ContactPointSystem (required)Constraints
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value | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdPatient.telecom.value (USCDI) The actual contact point details DefinitionThe actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address). Need to support legacy numbers that are not in a tightly controlled format. Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.
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use | S Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.telecom.use (USCDI) home | work | temp | old | mobile - purpose of this contact point DefinitionIdentifies the purpose for the contact point. Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose. Applications can assume that a contact is current unless it explicitly says that it is temporary or old. Use of contact point. ContactPointUse (required)Constraints
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rank | Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element IdPatient.telecom.rank Specify preferred order of use (1 = highest) DefinitionSpecifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values. Note that rank does not necessarily follow the order in which the contacts are represented in the instance.
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.telecom.period Time period when the contact point was/is in use DefinitionTime period when the contact point was/is in use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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gender | S Σ | 1..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.gender (USCDI) male | female | other | unknown DefinitionAdministrative Gender - the gender that the patient is considered to have for administration and record keeping purposes. Needed for identification of the individual, in combination with (at least) name and birth date. The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex. The gender of a person used for administrative purposes. AdministrativeGender (required)Constraints
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birthDate | S Σ | 0..1 | date | There are no (further) constraints on this element Element IdPatient.birthDate (USCDI) The date of birth for the individual DefinitionThe date of birth for the individual. Age of the individual drives many clinical processes. At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternity/infant care systems).
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deceased[x] | Σ ?! | 0..1 | There are no (further) constraints on this element Element IdPatient.deceased[x] (USCDI) Indicates if the individual is deceased or not DefinitionIndicates if the individual is deceased or not. The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive. If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.
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deceasedBoolean | boolean | There are no (further) constraints on this element Data Type | ||
deceasedDateTime | dateTime | There are no (further) constraints on this element Data Type | ||
address | S Σ | 0..* | Address | There are no (further) constraints on this element Element IdPatient.address (USCDI) An address for the individual DefinitionAn address for the individual. May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification. Patient may have multiple addresses with different uses or applicable periods.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element IdPatient.address.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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noFixedAddress | I | 0..1 | Extension(boolean) | Element IdPatient.address.extension:noFixedAddress No fixed address indicator Alternate namesextensions, user content DefinitionNo fixed address indicator. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://hl7.org/fhir/StructureDefinition/no-fixed-address Constraints
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.address.use (USCDI) home | work | temp | old | billing - purpose of this address DefinitionThe purpose of this address. Allows an appropriate address to be chosen from a list of many. Applications can assume that an address is current unless it explicitly says that it is temporary or old. The use of an address. AddressUse (required)Constraints
General home Mappings
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type | Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.address.type postal | physical | both DefinitionDistinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both. The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource). The type of an address (physical / postal). AddressType (required)Constraints
General both Mappings
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.address.text Text representation of the address DefinitionSpecifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts. A renderable, unencoded form. Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.
General 137 Nowhere Street, Erewhon 9132 Mappings
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line | S Σ | 0..* | string | There are no (further) constraints on this element Element IdPatient.address.line (USCDI) Street name, number, direction & P.O. Box etc. DefinitionThis component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information. Note that FHIR strings SHALL NOT exceed 1MB in size
General 137 Nowhere Street Mappings
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city | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.address.city (USCDI) Name of city, town etc. Alternate namesMunicpality DefinitionThe name of the city, town, suburb, village or other community or delivery center. Note that FHIR strings SHALL NOT exceed 1MB in size
General Erewhon Mappings
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district | Σ | 0..1 | stringBinding | Element IdPatient.address.district District name (aka county) Alternate namesCounty DefinitionThe name of the administrative area (county). District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead. Colorado counties codes (required) Constraints
General Madison Mappings
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state | S Σ | 0..1 | stringBinding | There are no (further) constraints on this element Element IdPatient.address.state (USCDI) Sub-unit of country (abbreviations ok) Alternate namesProvince, Territory DefinitionSub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes). Note that FHIR strings SHALL NOT exceed 1MB in size Two Letter USPS alphabetic codes. UspsTwoLetterAlphabeticCodes (extensible)Constraints
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postalCode | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.address.postalCode (USCDI) US Zip Codes Alternate namesZip, Zip Code DefinitionA postal code designating a region defined by the postal service. Note that FHIR strings SHALL NOT exceed 1MB in size
General 9132 Mappings
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country | Σ | 0..1 | string | There are no (further) constraints on this element Element IdPatient.address.country Country (e.g. can be ISO 3166 2 or 3 letter code) DefinitionCountry - a nation as commonly understood or generally accepted. ISO 3166 3 letter codes can be used in place of a human readable country name.
