<StructureDefinition xmlns="http://hl7.org/fhir">
  <text>
    <status value="empty" />
    <div xmlns="http://www.w3.org/1999/xhtml" />
  </text>
  <url value="http://ehealthontario.on.ca/fhir/StructureDefinition/ca-on-cms-profile-Patient" />
  <version value="1.0.0" />
  <name value="CMSPatient" />
  <status value="draft" />
  <description value="The elements marked as MustSupport ('S' in a red box) must be supported if the data is present in the sending system. Please &lt;a href= &quot;https://www.hl7.org/fhir/conformance-rules.html#mustSupport&quot; target=&quot;blank&quot;&gt;click here &lt;/a&gt; for the details." />
  <fhirVersion value="4.0.1" />
  <kind value="resource" />
  <abstract value="false" />
  <type value="Patient" />
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Patient" />
  <derivation value="constraint" />
  <differential>
    <element id="Patient.meta">
      <path value="Patient.meta" />
      <min value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Patient.meta.profile">
      <path value="Patient.meta.profile" />
      <comment value="#### **_` FOR CMS USAGE: The meta.profile = http://ehealthontario.ca/fhir/StructureDefinition/ca-on-cms-profile-Patient|1.0.0 `_**&#xD;&#xA;It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time.  The list of profile URLs is a set." />
      <min value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Patient.identifier">
      <path value="Patient.identifier" />
      <comment value="#### **_`FOR CMS USAGE: For Patient.identifier, Ontario Health Card Number (HCN) and Medical Record Number (MRN) are supported. In case of Ontario HCN, the identifier.system = &quot;https://fhir.infoway-inforoute.ca/NamingSystem/ca-on-patient-hcn&quot;. In case of MRN, identifier.system should be the corresponding MRN of the healthcare facility. CMS will reject the request upon receiving multiple Ontario HCNs.`_**" />
      <min value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Patient.identifier.extension:data-absent-reason">
      <path value="Patient.identifier.extension" />
      <sliceName value="data-absent-reason" />
      <definition value="Provides a reason why the expected value or elements in the element that is extended are missing." />
      <type>
        <code value="Extension" />
        <profile value="http://hl7.org/fhir/StructureDefinition/data-absent-reason" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="Patient.identifier.system">
      <path value="Patient.identifier.system" />
      <mustSupport value="true" />
    </element>
    <element id="Patient.identifier.value">
      <path value="Patient.identifier.value" />
      <mustSupport value="true" />
    </element>
    <element id="Patient.name">
      <path value="Patient.name" />
      <min value="1" />
      <constraint>
        <key value="ele-2" />
        <severity value="error" />
        <human value="SHALL atleast contain a family name or text" />
        <expression value="family.exist() or text.exist()" />
      </constraint>
      <mustSupport value="true" />
    </element>
    <element id="Patient.name.text">
      <path value="Patient.name.text" />
      <mustSupport value="true" />
    </element>
    <element id="Patient.name.family">
      <path value="Patient.name.family" />
      <mustSupport value="true" />
    </element>
    <element id="Patient.name.given">
      <path value="Patient.name.given" />
      <definition value="#### **_` FOR CMS USAGE: It is recommended to provide Patient's First Name in the first instance and the Middle Name(s) in the subsequent instances. CMS doesn't impose any limitations on the number of repetitions but recommends to align with Provincial Client Registry. `_**" />
      <mustSupport value="true" />
    </element>
    <element id="Patient.telecom">
      <path value="Patient.telecom" />
      <mustSupport value="true" />
    </element>
    <element id="Patient.telecom.system">
      <path value="Patient.telecom.system" />
      <min value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Patient.telecom.value">
      <path value="Patient.telecom.value" />
      <min value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Patient.gender">
      <path value="Patient.gender" />
      <min value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Patient.birthDate">
      <path value="Patient.birthDate" />
      <min value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Patient.deceased[x]">
      <path value="Patient.deceased[x]" />
      <mustSupport value="false" />
    </element>
    <element id="Patient.address">
      <path value="Patient.address" />
      <mustSupport value="true" />
    </element>
    <element id="Patient.address.use">
      <path value="Patient.address.use" />
      <mustSupport value="true" />
    </element>
    <element id="Patient.address.type">
      <path value="Patient.address.type" />
      <mustSupport value="true" />
    </element>
    <element id="Patient.address.line">
      <path value="Patient.address.line" />
      <definition value="This component contains the house number, apartment number, street name, street direction,  P.O. Box number, delivery hints, and similar address information.&#xD;&#xA;&#xD;&#xA;#### **_` FOR CMS USAGE: It's recommended to have 4 lines and each line to have a limit of 80 characters. `_**" />
      <mustSupport value="true" />
    </element>
    <element id="Patient.address.city">
      <path value="Patient.address.city" />
      <mustSupport value="true" />
    </element>
    <element id="Patient.address.state">
      <path value="Patient.address.state" />
      <mustSupport value="true" />
    </element>
    <element id="Patient.address.postalCode">
      <path value="Patient.address.postalCode" />
      <mustSupport value="true" />
    </element>
    <element id="Patient.address.country">
      <path value="Patient.address.country" />
      <mustSupport value="true" />
    </element>
    <element id="Patient.photo">
      <path value="Patient.photo" />
      <definition value="Image of the patient.&#xD;&#xA;&#xD;&#xA;#### **_` FOR CMS USAGE: The default cardinality is retained for this element. However, the current CMS Specification doesn't support any use-case to support photos due to their size and storage restrictions. `_**" />
    </element>
  </differential>
</StructureDefinition>