A boolean true value:

<active value="true" />

A negative integer value:

<score value="-14" />

A high-precision decimal value:

<pi value="3.14159265358979323846264338327950288419716939937510" />

A stream of bytes, base64 encoded:

<data value="/9j/4...KAP//Z" /> <!-- covers many lines -->

A unicode string:

<caption value="Noodles are called 面条 in Chinese" />

A uri that points to a website:

<reference value="http://www.hl7.org/fhir" />

A uri that is a urn:

<id value="urn:isbn:0451450523" />

A date of birth:

<date value="1951-06-04" />

An approximate date of birth:

<date value="1951-06" />

The instant a document was created, including time zone:

<instant value="2013-06-08T10:57:34+01:00" />

The instant a document was created, expressed in UTC, with milliseconds:

<instant value="2013-06-08T09:57:34.2112Z" />

2:35pm in the afternoon:

<time value="14:35" />

A uri that is the root oid of HL7:

<root value="urn:oid:2.16.840.1.113883" />

A uri that is a uuid:

<id value="urn:uuid:a5afddf4-e880-459b-876e-e4591b0acc11" />

A code:

<code value="acq4+acq5" />

A code with single internal space:

<code value="Question 4b" />

A numeric id:

<id value="314" />

An alphanumeric id:

<id value="alpha-gamma-14" />

A PDF document:

  <document>
    <contentType value="application/pdf" />
    <language value="en" />
    <data value="/9j/4...KAP//Z" /> <!-- covers many lines -->
    <title value="Definition of Procedure" />
  </document>

  document : {
    contentType :  { value : "application/pdf" },
    language : { value : "en" },
    data :  { value : "/9j/4...KAP//Z"},
    title :  { value : "Definition of Procedure" }
  }

Since the JSON examples have the same structure as the XML, only XML is shown for the rest of the examples.

A reference to a DICOM image via WADO:

  <image>
    <contentType value="application/dicom" />
    <url value="http://10.1.2.3:1000/wado?requestType=WADO&amp;wado_details..." />
    <hash value="EQH/..AgME" />
  </image>

Examples

A primary key from an application table (an OID in the space allocated by HL7 to some organization to further sub-allocate):

  <identifier>
    <use value="official" />
    <system value="urn:oid:2.16.840.1.113883.16.4.3.2.5" />
    <value value="123" />
  </identifier>

A patient identifier defined by a hospital:

  <identifier>
    <use value="official" />
    <system value="http://www.acmehosp.com/patients" />
    <value value="44552" />
    <period>
      <start value="2003-05-03" />
    </period>
  </identifier>

In this case, the period is used to track when the identifier was first assigned to the patient.

An identifier that refers to a patient FHIR resource on a particular system:

  <identifier>
   <system value="urn:ietf:rfc:3986" />
   <value value="http://pas-server/xxx/Patient/443556" />
  </identifier>

This is not a resource reference - it's a logical reference by the patient identifier.

A UUID:

  <identifier>
    <use value="temp" />
    <system value="urn:ietf:rfc:3986" />
    <value value="urn:uuid:a76d9bbf-f293-4fb7-ad4c-2851cac77162" />
  </identifier>

UUIDs are often used for temporary identifiers, though this is not necessary.

A US SSN:

  <identifier>
    <use value="usual" />
    <label value="SSN" />
    <system value="http://hl7.org/fhir/sid/us-ssn" />
    <value value="000111111" />
  </identifier>

Notes:

• US SSNs are often presented like this: 000-11-1111, the dashes are for presentation and should be removed, as specified in the definition of ssn-us
• The use of "usual" means that this institution prefers to use SSN when identifying the patient

A medical record number assigned on 5-July 2009:

  <identifier>
    <use value="usual" />
    <label value="MRN" />
    <system value="urn:oid:0.1.2.3.4.5.6.7" />
    <value value="2356" />
    <period>
      <start value="2009-07-05" />
    </period>
  </identifier>

Examples

A simple code for headache, in ICD-10:

  <code>
    <system value="http://hl7.org/fhir/sid/icd-10" />
    <code value="G44.1" />
  </code>

A SNOMED CT expression:

  <problem>
    <system value="http://snomed.info/sct" />
    <code value="128045006:{363698007=56459004}" />
  </problem>

Examples

A simple code for headache initially coded in SNOMED CT (by picking the SNOMED CT code from a pick-list), and then translated to ICD-10:

