2nd DSTU Draft For Comment

This page is part of the FHIR Specification (v0.4.0: DSTU 2 Draft). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

5.1.7 Resource Patient - Detailed Descriptions

Detailed Descriptions for the elements in the Patient resource.

Patient
Definition

Demographics and other administrative information about a person or animal receiving care or other health-related services.

Control1..1
Requirements

Tracking patient is the center of the healthcare process.

Alternate NamesSubjectOfCare Client Resident
Patient.identifier
Definition

An identifier that applies to this person as a patient.

Control0..*
TypeIdentifier
Requirements

Patients are almost always assigned specific numerical identifiers.

Summarytrue
Patient.name
Definition

A name associated with the individual.

Control0..*
TypeHumanName
Requirements

Need to be able to track the person by multiple names. Examples are your official name and a partner name.

Summarytrue
Comments

Person 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.

Patient.telecom
Definition

A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted.

Control0..*
TypeContactPoint
Requirements

People have (primary) ways to contact them in some way such as phone, email.

Summarytrue
Comments

Person may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address may not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).

Patient.gender
Definition

Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes.

Control0..1
BindingAdministrativeGender: Required: http://hl7.org/fhir/administrative-gender (The gender of a person used for administrative purposes)
Typecode
Requirements

Needed for identification of the individual, in combination with (at least) name and birth date. Gender of individual drives many clinical processes.

Summarytrue
Comments

The gender may 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 M and F, though the vast majority of systems and contexts only support M and F.

Patient.birthDate
Definition

The date of birth for the individual.

Control0..1
Typedate
Requirements

Age of the individual drives many clinical processes.

Summarytrue
Comments

At least an estimated year should be provided as a guess if the real dob is unknown.

LOINC Code21112-8
Patient.birthTime
Definition

The time of birth for the individual.

Control0..1
Typetime
Requirements

In some cases birth time is important (e.g. multiple births). Hospitals will capture the time of birth in most cases.

Summarytrue
LOINC Code21112-8
Patient.deceased[x]
Definition

Indicates if the individual is deceased or not.

Control0..1
Typeboolean|dateTime
Is Modifiertrue
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.

Summarytrue
Comments

If there's no value in the instance it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.

Patient.address
Definition

Addresses for the individual.

Control0..*
TypeAddress
Requirements

May need to keep track of persons addresses for contacting, billing or reporting requirements and also to help with identification.

Summarytrue
Comments

Person may have multiple addresses with different uses or applicable periods.

Patient.maritalStatus
Definition

This field contains a patient's most recent marital (civil) status.

Control0..1
BindingMaritalStatus: Preferred: See http://hl7.org/fhir/vs/marital-status (The domestic partnership status of a person)
TypeCodeableConcept
Requirements

Most, if not all systems capture it.

Summarytrue
Patient.multipleBirth[x]
Definition

Indicates whether the patient is part of a multiple or indicates the actual birth order.

Control0..1
Typeboolean|integer
Requirements

For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs.

Summarytrue
Patient.photo
Definition

Image of the person.

Control0..*
TypeAttachment
Requirements

Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too.

Patient.contact
Definition

A contact party (e.g. guardian, partner, friend) for the patient.

Control0..*
Requirements

Need to track people you can contact about the patient.

Comments

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.

InvariantsDefined on this element
pat-1: SHALL at least contain a contact's details or a reference to an organization (xpath: f:name or f:telecom or f:address or f:organization)
Patient.contact.relationship
Definition

The nature of the relationship between the patient and the contact person.

Control0..*
BindingContactRelationship: Preferred: See http://hl7.org/fhir/vs/patient-contact-relationship (The nature of the relationship between a patient and a contact person for that patient)
TypeCodeableConcept
Requirements

Used to determine which contact person is the most relevant to approach, depending on circumstances.

Patient.contact.name
Definition

A name associated with the person.

Control0..1
TypeHumanName
Requirements

Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that person.

Patient.contact.telecom
Definition

A contact detail for the person, e.g. a telephone number or an email address.

Control0..*
TypeContactPoint
Requirements

People have (primary) ways to contact them in some way such as phone, email.

Comments

Person may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification.

