<status value="draft" /> <date value="2020-11-09T22:28:57.3566147+00:00" /> <fhirVersion value="4.0.1" /> <mapping> <identity value="rim" /> <uri value="http://hl7.org/v3" /> <name value="RIM Mapping" /> </mapping> <mapping> <identity value="cda" /> <uri value="http://hl7.org/v3/cda" /> <name value="CDA (R2)" /> </mapping> <mapping> <identity value="w5" /> <uri value="http://hl7.org/fhir/fivews" /> <name value="FiveWs Pattern Mapping" /> </mapping> <mapping> <identity value="v2" /> <uri value="http://hl7.org/v2" /> <name value="HL7 v2 Mapping" /> </mapping> <mapping> <identity value="loinc" /> <uri value="http://loinc.org" /> <name value="LOINC code for the element" /> </mapping> <kind value="resource" /> <abstract value="false" /> <type value="Patient" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Patient" /> <derivation value="constraint" /> <differential> <element id="Patient"> <path value="Patient" /> <mustSupport value="true" /> </element> <element id="Patient.id"> <path value="Patient.id" /> <comment value="Usage Note: This will usually be a GUID assigned by the sending application." /> <mustSupport value="true" /> </element> <element id="Patient.meta"> <path value="Patient.meta" /> <mustSupport value="true" /> </element> <element id="Patient.meta.lastUpdated"> <path value="Patient.meta.lastUpdated" /> <mustSupport value="true" /> </element> <element id="Patient.meta.source"> <path value="Patient.meta.source" /> <mustSupport value="true" /> </element> <element id="Patient.meta.profile"> <path value="Patient.meta.profile" /> <mustSupport value="true" /> </element> <element id="Patient.text"> <path value="Patient.text" /> <mustSupport value="true" /> </element> <element id="Patient.extension"> <path value="Patient.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <rules value="open" /> </slicing> <min value="0" /> </element> <element id="Patient.extension:genderIdentity"> <path value="Patient.extension" /> <sliceName value="genderIdentity" /> <min value="0" /> <type> <code value="Extension" /> <profile value="http://hl7.org/fhir/StructureDefinition/patient-genderIdentity" /> </type> <mustSupport value="true" /> <isModifier value="false" /> </element> <element id="Patient.extension:genderIdentity.value[x]"> <path value="Patient.extension.value[x]" /> <slicing> <discriminator> <type value="type" /> <path value="$this" /> </discriminator> <rules value="open" /> </slicing> <mustSupport value="true" /> </element> <element id="Patient.extension:genderIdentity.value[x]:valueCodeableConcept"> <path value="Patient.extension.value[x]" /> <sliceName value="valueCodeableConcept" /> <mustSupport value="true" /> </element> <element id="Patient.extension:Pronouns"> <path value="Patient.extension" /> <sliceName value="Pronouns" /> <definition value="The pronouns to use when referring to an individual in verbal or written communication" /> <comment value="Usage Note: This is a pre-adoption of an HL7 extension, http://hl7.org/fhir/StructureDefinition/individual-pronouns in R5" /> <min value="0" /> <max value="1" /> <type> <code value="Extension" /> <profile value="http://telus.com/fhir/patientChart/StructureDefinition/ext-individual-pronouns" /> </type> <mustSupport value="true" /> <isModifier value="false" /> </element> <element id="Patient.identifier"> <path value="Patient.identifier" /> <slicing> <discriminator> <type value="pattern" /> <path value="type" /> </discriminator> <rules value="open" /> </slicing> <comment value="******** ADD JHN EXTENSION FOR VERSION HERE Usage Note: For all known profiles, this will be mandatory, with the exception of anonomyized data feeds such as RAPIDs." /> <mustSupport value="true" /> </element> <element id="Patient.identifier.type"> <path value="Patient.identifier.type" /> <mustSupport value="true" /> </element> <element id="Patient.identifier.system"> <path value="Patient.identifier.system" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Patient.identifier.value"> <path value="Patient.identifier.value" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Patient.identifier:MRN"> <path value="Patient.identifier" /> <sliceName value="MRN" /> <comment value="Conformance Rule: Sender local patient identifier MAY be stored by the receiving application and used for linking." /> <max value="1" /> <mustSupport value="true" /> </element> <element id="Patient.identifier:MRN.type"> <path value="Patient.identifier.type" /> <min value="1" /> <patternCodeableConcept> <coding> <system value="http://terminology.hl7.org/CodeSystem/v2-0203" /> <code value="MR" /> </coding> </patternCodeableConcept> <mustSupport value="true" /> </element> <element id="Patient.identifier:MRN.type.coding"> <path value="Patient.identifier.type.coding" /> <mustSupport value="true" /> </element> <element id="Patient.identifier:MRN.type.coding.system"> <path value="Patient.identifier.type.coding.system" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Patient.identifier:MRN.type.coding.code"> <path value="Patient.identifier.type.coding.code" /> <min value="1" /> <fixedCode value="MR" /> <mustSupport value="true" /> </element> <element id="Patient.identifier:MRN.system"> <path value="Patient.identifier.system" /> <comment value="Conformance Rule: This will generally be an OID of the form [Vendor OID].