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.address.period (USCDI) Time period when address was/is in use DefinitionTime period when address was/is in use. Allows addresses to be placed in historical context. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
General { "start": "2010-03-23", "end": "2010-07-01" } Mappings
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maritalStatus | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.maritalStatus Marital (civil) status of a patient DefinitionThis field contains a patient's most recent marital (civil) status. Most, if not all systems capture it. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The domestic partnership status of a person. Marital Status Codes (extensible)Constraints
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multipleBirth[x] | 0..1 | There are no (further) constraints on this element Element IdPatient.multipleBirth[x] Whether patient is part of a multiple birth DefinitionIndicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer). For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs. 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).
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multipleBirthBoolean | boolean | There are no (further) constraints on this element Data Type | ||
multipleBirthInteger | integer | There are no (further) constraints on this element Data Type | ||
photo | I | 0..* | Attachment | There are no (further) constraints on this element Element IdPatient.photo Image of the patient DefinitionImage of the patient. Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too. Guidelines:
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contact | I | 0..* | BackboneElement | There are no (further) constraints on this element Element IdPatient.contact A contact party (e.g. guardian, partner, friend) for the patient DefinitionA contact party (e.g. guardian, partner, friend) for the patient. Need to track people you can contact about the patient. Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.
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relationship | 0..* | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.contact.relationship The kind of relationship DefinitionThe nature of the relationship between the patient and the contact person. Used to determine which contact person is the most relevant to approach, depending on circumstances. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The nature of the relationship between a patient and a contact person for that patient. PatientContactRelationship (extensible)Constraints
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name | 0..1 | HumanName | There are no (further) constraints on this element Element IdPatient.contact.name A name associated with the contact person DefinitionA name associated with the contact person. Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person. Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts might or might not be imbued with some implicit meaning; various cultures associate different importance with the name parts and the degree to which systems must care about name parts around the world varies widely.
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telecom | I | 0..* | ContactPoint | There are no (further) constraints on this element Element IdPatient.contact.telecom A contact detail for the person DefinitionA contact detail for the person, e.g. a telephone number or an email address. People have (primary) ways to contact them in some way such as phone, email. Contact may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification.
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address | 0..1 | Address | There are no (further) constraints on this element Element IdPatient.contact.address Address for the contact person DefinitionAddress for the contact person. Need to keep track where the contact person can be contacted per postal mail or visited. Note: address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource).
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gender | 0..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.contact.gender male | female | other | unknown DefinitionAdministrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes. Needed to address the person correctly. Note that FHIR strings SHALL NOT exceed 1MB in size The gender of a person used for administrative purposes. AdministrativeGender (required)Constraints
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organization | I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdPatient.contact.organization Organization that is associated with the contact DefinitionOrganization on behalf of which the contact is acting or for which the contact is working. For guardians or business related contacts, the organization is relevant. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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period | I | 0..1 | Period | There are no (further) constraints on this element Element IdPatient.contact.period The period during which this contact person or organization is valid to be contacted relating to this patient DefinitionThe period during which this contact person or organization is valid to be contacted relating to this patient. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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communication | 0..* | BackboneElement | There are no (further) constraints on this element Element IdPatient.communication (USCDI) A language which may be used to communicate with the patient about his or her health DefinitionA language which may be used to communicate with the patient about his or her health. If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest. If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.
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language | S | 1..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdPatient.communication.language (USCDI) The language which can be used to communicate with the patient about his or her health DefinitionThe ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English. Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect. The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type. A human language. LanguageCodesWithLanguageAndOptionallyARegionModifier (extensible)Constraints
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preferred | 0..1 | boolean | There are no (further) constraints on this element Element IdPatient.communication.preferred Language preference indicator DefinitionIndicates whether or not the patient prefers this language (over other languages he masters up a certain level). People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method. This language is specifically identified for communicating healthcare information.
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generalPractitioner | I | 0..* | Reference(Organization | Practitioner | PractitionerRole) | There are no (further) constraints on this element Element IdPatient.generalPractitioner Patient's nominated primary care provider Alternate namescareProvider DefinitionPatient's nominated care provider. This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues. Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type. Reference(Organization | Practitioner | PractitionerRole) Constraints
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managingOrganization | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdPatient.managingOrganization Organization that is the custodian of the patient record DefinitionOrganization that is the custodian of the patient record. Need to know who recognizes this patient record, manages and updates it. There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association).
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link | Σ ?! | 0..* | BackboneElement | There are no (further) constraints on this element Element IdPatient.link Link to another patient resource that concerns the same actual person DefinitionLink to another patient resource that concerns the same actual patient. There are multiple use cases:
There is no assumption that linked patient records have mutual links.
