{
  "resourceType": "StructureDefinition",
  "id": "Patient",
  "meta": {
    "versionId": "34",
    "lastUpdated": "2022-08-04T03:35:44.125+00:00"
  },
  "url": "http://StructureDefinition.hl7fhir.cn/Patient",
  "name": "Patient",
  "title": "患者",
  "status": "draft",
  "date": "2020-12-07T02:46:23.4482715+00:00",
  "publisher": "hl7fhir.cn",
  "description": "接受医疗健康服务的个人或动物，医疗过程是以患者为中心的。对交叉索进行中国本地化约定",
  "fhirVersion": "4.0.0",
  "mapping": [
    {
      "identity": "rim",
      "uri": "http://hl7.org/v3",
      "name": "RIM Mapping"
    },
    {
      "identity": "cda",
      "uri": "http://hl7.org/v3/cda",
      "name": "CDA (R2)"
    },
    {
      "identity": "w5",
      "uri": "http://hl7.org/fhir/fivews",
      "name": "FiveWs Pattern Mapping"
    },
    {
      "identity": "v2",
      "uri": "http://hl7.org/v2",
      "name": "HL7 v2 Mapping"
    },
    {
      "identity": "loinc",
      "uri": "http://loinc.org",
      "name": "LOINC code for the element"
    }
  ],
  "kind": "resource",
  "abstract": false,
  "type": "Patient",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Patient",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "Patient",
        "path": "Patient",
        "short": "接受医疗健康服务的个人或动物",
        "definition": "接受医疗健康服务个人的人口学信息或动物的管理信息。"
      },
      {
        "id": "Patient.extension",
        "path": "Patient.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        }
      },
      {
        "id": "Patient.extension:Ethnicity",
        "path": "Patient.extension",
        "sliceName": "Ethnicity",
        "short": "民族类别",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "http://StructureDefinition.hl7fhir.cn/ChineseEthnicity"
            ]
          }
        ],
        "binding": {
          "strength": "required",
          "description": "民族类别代码表",
          "valueSet": "http://ValueSet.hl7fhir.cn/nationalities-vs"
        }
      },
      {
        "id": "Patient.extension:Nationality",
        "path": "Patient.extension",
        "sliceName": "Nationality",
        "definition": "世界各国和地区名称代码",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "http://StructureDefinition.hl7fhir.cn/Nationality"
            ]
          }
        ],
        "binding": {
          "strength": "required",
          "description": "世界各国和地区名称代码",
          "valueSet": "http://ValueSet.hl7fhir.cn/countries-and-regions-vs"
        }
      },
      {
        "id": "Patient.extension:DegreeOfEducation",
        "path": "Patient.extension",
        "sliceName": "DegreeOfEducation",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "http://StructureDefinition.hl7fhir.cn/degree-of-education"
            ]
          }
        ],
        "binding": {
          "strength": "required",
          "description": "学历代码",
          "valueSet": "http://ValueSet.hl7fhir.cn/education-vs"
        }
      },
      {
        "id": "Patient.extension:Occupations",
        "path": "Patient.extension",
        "sliceName": "Occupations",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "http://StructureDefinition.hl7fhir.cn/occupations"
            ]
          }
        ],
        "binding": {
          "strength": "required",
          "description": "职业代码",
          "valueSet": "http://ValueSet.hl7fhir.cn/classification-code-of-occupations-vs"
        }
      },
      {
        "id": "Patient.extension:PoliticalAffiliation",
        "path": "Patient.extension",
        "sliceName": "PoliticalAffiliation",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "http://StructureDefinition.hl7fhir.cn/politic-affiliation"
            ]
          }
        ]
      },
      {
        "id": "Patient.identifier",
        "path": "Patient.identifier",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "system"
            }
          ],
          "rules": "open"
        },
        "short": "患者主索引以及交叉索引",
        "definition": "患者主索引：患者的唯一标识，患者交叉索引，可以通过各种不同的业务标识符交叉检索到此患者",
        "comment": "若通过业务标识符如一卡通号或住院号来表示，则system中应指定医院uri的值，否则跨院检索会有问题",
        "requirements": "患者总会被分配特定的业务标识符。此本地规则中预置了对身份证、医保卡、健康卡的支持。",
        "type": [
          {
            "code": "Identifier",
            "profile": [
              "http://StructureDefinition.hl7fhir.cn/Identifier"
            ]
          }
        ]
      },
      {
        "id": "Patient.identifier:identityDocument",