  <concept>
    <coding>
      <system value="http://hl7.org/fhir/sid/icd-10" />
      <code value="R51" />
    </coding>
    <coding>
      <system value="http://snomed.info/sct" />
      <code value="25064002" />
      <display value="Headache" />
      <primary value="true" />
    </coding>
    <text value="general headache" />
  </concept>

A concept represented in an institution's local coding systems for unit for which no UCUM equivalent exists:

  <unit>
    <coding>
      <system value="urn:oid:2.16.840.1.113883.19.5.2" />
      <code value="tab" />
      <display value="Tablet" />
    </coding>
    <coding>
      <system value="http://unitsofmeasure.org" />
    </coding>
  </unit>

A SNOMED CT expression:

  <diagnosis>
    <coding>
      <system value="http://snomed.info/sct" />
      <code value="128045006:{363698007=56459004}" />
    </coding>
    <text value="Cellulitis of the foot" />
  </diagnosis>

In this case, there is no display element, because no display is defined for SNOMED CT expressions.

Using the valueset:

The results on a urinalysis strip:

  <valueCoding>
    <system value="http://example.org/codes/simple-grades" />
    <code value="+" />
    <valueSet>
      <reference url="ValueSet/simple-grades" />
    </valueSet>
  </valueCoding>

And where the value set would be something like this:

  <ValueSet xmlns="http://hl7.org/fhir">
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
        <p>Possible Clinistix codes: neg, trace, +, ++, and +++</p>
      </div>
    </text>
    <identifier value="http://hl7.org/fhir/vs/clinistix"/>
    <name value="Codes for Clinistix"/>
    <publisher value="HL7"/>
    <telecom>
      <system value="url"/>
      <value value="http://hl7.org/fhir"/>
    </telecom>
    <description value="Clinistix Codes"/>
    <status value="draft"/>
    <experimental value="true"/>
    <date value="2013-10-01"/>
    <define>
      <system value="http://hl7.org/fhir/clinistix"/>
      <caseSensitive value="false"/>
      <concept>
        <code value="neg"/>     
      </concept>
      <concept>
        <code value="trace"/>     
      </concept>
      <concept>
        <code value="+"/>     
      </concept>
      <concept>
        <code value="+"/>     
      </concept>
      <concept>
        <code value="++"/>     
      </concept>
      <concept>
        <code value="+++"/>     
      </concept>
    </define>
  </ValueSet>

Examples

A duration:

  <time>
    <value value="25" />
    <units value="sec" />
    <system value="http://unitsofmeasure.org" />
    <code value="s" />
  </time>

A concentration where the value was out of range:

  <result>
    <value value="40000" />
    <comparator value="&gt;" />
    <units value="mcg/L" />
    <system value="http://unitsofmeasure.org" />
    <code value="ug" />
  </result>

An amount of prescribed medication:

  <dose>
    <value value="3" />
    <units value="capsules" />
    <system value="http://snomed.info/sct" />
    <code value="385049006" />
  </dose>

A price (coded using currency codes defined in ISO 4217):

  <cost>
    <value value="25.45" />
    <units value="US$" />
    <system value="urn:std:iso:4217" />
    <code value="USD" />
  </cost>

Examples

Range of Quantity (distance):

  <estimate>
   <low>
     <value value="1.6" />
     <units value="m" />
   </low>
   <high>
     <value value="1.9" />
     <units value="m" />
   </high>
  </estimate>

Examples

Titer (Ratio of integer:integer)

  <result>
   <numerator>
     <value value="1" />
   </numerator>
   <denominator>
     <value value="128" />
   </denominator>
  </result>

Unit cost (Ratio of Money:Quantity):

  <charge>
   <numerator>
     <value value="103.50" />
     <units value="US$" />
     <code value="USD" />
     <system value="urn:std:iso:4217" />
   </numerator>
   <denominator>
     <value value="1" />
     <units value="day" />
     <code value="day" />
     <system value="http://unitsofmeasure.org" />
   </denominator>
  </charge>

Examples

23rd May 2011 to 27th May, including 27th May:

  <coverage>
   <start value="2011-05-23" />
   <end value="2011-05-27" />
  </coverage>

Example

The output from an EKG device:

 <sampledData>
  <origin>
   <value value="0"/>
   <units value="μV"/>
   <system value="http://unitsofmeasure.org"/>
   <code value="uV"/>   
  </origin>
  <period value="2"/>
  <factor value="2.5"/>
  <dimensions value="1"/>
  <data value="-4 -13 -18 -18 -18 -17 -16 -16 -16 -16 -16 -17 -18 -18 -18 ...."/>
 </sampledData>

A Simple example

<name>
  <family value="Everyman" />
  <given value="Adam" />
  <given value="A." />
</name>

Composite names

<name>
  <family value="Contrata" />
  <given value="Mary Jane" />
</name>

These cases can be quite ambiguous - is "Mary Jane" one name, or two? Different systems, and data enterers may treat this differently, and the person themselves may not know. Parts are allowed to contain spaces, but systems should consider how to treat these cases. Composite names separated by "-" should be treated as a single name part.