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other | Σ I | 1..1 | Reference(Patient | RelatedPerson) | There are no (further) constraints on this element Element IdPatient.link.other The other patient or related person resource that the link refers to DefinitionThe other patient resource that the link refers to. Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual. Reference(Patient | RelatedPerson) Constraints
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type | Σ | 1..1 | codeBinding | There are no (further) constraints on this element Element IdPatient.link.type replaced-by | replaces | refer | seealso DefinitionThe type of link between this patient resource and another patient resource. Note that FHIR strings SHALL NOT exceed 1MB in size The type of link between this patient resource and another patient resource. LinkType (required)Constraints
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{ "resourceType": "StructureDefinition", "id": "signal-patient", "url": "http://signalbhn.org/fhir/StructureDefinition/patient", "name": "SignalPatient", "title": "Patient Profile", "status": "draft", "date": "2023-06-15T17:41:33.182674+00:00", "description": "Constraints and extensions on the US Core Patient Resource", "fhirVersion": "4.0.1", "kind": "resource", "abstract": false, "type": "Patient", "baseDefinition": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient", "derivation": "constraint", "differential": { "element": [ { "id": "Patient.extension:adoptionInfo", "path": "Patient.extension", "sliceName": "adoptionInfo", "type": [ { "code": "Extension", "profile": [ "http://hl7.org/fhir/StructureDefinition/patient-adoptionInfo" ] } ], "isModifier": false }, { "id": "Patient.identifier", "path": "Patient.identifier", "slicing": { "discriminator": [ { "type": "value", "path": "system" } ], "rules": "open" } }, { "id": "Patient.identifier:SSN", "path": "Patient.identifier", "sliceName": "SSN", "short": "SSN Identifier for this patient", "definition": "SSN identifier for this patient." }, { "id": "Patient.identifier:SSN.type.coding.system", "path": "Patient.identifier.type.coding.system", "fixedUri": "https://www.hl7.org/fhir/valueset-identifier-type.html" }, { "id": "Patient.identifier:SSN.type.coding.code", "path": "Patient.identifier.type.coding.code", "fixedCode": "SB" }, { "id": "Patient.identifier:SSN.type.coding.display", "path": "Patient.identifier.type.coding.display", "fixedString": "Social Beneficiary Identifier" }, { "id": "Patient.identifier:SSN.type.text", "path": "Patient.identifier.type.text", "fixedString": "Social Security Number" }, { "id": "Patient.identifier:SSN.system", "path": "Patient.identifier.system", "fixedUri": "http://hl7.org/fhir/sid/us-ssn" }, { "id": "Patient.identifier:MedicaidID", "path": "Patient.identifier", "sliceName": "MedicaidID", "short": "Medicaid identifier for this patient", "definition": "Medicaid identifier for this patient." }, { "id": "Patient.identifier:MedicaidID.type.coding.system", "path": "Patient.identifier.type.coding.system", "fixedUri": "https://www.hl7.org/fhir/valueset-identifier-type.html" }, { "id": "Patient.identifier:MedicaidID.type.coding.code", "path": "Patient.identifier.type.coding.code", "fixedCode": "SB" }, { "id": "Patient.identifier:MedicaidID.type.coding.display", "path": "Patient.identifier.type.coding.display", "fixedString": "Social Beneficiary Identifier" }, { "id": "Patient.identifier:MedicaidID.type.text", "path": "Patient.identifier.type.text", "fixedString": "Patient Medicaid number" }, { "id": "Patient.identifier:MedicaidID.system", "path": "Patient.identifier.system", "fixedUri": "https://signalbhn.org/fhir/sid/us-medicaidid" }, { "id": "Patient.identifier:MedicareID", "path": "Patient.identifier", "sliceName": "MedicareID", "short": "Medicare identifier for this patient", "definition": "Medicare identifier for this patient." }, { "id": "Patient.identifier:MedicareID.type.coding.system", "path": "Patient.identifier.type.coding.system", "fixedUri": "https://www.hl7.org/fhir/valueset-identifier-type.html" }, { "id": "Patient.identifier:MedicareID.type.coding.code", "path": "Patient.identifier.type.coding.code", "fixedCode": "SB" }, { "id": "Patient.identifier:MedicareID.type.coding.display", "path": "Patient.identifier.type.coding.display", "fixedString": "Social Beneficiary Identifier" }, { "id": "Patient.identifier:MedicareID.type.text", "path": "Patient.identifier.type.text", "fixedString": "Patient Unique Medicare Number" }, { "id": "Patient.identifier:MedicareID.system", "path": "Patient.identifier.system", "fixedUri": "http://hl7.org/fhir/sid/us-mbi" }, { "id": "Patient.identifier:ProviderClientId", "path": "Patient.identifier", "sliceName": "ProviderClientId", "short": "ProviderClient identifier for this patient", "definition": "ProviderClient identifier for this