        "path": "Patient.identifier",
        "sliceName": "identityDocument",
        "label": "证件",
        "short": "身份证件及其号码",
        "definition": "用于绑定患者的中国法定有效证件。并不用于就诊的业务标识。",
        "max": "1",
        "type": [
          {
            "code": "Identifier",
            "profile": [
              "http://StructureDefinition.hl7fhir.cn/Identifier"
            ]
          }
        ]
      },
      {
        "id": "Patient.identifier:identityDocument.system",
        "path": "Patient.identifier.system",
        "fixedUri": "http://NamingSystem.hl7fhir.cn/identity-document"
      },
      {
        "id": "Patient.identifier:patientIdentifier",
        "path": "Patient.identifier",
        "sliceName": "patientIdentifier",
        "label": "患者标识",
        "short": "患者业务标识",
        "definition": "患者的业务标识（如就诊卡号、电子健康卡号、医保卡号、身份证号等），用于通过某种介质明确的标识某个患者。常用作业务标识符，在不同业务域中的唯一标识ID。在很多场景下可作为交叉索引使用。",
        "max": "1",
        "type": [
          {
            "code": "Identifier",
            "profile": [
              "http://StructureDefinition.hl7fhir.cn/Identifier"
            ]
          }
        ]
      },
      {
        "id": "Patient.identifier:patientIdentifier.type",
        "path": "Patient.identifier.type",
        "binding": {
          "strength": "extensible",
          "description": "患者标识类别，院内卡、健康卡、医保卡、病案号、身份证号等，可扩允",
          "valueSet": "http://ValueSet.hl7fhir.cn/patient-id-type"
        }
      },
      {
        "id": "Patient.identifier:patientIdentifier.system",
        "path": "Patient.identifier.system",
        "fixedUri": "http://NamingSystem.hl7fhir.cn/patient-identifier"
      },
      {
        "id": "Patient.identifier:healthcard",
        "path": "Patient.identifier",
        "sliceName": "healthcard",
        "short": "健康卡号",
        "definition": "标识符，描述患者的健康卡号",
        "max": "1",
        "type": [
          {
            "code": "Identifier",
            "profile": [
              "http://StructureDefinition.hl7fhir.cn/Identifier"
            ]
          }
        ]
      },
      {
        "id": "Patient.identifier:healthcard.type",
        "path": "Patient.identifier.type",
        "short": "健康卡号",
        "definition": "患者的健康卡号",
        "binding": {
          "strength": "extensible",
          "description": "健康卡号",
          "valueSet": "http://ValueSet.hl7fhir.cn/patient-id-type"
        }
      },
      {
        "id": "Patient.identifier:healthcard.system",
        "path": "Patient.identifier.system",
        "fixedUri": "http://NamingSystem.hl7fhir.cn/health-card"
      },
      {
        "id": "Patient.identifier:other-Identifier",
        "path": "Patient.identifier",
        "sliceName": "other-Identifier",
        "short": "其他业务标识符",
        "definition": "其它标识患者的业务ID",
        "type": [
          {
            "code": "Identifier",
            "profile": [
              "http://StructureDefinition.hl7fhir.cn/Identifier"
            ]
          }
        ]
      },
      {
        "id": "Patient.active",
        "path": "Patient.active",
        "short": "是否为活动记录",
        "definition": "此患者记录是否可使用的活动记录。许多系统使用此属性将患者标记为非当前患者，例如根据组织的业务规则在一段时间内未就诊的患者。 它通常用于筛选有效患者记录，排除不活动的患者。 死亡的病人也可能被标记为不活动，但在死亡后的一段时间内病历可能还在使用，可以认为是活动的。",
        "comment": "如果某个患者记录A处于非活动状态并被链接到另一个处于活动状态的患者记录B，则后来对患者记录的更新应在B上进行。",
        "requirements": "需要能够将错误创建的记录标记为不使用（False)。",
        "meaningWhenMissing": "如果没有为active元素提供值，则默认假定此资源是活动的",
        "isModifierReason": "此元素值为fasle时，意味着此记录应被视为无效"
      },
      {
        "id": "Patient.name",
        "path": "Patient.name",
        "short": "患者姓名",
        "definition": "符合中国人使用姓名的习惯，支持曾用名、别名，同时支持\"全名\"和\"姓+名\"的形式。",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "HumanName",
            "profile": [
              "http://StructureDefinition.hl7fhir.cn/ChineseName"
            ]
          }
        ]
      },
      {
        "id": "Patient.telecom",
        "path": "Patient.telecom",
        "definition": "联系方式的详细信息",
        "type": [
          {
            "code": "ContactPoint",
            "profile": [
              "http://StructureDefinition.hl7fhir.cn/ContactPoint"
            ]
          }
        ]
      },
      {
        "id": "Patient.gender",
        "path": "Patient.gender",
        "short": "性别",
        "definition": "生理性别 GB/T 2261.1",
        "binding": {
          "strength": "required",