A common pattern: a person is called by a name other than that expected from their official name (first given name in most cultures).

<name>
  <use value="official" />
  <family value="Chalmers" />
  <given value="Peter" />
  <given value="James" />
</name>
<name>
  <use value="usual" />
  <given value="Jim" />
</name>

This same pattern is often encountered with immigrants, who retain their real name for official use, but adopt a localized name for everyday use:

<name>
  <use value="official" />
  <family value="Sczypinski" />
  <given value="Piotr" />
  <given value="Andre" />
</name>
<name>
  <use value="usual" />
  <family value="Skipper" />
  <given value="Jim" />
</name>

Karen van Hentenryck is of Dutch origin, and the "van" is a voorvoegsel.

<name>
  <use value="official" />  
  <family value="van">
    <extension url="http://hl7.org/fhir/ExtensionDefinition/iso21090-EN-qualifier" >
	   <valueCode value="VV" />
    </extension>
  </family>
  <family value="Hentenryck" />
  <given value="Karen" />
</name>

See the Extensibility Example for more information. Note that this name has multiple family name parts. Systems that do not support as many name parts as are provided in an instance they are processing may wish to append parts together using spaces, so that this becomes "van Hentenryck".

Complex example from Germany: Dr.phil. Regina Johanna Maria Gräfin Hochheim-Weilenfels, NCFSA. This example shows extensive use of multiple given names, prefixes, suffixes, for academic degrees, nobility titles, and professional designations.

<name>
  <use value="official" />  
  <family value="Hochheim-Weilenfels" />
  <given value="Regina" />
  <given value="Johanna" />
  <given value="Maria" />
  <prefix value="Gräfin">
    <extension url="http://hl7.org/fhir/ExtensionDefinition/iso21090-EN-qualifier" >
      <valueCode value="NB" />
    </extension>
  </prefix>
  <prefix value="Dr. phil.">
    <extension url="http://hl7.org/fhir/ExtensionDefinition/iso21090-EN-qualifier" >
      <valueCode value="AC" />
    </extension>
  </prefix>
  <suffix value="NCFSA" />
</name>
<name>
  <use value="maiden" />  
  <family value="Hochheim" />
</name>

This example makes use of the ISO 21090 extensions to carry the rare ISO 21090 qualifier attributes "AC" and "NB".

Japanese example in the three forms: ideographic (Kanji), syllabic (Hiragana) and alphabetic (Romaji).

<name>
  <family value="木村" />
  <given value="通男" />
  </name>
<name>
 <family value="きむら" /> 
 <given value="みちお" /> 
</name>
<name>
  <family value="KIMURA" />
  <given value="MICHIO" />
</name>

The three forms are differentiated by the character subset each contains.

Russian example in the two forms: cyrillic, and latin:

<name>
  <family value="ЕМЕЛИН" />
  <given value="ИВАН" />
  <given value="ВЛАДИМИРОВИЧ" />
</name>
<name>
  <family value="EMELIN" />
  <given value="IVAN" />
  <given value="VLADIMIROVICH" />
</name>

In Russian usage, these names are known as the domestic and foreign names respectively. The two forms are differentiated by the character subset each contains.

Scandinavian example: Erikson is the family name. Jan Erik are the given names, and Östlund the family name of the mother, which is taken as a Mellannamn.

<name>
  <use value="official" />  
  <family value="Erikson" />
  <given value="Jan" />
  <given value="Erik" />
  <given value="Östlund">
    <extension url="http://hl7.org/fhir/Profileiso-20190#name-qualifier" >
      <valueCoding>
         <code value="MID" />
         <system value="http://hl7.org/fhir/v3/EntityNamePartQualifier2" />
      </valueCoding>
    </extension>
  </given>
</name>

This example makes use of the ISO 21090 extension to carry the culture specific ISO 21090 qualifier attribute "MID" for the Mellannamn.

Then Jan Erikson has a daughter, Karin, with his wife Margrete Hansen. The first communications of the new born name is "Margrete Jente" (Margrete's Girl) and the mother's family name, not the given name (Karin). The father's Family name is not used at all. This is a known temporary name assigned directly after the birth of the child.

