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Patient
Definition	The US Core Patient Profile is based upon the core FHIR Patient Resource and designed to meet the applicable patient demographic data elements from the 2015 Edition Common Clinical Data Set.
Cardinality	0...*
Type	DomainResource
Alias	SubjectOfCare Client Resident
Mappings	cda: ClinicalDocument.recordTarget.patientRole rim: Patient[classCode=PAT] w5: administrative.individual argonaut-dq-dstu2: Patient
Patient.id
Definition	The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality	0...1
Type	id
Summary	True
Patient.meta
Definition	The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.
Cardinality	0...1
Type	Meta
Summary	True
Patient.implicitRules
Definition	A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.
Cardinality	0...1
Type	uri
Modifier	True
Summary	True
Patient.language
Definition	The base language in which the resource is written.
Cardinality	0...1
Type	code
Binding	A human language. ?? (required)
Patient.text
Definition	A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Cardinality	0...1
Type	Narrative
Alias	narrative, html, xhtml, display
Mappings	rim: Act.text?
Patient.contained
Definition	These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Cardinality	0...*
Type	Resource
Alias	inline resources, anonymous resources, contained resources
Mappings	rim: N/A
Patient.extension
Definition	May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Slicing	Unordered, Open, by url(Value)
Mappings	rim: N/A
Patient.extension:race
Definition	Concepts 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](http://www.cdc.gov/phin/resources/vocabulary/index.html) 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: - American Indian or Alaska Native - Asian - Black or African American - Native Hawaiian or Other Pacific Islander - White.
Cardinality	0...1
Type	Extension
Must Support	True
Alias	extensions, user content
Invariants	ele-1: All FHIR elements must have a @value or children `children().count() > id.count()` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A argonaut-dq-dstu2: Patient.extension
Patient.extension:ethnicity
Definition	Concepts 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](http://www.cdc.gov/phin/resources/vocabulary/index.html) 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.
Cardinality	0...1
Type	Extension
Must Support	True
Alias	extensions, user content
Invariants	ele-1: All FHIR elements must have a @value or children `children().count() > id.count()` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A argonaut-dq-dstu2: Patient.extension
Patient.extension:birthsex
Definition	A code classifying the person's sex assigned at birth as specified by the [Office of the National Coordinator for Health IT (ONC)](https://www.healthit.gov/newsroom/about-onc).
Cardinality	0...1
Type	Extension
Binding	Code for sex assigned at birth ?? (required)
Must Support	True
Alias	extensions, user content
Comments	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.
Invariants	ele-1: All FHIR elements must have a @value or children `children().count() > id.count()` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/administrativeGender iso11179: .patient.administrativeGenderCode argonaut-dq-dstu2: Patient.extension
Patient.modifierExtension
Definition	May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality	0...*
Type	Extension
Modifier	True
Alias	extensions, user content
Mappings	rim: N/A
Patient.identifier
Definition	An identifier for this patient.
Cardinality	1...*
Type	Identifier
Must Support	True
Summary	True
Requirements	Patients are almost always assigned specific numerical identifiers.
Mappings	cda: .id v2: PID-3 rim: id w5: id argonaut-dq-dstu2: Patient.identifier
Patient.active
Definition	Whether this patient record is in active use.
Cardinality	0...1
Type	boolean
Modifier	True
Summary	True
Requirements	Need to be able to mark a patient record as not to be used because it was created in error.
Mappings	cda: n/a rim: statusCode w5: status
Patient.name
Definition	A name associated with the individual.
Cardinality	1...*
Type	HumanName
Must Support	True
Summary	True
Requirements	Need to be able to track the patient by multiple names. Examples are your official name and a partner name.
Mappings	cda: .patient.name v2: PID-5, PID-9 rim: name argonaut-dq-dstu2: Patient.name
Patient.telecom
Definition	A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted.
Cardinality	0...*
Type	ContactPoint
Summary	True
Requirements	People have (primary) ways to contact them in some way such as phone, email.
Mappings	cda: .telecom v2: PID-13, PID-14, PID-40 rim: telecom
Patient.gender
Definition	Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes.
Cardinality	1...1
Type	code
Binding	The gender of a person used for administrative purposes. ?? (required)
Must Support	True
Summary	True
Requirements	Needed for identification of the individual, in combination with (at least) name and birth date. Gender of individual drives many clinical processes.
Mappings	cda: .patient.administrativeGenderCode v2: PID-8 rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/administrativeGender argonaut-dq-dstu2: Patient.gender
Patient.birthDate
Definition	The date of birth for the individual.