          "description": "GB/T 2261.1",
          "valueSet": "http://ValueSet.hl7fhir.cn/physiological-gender-vs"
        }
      },
      {
        "id": "Patient.gender.extension",
        "path": "Patient.gender.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        }
      },
      {
        "id": "Patient.gender.extension:genser",
        "path": "Patient.gender.extension",
        "sliceName": "genser",
        "definition": "描述人的生理性别   遵循标准 GB/T 2261.1",
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "http://StructureDefinition.hl7fhir.cn/sexual-distinction-of-human"
            ]
          }
        ],
        "binding": {
          "strength": "required",
          "description": "GB/T 2261.1",
          "valueSet": "http://ValueSet.hl7fhir.cn/physiological-gender-vs"
        }
      },
      {
        "id": "Patient.birthDate",
        "path": "Patient.birthDate",
        "short": "出生日期",
        "definition": "患者的出生年月日"
      },
      {
        "id": "Patient.deceased[x]",
        "path": "Patient.deceased[x]",
        "short": "是否死亡",
        "definition": "指示患者是否死亡，若已亡故，可指定亡故日期",
        "comment": "如果实例中没有值，则表示没有声明该个人是否已死亡。大多数系统都会默认为未死亡。",
        "requirements": "病人死亡的事实会影响临床程序。此外，在人际沟通和关系管理中，有必要知道这个人是否还活着。",
        "isModifierReason": "一旦患者被标记为已死亡，则适合对此患者执行的操作可能会显著不同。"
      },
      {
        "id": "Patient.address",
        "path": "Patient.address",
        "definition": "使用中国行政区划表示的地址 （非GPS或经纬度地址）。",
        "type": [
          {
            "code": "Address",
            "profile": [
              "http://StructureDefinition.hl7fhir.cn/Address"
            ]
          }
        ]
      },
      {
        "id": "Patient.maritalStatus",
        "path": "Patient.maritalStatus",
        "short": "婚姻状况",
        "definition": "患者最近的婚姻（民事）状态。GB/T 2261.2",
        "type": [
          {
            "code": "CodeableConcept",
            "profile": [
              "http://StructureDefinition.hl7fhir.cn/CodeableConcept"
            ]
          }
        ],
        "binding": {
          "strength": "required",
          "description": "GB/T 2261.2",
          "valueSet": "http://ValueSet.hl7fhir.cn/marital-status-vs"
        }
      },
      {
        "id": "Patient.multipleBirth[x]",
        "path": "Patient.multipleBirth[x]",
        "short": "多胞胎",
        "definition": "填写布尔值用于说明患者是否为多胞胎中的一员；填写整数值则表明患者在多胞胎中的实际出生顺序。",
        "comment": "填写整数值，表示的是患者在多胞胎中的实际出生顺序编号。例如，三胞胎中第2个出生者为valueInteger=2，第三个出生者为valueInteger=3。如果用布尔值填写，则3个患者的此元素都应该填写value boolean=true（未指明顺序）。",
        "requirements": "用于排除多胞胎的歧义，特别是在医护人员未能与患者见面的时，可使用此字段确定长幼顺序。"
      },
      {
        "id": "Patient.photo",
        "path": "Patient.photo",
        "short": "照片",
        "definition": "患者的照片",
        "comment": "指南:\n* 使用证件照而非临床照片.\n* 将尺寸限制为缩略图.\n* 尽量限制图像所占用的存储大小以便资源更新。",
        "requirements": "建议使用存储在身份证、居民健康卡或医保卡的照片",
        "type": [
          {
            "code": "Attachment",
            "profile": [
              "http://StructureDefinition.hl7fhir.cn/Attachment"
            ]
          }
        ]
      },
      {
        "id": "Patient.contact",
        "path": "Patient.contact",
        "short": "联系人",
        "definition": "可以联系到患者的其它人，如紧急联系人、配偶、亲属、朋友、担保人等",
        "comment": "包括各种联系人：家庭成员、业务联系人、监护人、照护人员。不适用于登记血统和家庭关系以外的使用有联系。"
      },
      {
        "id": "Patient.contact.relationship",
        "path": "Patient.contact.relationship",
        "short": "联系人关系",
        "definition": "患者与此联系人的关系",
        "type": [
          {
            "code": "CodeableConcept",
            "profile": [
              "http://StructureDefinition.hl7fhir.cn/CodeableConcept"
            ]
          }
        ],
        "binding": {
          "strength": "extensible",
          "description": "联系人关系",
          "valueSet": "http://ValueSet.hl7fhir.cn/family-relationship-vs"
        }
      },
      {
        "id": "Patient.contact.name",
        "path": "Patient.contact.name",
        "short": "联系人姓名",
        "definition": "联系人姓名",
        "type": [
          {
            "code": "HumanName",
            "profile": [
              "http://StructureDefinition.hl7fhir.cn/ChineseName"
            ]
          }
        ]
      },
      {
        "id": "Patient.contact.telecom",
        "path": "Patient.contact.telecom",
        "short": "联系人电话号码",
        "definition": "联系人电话号码，包括手机或座机.",