Patient.contact.address
Definition

Address for the contact person.

Control0..1
TypeAddress
Requirements

Need to keep track where the contact person can be contacted per postal mail or visited.

Patient.contact.gender
Definition

Administrative Gender - the gender that the person is considered to have for administration and record keeping purposes.

Control0..1
BindingAdministrativeGender: Required: http://hl7.org/fhir/administrative-gender (The gender of a person used for administrative purposes)
Typecode
Requirements

Needed to address the person correctly.

Patient.contact.organization
Definition

Organization on behalf of which the contact is acting or for which the contact is working.

Control0..1
TypeReference(Organization)
Requirements

For guardians or business related contacts, the organization is relevant.

InvariantsAffect this element
pat-1: SHALL at least contain a contact's details or a reference to an organization (xpath: f:name or f:telecom or f:address or f:organization)
Patient.contact.period
Definition

The period during which this person or organization is valid to be contacted relating to this patient.

Control0..1
TypePeriod
Patient.animal
Definition

This element has a value if the patient is an animal.

Control0..1
Is Modifiertrue
Requirements

Many clinical systems are extended to care for animal patients as well as human.

Summarytrue
Comments

The animal element is labeled "Is Modifier" since patients may be non-human. Systems SHALL either handle patient details appropriately (e.g. inform users patient is not human) or reject non-human patient records.

Patient.animal.species
Definition

Identifies the high level categorization of the kind of animal.

Control1..1
BindingAnimalSpecies: Example: See http://hl7.org/fhir/vs/animal-species (The species of an animal)
TypeCodeableConcept
Requirements

Need to know what kind of animal.

Summarytrue
Comments

If the patient is non-human, at least a species SHALL be specified.

Patient.animal.breed
Definition

Identifies the detailed categorization of the kind of animal.

Control0..1
BindingAnimalBreed: Example: See http://hl7.org/fhir/vs/animal-breeds (The breed of an animal)
TypeCodeableConcept
Requirements

May need to know the specific kind within the species.

Summarytrue
Patient.animal.genderStatus
Definition

Indicates the current state of the animal's reproductive organs.

Control0..1
BindingAnimalGenderStatus: Example: See http://hl7.org/fhir/vs/animal-genderstatus (The state of the animal's reproductive organs)
TypeCodeableConcept
Requirements

Gender status can affect housing and animal behavior.

Summarytrue
Patient.communication
Definition

Languages which may be used to communicate with the patient about his or her health.

Control0..*
BindingLanguage: Required: IETF language tag (A human language)
TypeCodeableConcept
Requirements

If a patient does not speak the local language, interpreters may be required, so languages spoken is an important things to keep track of both for patient and other persons of interest.

Comments

If no language is specified, this implies that the default local language is spoken. For animals, language is not a relevant field, and should be absent from the instance.

Patient.careProvider
Definition

Patient's nominated care provider.

Control0..*
TypeReference(Organization | Practitioner)
To DoNeed to rationalize this with circleOfCare from CarePlan.
Patient.managingOrganization
Definition

Organization that is the custodian of the patient record.

Control0..1
TypeReference(Organization)
Requirements

Need to know who recognizes this patient record, manages and updates it.

Summarytrue
Patient.link
Definition

Link to another patient resource that concerns the same actual person.

Control0..*
Is Modifiertrue
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.

Summarytrue
Comments

There is no assumption that linked patient records have mutual links.

Patient.link.other
Definition

The other patient resource that the link refers to.

Control1..1
TypeReference(Patient)
Is Modifiertrue
Summarytrue
Patient.link.type
Definition

The type of link between this patient resource and another patient resource.

Control1..1
BindingLinkType: Required: http://hl7.org/fhir/link-type (The type of link between this patient resource and another patient resource.)
Typecode
Is Modifiertrue
Summarytrue
Patient.active
Definition

Whether this patient record is in active use.

Control0..1
Typeboolean
Is Modifiertrue
Default Valuetrue
Requirements

Need to be able to mark a patient record as not to be used because it was created in error.

Summarytrue
Comments

Default is true. If a record is inactive, and linked to an active record, then future patient/person/record updates should occur on the other patient.