[Application Instance node].1.Suggested format: A branch “.1” is appended to create a unique namespace for the Patient ID." /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Patient.identifier:MRN.value"> <path value="Patient.identifier.value" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Patient.identifier:JHN"> <path value="Patient.identifier" /> <sliceName value="JHN" /> <comment value="Conformance: The TELUS Patient Jurisdictional Health Number Identifier . This must be supplied when known. Usage Note: There may be multiple active HN's; example, a baby will use the mother's JHN for a period of time before the baby obtains their own PHN. There could also be two if a person is moving from one province to another" /> <mustSupport value="true" /> </element> <element id="Patient.identifier:JHN.type"> <path value="Patient.identifier.type" /> <min value="1" /> <patternCodeableConcept> <coding> <system value="http://terminology.hl7.org/CodeSystem/v2-0203" /> <code value="JHN" /> </coding> </patternCodeableConcept> <mustSupport value="true" /> </element> <element id="Patient.identifier:JHN.type.coding"> <path value="Patient.identifier.type.coding" /> <min value="1" /> <max value="1" /> <mustSupport value="true" /> </element> <element id="Patient.identifier:JHN.type.coding.system"> <path value="Patient.identifier.type.coding.system" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Patient.identifier:JHN.type.coding.code"> <path value="Patient.identifier.type.coding.code" /> <min value="1" /> <fixedCode value="JHN" /> <mustSupport value="true" /> </element> <element id="Patient.identifier:JHN.system"> <path value="Patient.identifier.system" /> <comment value="Conformance Rule: This is the OID representing the jurisdictional identifier. If identifier.system is urn:ietf:rfc:3986, then the identifier.value must be a full URI (e.g. start with a scheme)." /> <min value="1" /> <mustSupport value="true" /> <binding> <strength value="extensible" /> <valueSet value="http://telus.com/fhir/ValueSet/telus-identifier-system-patient-jhn" /> </binding> </element> <element id="Patient.identifier:JHN.value"> <path value="Patient.identifier.value" /> <comment value="Conformance Rule: This is the patient's jurisdictional health number If the value is a full URI, then the system must be urn:ietf:rfc:3986." /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Patient.name"> <path value="Patient.name" /> <slicing> <discriminator> <type value="value" /> <path value="use" /> </discriminator> <rules value="open" /> </slicing> <comment value="Usage: EMRs typically record the name from the healthcard in which case this should be the "official" name and should always be sent. Additionally, there is often a preferred name or "usual"name in the EMR that should also be sent. Old and/or maiden names can also be helpful for receiving applications who may have existing records with these names. Usage: If the EMR uses the label "nickname", or "preferred" name this should map to usual. In PSS, "preferred" name will map to "usual"; in MA, "nickname" will map to "usual" 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." /> <min value="1" /> <max value="1" /> <mustSupport value="true" /> </element> <element id="Patient.name.use"> <path value="Patient.name.use" /> <comment value="Usage Note: This may be referred to as the Preferred name in some EMRs - this would map to "usual". Usage Note: "Official" use should always be present. "Usual" should be used for preferred when this name is populated as a separate field in the EMR. Applications can assume that a name is current unless it explicitly says that it is temporary or old." /> <mustSupport value="true" /> </element> <element id="Patient.name.family"> <path value="Patient.name.family" /> <mustSupport value="true" /> </element> <element id="Patient.name.given"> <path value="Patient.name.given" /> <mustSupport value="true" /> </element> <element id="Patient.name.prefix"> <path value="Patient.name.prefix" /> <mustSupport value="true" /> </element> <element id="Patient.name.suffix"> <path value="Patient.name.suffix" /> <mustSupport value="true" /> </element> <element id="Patient.gender"> <path value="Patient.gender" /> <comment value="Usage Note: This data is most often captured as a single data element in the EMR. This can also be considered as the Recorded Sex or Gender, that is introduced as an extension in R5. (http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender) which will map into this data element. This extension is not used at this point in time. The gender field in the EMRs tend to represent sex at birth, or admin sex or chromosomal sex. Typically this comes from a birth certificate, OHIP/JHN passport, etc - known government identification Usage Note: When gender has a value of "other" or unknown", systems may be capable of specifying the "Sex for Clinical Use" which an HL7 extension introduced for R5 (http://hl7.org/fhir/StructureDefinition/patient-sexForClinicalUse). This field may be recorded as part of the lab, observation or any other resource where this context is appropriate. 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." /> <mustSupport value="true" /> </element> <element id="Patient.birthDate"> <path value="Patient.birthDate" /> <comment value="Usage Note: At least an estimated year should be provided as a guess if the real DOB is unknown. Usage Note: There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternity/infant care systems)." /> <mustSupport value="true" /> </element> <element id="Patient.deceased[x]"> <path value="Patient.deceased[x]" /> <mustSupport value="true" /> </element> <element id="Patient.contact"> <path value="Patient.contact" /> <comment value="Usage Rule: Privacy reviews are imperative prior to sharing contact infromation 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." /> <mustSupport value="true" /> </element> <element id="Patient.contact.relationship"> <path value="Patient.contact.relationship" /> <mustSupport value="true" /> </element> <element id="Patient.contact.relationship.coding"> <path value="Patient.contact.relationship.coding" /> <mustSupport value="true" /> </element> <element