Cardinality	0...1
Type	date
Must Support	True
Summary	True
Requirements	Age of the individual drives many clinical processes.
Mappings	loinc: 21112-8 cda: .patient.birthTime v2: PID-7 rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/birthTime argonaut-dq-dstu2: Patient.birthDate
Patient.deceased[x]
Definition	Indicates if the individual is deceased or not.
Cardinality	0...1
Type	boolean, dateTime
Modifier	True
Summary	True
Requirements	The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.
Mappings	cda: n/a v2: PID-30 (bool) and PID-29 (datetime) rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN\|ANM and determinerCode=INSTANCE]/deceasedTime
Patient.address
Definition	Addresses for the individual.
Cardinality	0...*
Type	Address
Summary	True
Requirements	May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.
Mappings	cda: .addr v2: PID-11 rim: addr
Patient.maritalStatus
Definition	This field contains a patient's most recent marital (civil) status.
Cardinality	0...1
Type	CodeableConcept
Binding	The domestic partnership status of a person. ?? (required)
Requirements	Most, if not all systems capture it.
Mappings	cda: .patient.maritalStatusCode v2: PID-16 rim: player[classCode=PSN]/maritalStatusCode
Patient.multipleBirth[x]
Definition	Indicates whether the patient is part of a multiple or indicates the actual birth order.
Cardinality	0...1
Type	boolean, integer
Requirements	For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs.
Mappings	cda: n/a v2: PID-24 (bool), PID-25 (integer) rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/multipleBirthInd, player[classCode=PSN\|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber
Patient.photo
Definition	Image of the patient.
Cardinality	0...*
Type	Attachment
Requirements	Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too.
Mappings	cda: n/a v2: OBX-5 - needs a profile rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/desc
Patient.contact
Definition	A contact party (e.g. guardian, partner, friend) for the patient.
Cardinality	0...*
Type	BackboneElement
Requirements	Need to track people you can contact about the patient.
Invariants	pat-1: SHALL at least contain a contact's details or a reference to an organization
Mappings	cda: n/a rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON]
Patient.contact.id
Definition	unique id for the element within a resource (for internal references).
Cardinality	0...1
Type	id
Mappings	rim: n/a
Patient.contact.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Mappings	rim: n/a
Patient.contact.modifierExtension
Definition	May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality	0...*
Type	Extension
Modifier	True
Alias	extensions, user content, modifiers
Mappings	rim: N/A
Patient.contact.relationship
Definition	The nature of the relationship between the patient and the contact person.
Cardinality	0...*
Type	CodeableConcept
Binding	The nature of the relationship between a patient and a contact person for that patient. ?? (extensible)
Requirements	Used to determine which contact person is the most relevant to approach, depending on circumstances.
Mappings	cda: n/a v2: NK1-7, NK1-3 rim: code
Patient.contact.name
Definition	A name associated with the contact person.
Cardinality	0...1
Type	HumanName
Requirements	Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person.
Mappings	cda: n/a v2: NK1-2 rim: name
Patient.contact.telecom
Definition	A contact detail for the person, e.g. a telephone number or an email address.
Cardinality	0...*
Type	ContactPoint
Requirements	People have (primary) ways to contact them in some way such as phone, email.
Mappings	cda: n/a v2: NK1-5, NK1-6, NK1-40 rim: telecom
Patient.contact.address
Definition	Address for the contact person.
Cardinality	0...1
Type	Address
Requirements	Need to keep track where the contact person can be contacted per postal mail or visited.
Mappings	cda: n/a v2: NK1-4 rim: addr
Patient.contact.gender
Definition	Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes.
Cardinality	0...1
Type	code
Binding	The gender of a person used for administrative purposes. ?? (required)
Requirements	Needed to address the person correctly.
Mappings	cda: n/a v2: NK1-15 rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/administrativeGender
Patient.contact.organization
Definition	Organization on behalf of which the contact is acting or for which the contact is working.
Cardinality	0...1
Type	http://hl7.org/fhir/StructureDefinition/Organization()
Requirements	For guardians or business related contacts, the organization is relevant.
Mappings	cda: n/a v2: NK1-13, NK1-30, NK1-31, NK1-32, NK1-41 rim: scoper
Patient.contact.period
Definition	The period during which this contact person or organization is valid to be contacted relating to this patient.
Cardinality	0...1
Type	Period
Mappings	cda: n/a rim: effectiveTime
Patient.animal
Definition	This patient is known to be an animal.
Cardinality	0...0
Type	BackboneElement
Summary	True
Requirements	Many clinical systems are extended to care for animal patients as well as human.