<name>
  <use value="temp" />  
  <!-- use could be OR+OLD, depends how record keeping is done -->
  <family value="Hansen" />
  <given value="Margrete Jente" />
</name>

The baby's name is subsequently changed to the fathers' family name, and to use the mother's name as mellomnamn.

<name>
  <use value="official" />  
  <family value="Erikson" />
  <given value="Karin" />
  <given value="Hansen">
    <extension url="http://hl7.org/fhir/Profileiso-20190#name-qualifier" >
      <valueCoding>
         <code value="MID" />
         <system value="http://hl7.org/fhir/v3/EntityNamePartQualifier2" />
      </valueCoding>
    </extension>
  </given>
</name>

Later, Karin gets married to Per Berg, and decides to adopts Berg as her family name, and also decides to use Erikson as the mellom navn. (Note: Karin could have chosen to use another mellom navn, e.g. the family name of her mother, her father or other family names as specified by naming laws of the country in question).

<name>
  <use value="old" />  
  <family value="Erikson" />
  <given value="Karin" />
  <given value="Hansen">
    <extension url="http://hl7.org/fhir/Profileiso-20190#name-qualifier" >
      <valueCoding>
        <code value="MID" />
        <system value="http://hl7.org/fhir/v3/EntityNamePartQualifier2" />
      </valueCoding>
    </extension>
  </given>
</name>
<name>
  <use value="official" />  
  <family value="Berg" />
  <given value="Karin" />
  <given value="Erikson">
    <extension url="http://hl7.org/fhir/Profileiso-20190#name-qualifier" >
      <valueCoding>
        <code value="MID" />
        <system value="http://hl7.org/fhir/v3/EntityNamePartQualifier2" />
      </valueCoding>
    </extension>
  </given>
</name>
<name>
  <use value="usual" />  
  <family value="Berg" />
  <given value="Karin" />
</name>

Example

HL7 office's address.

  <address>
   <use value="work" />
   <text value="1050 W Wishard Blvd
RG 
         5th floor
Indianapolis, IN 46240" />
   <line value="1050 W Wishard Blvd" />
   <line value="RG 5th floor" />
   <city value="Indianapolis" />
   <state value="IN" />
   <postalCode value="46240" />
  </address>

A UK example address.

  <address>
    <extension url="http://hl7.org/fhir/ExtensionDefinition/iso21090-ADXP-county" > <!-- todo: review this -->
      <valueString value="HUDDERSFIELD"/>
    </extension>
    <text value="1 Back Lane&#13;&#10;Holmfirth&#13;&#10;HUDDERSFIELD&#13;&#10;HD7 1HQ"/>
    <line value="1 Back Lane"/>
    <city value="Holmfirth"/>
    <postalCode value="HD7 1HQ"/>
  </address>

A Postal address - i.e. an address that it doesn't make sense to try and visit.

  <address>
    <extension url="http://hl7.org/fhir/ExtensionDefinition/iso21090-AD-use"> <!-- todo: review this -->
      <valueCode value="PST"/>
    </extension>
    <line value="PO Box 31445"/>
    <city value="Erewhon"/>
    <postalCode value="0001"/>
  </address>

Example

Home phone number:

  <telecom>
   <system value="phone" />
   <value value="+15556755745" />
   <use value="home" />
  </telecom>

Example

A series of appointments for radiotherapy:

  <schedule>
    <event>
      <start value="2012-01-07T09:00:00+10:00" />
      <end value="2012-01-07T13:00:00+10:00" />
    </event>
    <event>
      <start value="2012-01-14T09:00:00+10:00" />
      <end value="2012-01-14T13:00:00+10:00" />
    </event>
    <event>
      <start value="2012-01-22T11:00:00+10:00" />
      <end value="2012-01-22T15:00:00+10:00" />
    </event>
  </schedule>

BID (twice a day) (no start or end specified):

  <schedule>
   <repeat>
     <frequency value="2" />
     <duration value="1" />
     <units value="d" />
   </repeat>
  </schedule>

1/2 an hour before breakfast for 10 days from 23-Dec 2011:

  <schedule>
    <event>
      <start value="2011-12-23" />
    </event>
    <repeat>
      <when value="ACM" />
      <duration value="30" />
      <units value="min" />
      <end value="2012-01-02" />
    </repeat>
  </schedule>

Note that the end date is inclusive like the high date of a Period.

Example

todo

  <signature>
    <!-- todo -->
  </signature>