        "type": [
          {
            "code": "ContactPoint",
            "profile": [
              "http://StructureDefinition.hl7fhir.cn/Telephone"
            ]
          }
        ]
      },
      {
        "id": "Patient.contact.address",
        "path": "Patient.contact.address",
        "definition": "使用中国行政区划表示的地址  （非GPS或经纬度地址）。",
        "type": [
          {
            "code": "Address",
            "profile": [
              "http://StructureDefinition.hl7fhir.cn/Address"
            ]
          }
        ]
      },
      {
        "id": "Patient.contact.gender",
        "path": "Patient.contact.gender",
        "short": "性 别",
        "definition": "生理 性别 GB/T 2261.1",
        "binding": {
          "strength": "required",
          "description": "GB/T 2261.1",
          "valueSet": "http://ValueSet.hl7fhir.cn/physiological-gender-vs"
        }
      },
      {
        "id": "Patient.contact.gender.extension",
        "path": "Patient.contact.gender.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        }
      },
      {
        "id": "Patient.contact.gender.extension:contactgenser",
        "path": "Patient.contact.gender.extension",
        "sliceName": "contactgenser",
        "short": "生理 性别",
        "definition": "描述人的生理性别   遵循标准 GB/T 2261.1",
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "http://StructureDefinition.hl7fhir.cn/sexual-distinction-of-human"
            ]
          }
        ],
        "binding": {
          "strength": "required",
          "description": "GB/T 2261.1",
          "valueSet": "http://ValueSet.hl7fhir.cn/physiological-gender-vs"
        }
      },
      {
        "id": "Patient.contact.organization",
        "path": "Patient.contact.organization",
        "short": "与联系人相关的组织",
        "definition": "联系人所代表的组织或联系人工作的组织。",
        "type": [
          {
            "code": "Reference",
            "profile": [
              "http://StructureDefinition.hl7fhir.cn/Reference"
            ],
            "targetProfile": [
              "http://StructureDefinition.hl7fhir.cn/Organization"
            ]
          }
        ]
      },
      {
        "id": "Patient.contact.period",
        "path": "Patient.contact.period",
        "type": [
          {
            "code": "Period",
            "profile": [
              "http://StructureDefinition.hl7fhir.cn/Period"
            ]
          }
        ]
      },
      {
        "id": "Patient.communication",
        "path": "Patient.communication",
        "max": "0"
      },
      {
        "id": "Patient.generalPractitioner",
        "path": "Patient.generalPractitioner",
        "definition": "患者提名的初诊提供者",
        "max": "0"
      },
      {
        "id": "Patient.managingOrganization",
        "path": "Patient.managingOrganization",
        "short": "管理机构",
        "definition": "保管此患者病历的组织机构",
        "type": [
          {
            "code": "Reference",
            "profile": [
              "http://StructureDefinition.hl7fhir.cn/Reference"
            ],
            "targetProfile": [
              "http://StructureDefinition.hl7fhir.cn/Organization"
            ]
          }
        ]
      },
      {
        "id": "Patient.link",
        "path": "Patient.link",
        "short": "关联人",
        "definition": "链接到与此患者相关的另一个患者资源或相关人员",
        "comment": "链接的患者记录不一定是相互链接的。",
        "requirements": "两个用途：\r\n1、链接没有及时发现的重复患者记录\r\n2、链接分布式服务器上的相关患者信息。",
        "isModifierReason": "当link.type值为“replaced-by”时，说明主患者资源应该使用引用的患者而不是此患者记录。"
      },
      {
        "id": "Patient.link.other",
        "path": "Patient.link.other",
        "short": "关联记录",
        "definition": "链接所指向的其他相关患者资源",
        "comment": "仅用于关联疑似同一患者的记录。去掉了对相关人资源(RelatedPerson)的链接",
        "type": [
          {
            "code": "Reference",
            "profile": [
              "http://StructureDefinition.hl7fhir.cn/Reference"
            ],
            "targetProfile": [
              "http://StructureDefinition.hl7fhir.cn/Patient"
            ]
          }
        ]
      },
      {
        "id": "Patient.link.type",
        "path": "Patient.link.type",
        "short": "关系类别",
        "definition": "此患者与另一患者资源之间的关系，包括被替代、替代、引用、参见（replaced-by | replaces | refer | seealso）",
        "binding": {
          "strength": "required",
          "description": "此患者与另一患者资源之间关系"
        }
      }
    ]
  }
}