Mappings	cda: n/a rim: player[classCode=ANM] argonaut-dq-dstu2: Patient.animal
Patient.animal.id
Definition	unique id for the element within a resource (for internal references).
Cardinality	0...1
Type	id
Mappings	rim: n/a
Patient.animal.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Mappings	rim: n/a
Patient.animal.modifierExtension
Definition	May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality	0...*
Type	Extension
Modifier	True
Alias	extensions, user content, modifiers
Mappings	rim: N/A
Patient.animal.species
Definition	Identifies the high level taxonomic categorization of the kind of animal.
Cardinality	1...1
Type	CodeableConcept
Binding	The species of an animal. ?? (example)
Summary	True
Requirements	Need to know what kind of animal.
Mappings	cda: n/a v2: PID-35 rim: code
Patient.animal.breed
Definition	Identifies the detailed categorization of the kind of animal.
Cardinality	0...1
Type	CodeableConcept
Binding	The breed of an animal. ?? (example)
Summary	True
Requirements	May need to know the specific kind within the species.
Mappings	cda: n/a v2: PID-37 rim: playedRole[classCode=GEN]/scoper[classCode=ANM, determinerCode=KIND]/code
Patient.animal.genderStatus
Definition	Indicates the current state of the animal's reproductive organs.
Cardinality	0...1
Type	CodeableConcept
Binding	The state of the animal's reproductive organs. ?? (example)
Summary	True
Requirements	Gender status can affect housing and animal behavior.
Mappings	cda: n/a v2: N/A rim: genderStatusCode
Patient.communication
Definition	Languages which may be used to communicate with the patient about his or her health.
Cardinality	0...*
Type	BackboneElement
Must Support	True
Requirements	If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency is an important things to keep track of both for patient and other persons of interest.
Mappings	cda: patient.languageCommunication rim: LanguageCommunication argonaut-dq-dstu2: Patient.communication
Patient.communication.id
Definition	unique id for the element within a resource (for internal references).
Cardinality	0...1
Type	id
Mappings	rim: n/a
Patient.communication.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Mappings	rim: n/a
Patient.communication.modifierExtension
Definition	May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality	0...*
Type	Extension
Modifier	True
Alias	extensions, user content, modifiers
Mappings	rim: N/A
Patient.communication.language
Definition	The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English.
Cardinality	1...1
Type	CodeableConcept
Binding	A human language. ?? (extensible)
Must Support	True
Requirements	Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.
Mappings	cda: .languageCode v2: PID-15, LAN-2 rim: player[classCode=PSN\|ANM and determinerCode=INSTANCE]/languageCommunication/code argonaut-dq-dstu2: Patient.communication.language
Patient.communication.preferred
Definition	Indicates whether or not the patient prefers this language (over other languages he masters up a certain level).
Cardinality	0...1
Type	boolean
Requirements	People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method.
Mappings	cda: .preferenceInd v2: PID-15 rim: preferenceInd
Patient.careProvider
Definition	Patient's nominated care provider.
Cardinality	0...*
Type	http://hl7.org/fhir/StructureDefinition/Organization( \| )
Mappings	cda: n/a v2: PD1-4 rim: subjectOf.CareEvent.performer.AssignedEntity
Patient.managingOrganization
Definition	Organization that is the custodian of the patient record.
Cardinality	0...1
Type	http://hl7.org/fhir/StructureDefinition/Organization()
Summary	True
Requirements	Need to know who recognizes this patient record, manages and updates it.
Mappings	cda: .providerOrganization rim: scoper
Patient.link
Definition	Link to another patient resource that concerns the same actual patient.
Cardinality	0...*
Type	BackboneElement
Modifier	True
Requirements	There are multiple usecases: * Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and * Distribution of patient information across multiple servers.
Mappings	cda: n/a rim: outboundLink
Patient.link.id
Definition	unique id for the element within a resource (for internal references).
Cardinality	0...1
Type	id
Mappings	rim: n/a
Patient.link.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Mappings	rim: n/a
Patient.link.modifierExtension
Definition	May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality	0...*
Type	Extension
Modifier	True
Alias	extensions, user content, modifiers
Mappings	rim: N/A
Patient.link.other
Definition	The other patient resource that the link refers to.
Cardinality	1...1
Type	http://hl7.org/fhir/StructureDefinition/Patient()
Modifier	True
Mappings	cda: n/a v2: PID-3, MRG-1 rim: id
Patient.link.type
Definition	The type of link between this patient resource and another patient resource.
Cardinality	1...1
Type	code
Binding	The type of link between this patient resource and another patient resource. ?? (required)
Modifier	True
Mappings	cda: n/a rim: typeCode