patient." }, { "id": "Patient.identifier:ProviderClientId.type.coding.system", "path": "Patient.identifier.type.coding.system", "fixedUri": "https://www.hl7.org/fhir/valueset-identifier-type.html" }, { "id": "Patient.identifier:ProviderClientId.type.coding.code", "path": "Patient.identifier.type.coding.code", "fixedCode": "MR" }, { "id": "Patient.identifier:ProviderClientId.type.coding.display", "path": "Patient.identifier.type.coding.display", "fixedString": "Medical Record Number" }, { "id": "Patient.identifier:ProviderClientId.system", "path": "Patient.identifier.system", "definition": "This needs to be the URL that is specific to the Provider's domain; e.g. http://example.org" }, { "id": "Patient.identifier:ClientId", "path": "Patient.identifier", "sliceName": "ClientId", "short": "Client identifier for this patient", "definition": "Signal's Beacon legacy identifier for client." }, { "id": "Patient.identifier:ClientId.type.coding.system", "path": "Patient.identifier.type.coding.system", "fixedUri": "https://www.hl7.org/fhir/valueset-identifier-type.html" }, { "id": "Patient.identifier:ClientId.type.coding.code", "path": "Patient.identifier.type.coding.code", "fixedCode": "MR" }, { "id": "Patient.identifier:ClientId.type.coding.display", "path": "Patient.identifier.type.coding.display", "fixedString": "Medical Record Number" }, { "id": "Patient.identifier:ClientId.system", "path": "Patient.identifier.system", "fixedUri": "https://signalbhn.org/fhir/sid/beacon-legacy" }, { "id": "Patient.address.extension:noFixedAddress", "path": "Patient.address.extension", "sliceName": "noFixedAddress", "type": [ { "code": "Extension", "profile": [ "http://hl7.org/fhir/StructureDefinition/no-fixed-address" ] } ], "isModifier": false }, { "id": "Patient.address.district", "path": "Patient.address.district", "binding": { "strength": "required", "valueSet": "https://signalbhn.org/fhir/ValueSet/fips-county-co" } } ] } }
Profile usage
The Patient resource is used to collect basic demographic and administrative information on individuals that are receiving one or more services. The profile is expected to comply with the US Core Patient Profile specifications, plus contains additional extensions and identifier slices specific for Signal.
Note there is no program, admission, encounter, or other provider interaction information contained on the Patient resource. Nor is there any insurance, coverage, or payment information directly on Patient. This resource only covers the "who" information about the patient.
The patient profile is designed to be specific to each provider organization utilizing the managingOrganization
element. Multiple resources for an indiviaul may exist, and in this way, duplicate records for an individual are expected within this system across provider organizations.
Profile element notes
.managingOrganization
- SHALL reference the provider agency from whom the patient record was entered
- The patient record SHOULD be available to all locations in the Organization.partOf hierarchy
.identifier:SSN
- Contains the Social Security Number for the patient, if available
- Fixed values are created for the associated codeable concepts
.identifier:MedicaidID
- Contains the Medicaid ID for the patient, if available
- Fixed values are created for the associated codeable concepts
- No assumption is made as to the state associated for the Medicaid ID; to accomodate this,
.system
is set as a fixed value tohttps://signalbhn.org/fhir/sid/us-medicaidid
.identifier:MedicareID
- Contains the Medicaid ID for the patient, if available
- Fixed values are created for the associated codeable concepts
- Note, this includes only the Medicare ID, information on benefits is contained on the Coverage resource
.identifier:ProviderClientID
- Contains any of the Provider's ID(s) for the patient
- Note, the
system
element needs to be entered as the URL to that Provider's domain; e.g. https://example.org to be linked to the proper provider identity
.identifier:ClientID
- Contains the carryover identifiers for the patient from Signal's Beacon system
.adoptionInfo (extension) - Patient.extension:adoptionInfo
- Utilized for specific programs
- If present, a fixed value representing the SNOWMED code for "Adopted" is supplied in the
Extension.value[x]:valueCodeableConcept
Extension.value[x]:valueDate
represents the adoption date and is required when adoption is used.
.address.noFixedAddress (extension) - Patient.address.extension:noFixedAddress
- The No Fixed Address indictor, when present, will be assigned a fixed boolean value of
true
onExtension.value[x]:valueBoolean
- The No Fixed Address indicator SHALL take priority for administrative purposes, even if some other address fields contain information
.address.district - Patient.address.district
- Contains a ValueSet binding for Colorado counties using FIPs code plus Other