id="Patient.contact.relationship.coding.system"> <path value="Patient.contact.relationship.coding.system" /> <mustSupport value="true" /> </element> <element id="Patient.contact.relationship.coding.code"> <path value="Patient.contact.relationship.coding.code" /> <mustSupport value="true" /> </element> <element id="Patient.contact.relationship.coding.display"> <path value="Patient.contact.relationship.coding.display" /> <mustSupport value="true" /> </element> <element id="Patient.contact.name"> <path value="Patient.contact.name" /> <mustSupport value="true" /> </element> <element id="Patient.contact.name.use"> <path value="Patient.contact.name.use" /> <mustSupport value="true" /> </element> <element id="Patient.contact.name.family"> <path value="Patient.contact.name.family" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Patient.contact.name.given"> <path value="Patient.contact.name.given" /> <mustSupport value="true" /> </element> <element id="Patient.contact.telecom"> <path value="Patient.contact.telecom" /> <mustSupport value="true" /> </element> <element id="Patient.contact.telecom.system"> <path value="Patient.contact.telecom.system" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Patient.contact.telecom.value"> <path value="Patient.contact.telecom.value" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Patient.contact.telecom.use"> <path value="Patient.contact.telecom.use" /> <mustSupport value="true" /> </element> <element id="Patient.contact.address"> <path value="Patient.contact.address" /> <mustSupport value="true" /> </element> <element id="Patient.contact.address.use"> <path value="Patient.contact.address.use" /> <mustSupport value="true" /> </element> <element id="Patient.contact.address.line"> <path value="Patient.contact.address.line" /> <mustSupport value="true" /> </element> <element id="Patient.contact.address.city"> <path value="Patient.contact.address.city" /> <mustSupport value="true" /> </element> <element id="Patient.contact.address.state"> <path value="Patient.contact.address.state" /> <mustSupport value="true" /> </element> <element id="Patient.contact.address.postalCode"> <path value="Patient.contact.address.postalCode" /> <mustSupport value="true" /> </element> <element id="Patient.contact.address.country"> <path value="Patient.contact.address.country" /> <mustSupport value="true" /> </element> <element id="Patient.contact.organization"> <path value="Patient.contact.organization" /> <comment value="Usage: Example may be family and child services 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." /> <mustSupport value="true" /> </element> <element id="Patient.contact.organization.reference"> <path value="Patient.contact.organization.reference" /> <mustSupport value="true" /> </element> <element id="Patient.contact.organization.display"> <path value="Patient.contact.organization.display" /> <mustSupport value="true" /> </element> <element id="Patient.communication"> <path value="Patient.communication" /> <mustSupport value="true" /> </element> <element id="Patient.communication.language"> <path value="Patient.communication.language" /> <mustSupport value="true" /> </element> <element id="Patient.communication.language.coding"> <path value="Patient.communication.language.coding" /> <mustSupport value="true" /> </element> <element id="Patient.communication.language.coding.system"> <path value="Patient.communication.language.coding.system" /> <mustSupport value="true" /> </element> <element id="Patient.communication.language.coding.code"> <path value="Patient.communication.language.coding.code" /> <mustSupport value="true" /> </element> <element id="Patient.communication.language.text"> <path value="Patient.communication.language.text" /> <mustSupport value="true" /> </element> <element id="Patient.generalPractitioner"> <path value="Patient.generalPractitioner" /> <comment value="Usage note: Provider reference to the organization and the practitioner resource If a patient has not been assigned a doctor at the clinic only provide reference to the organization (parent organization) When a Primary MD/NP for that provider at that clinic is assigned provide reference to the organization or in some cases, the sub-organization (eg conceptual location in EMRs where two orgs exist under the same application instance) and the practitioner Usage Note: Primary and secondary providers in PSS are determined by the appointment system. ***Further discussion is required to determine how this would be conveyed in FHIR. 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." /> <mustSupport value="true" /> </element> <element id="Patient.generalPractitioner.reference"> <path value="Patient.generalPractitioner.reference" /> <mustSupport value="true" /> </element> <element id="Patient.generalPractitioner.display"> <path value="Patient.generalPractitioner.display" /> <mustSupport value="true" /> </element> <element id="Patient.managingOrganization"> <path value="Patient.managingOrganization" /> <comment value="Usage note: This should be populated with a particular Org (parent organization with the EMR instance) that is associated with the patient. 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)." /> <mustSupport value="true" /> </element> <element id="Patient.managingOrganization.reference"> <path value="Patient.managingOrganization.reference" /> <comment value="Usage Note: Either the identifier or reference may be used. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server." /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Patient.managingOrganization.display"> <path value="Patient.managingOrganization.display" /> <mustSupport value="true" /> </element> </differential> </StructureDefinition>