FHIR General Extensions IG
0.1.0 - Working Copy International flag

This page is part of the FHIR Core Extensions Registry (v0.1.0: Releases Draft) based on FHIR v5.0.0. . For a full list of available versions, see the Directory of published versions

Artifacts Summary

This page provides a list of the FHIR artifacts defined as part of this implementation guide.

Behavior: Search Parameters

These define the properties by which a RESTful server can be searched. They can also be used for sorting and including related resources.

Research Study SearchParameter

SearchParameter for Research Study Extension

workflow

Optional Extensions Element

keyword

Optional Extensions Element

effective

Optional Extensions Element

author

Optional Extensions Element

end

Optional Extensions Element

keyword

Optional Extensions Element

effective

Optional Extensions Element

workflow

Optional Extensions Element

end

Optional Extensions Element

author

Optional Extensions Element

mothers Maiden Name

Search based on patient’s mother’s maiden name

birth Order Boolean

Search based on whether a patient was part of a multiple birth or not.

age

Searches for patients based on age as calculated based on current date and date of birth. Deceased patients are excluded from the search.

din

The donation identification number (DIN)

Structures: Extension Definitions

These define constraints on FHIR data types for systems conforming to this implementation guide.

Organization Period

The date range that this organization should be considered available.

Organization Preferred Contact

This Contact is the preferred contact at this organization for the purpose of the contact

There can be multiple contacts on an Organizations record with this value set to true, but these should all have different purpose values.

AuditEvent Instance

Th SOP Instance UID values.

AuditEvent Number Of Instances

The Number of SOP Instances referred to by this entity.

AuditEvent Lifecycle

An Lifecycle event associated with this participant object.

AuditEvent Encrypted

True or False indicating whether the data was encrypted.

AuditEvent Participant Object Contains Study

A Study Instance ID, which may be used when the Entity type is not (110180, DCM, “Study Instance UID”).

AuditEvent Anonymized

True or False indicating whether all patient identifying information was removed from the data.

AuditEvent SOPClass

Required if ParticipantObjectIDTypeCode is (110180, DCM, “Study Instance UID”) and any of the optional fields (AccessionNumber, ContainsMPPS, NumberOfInstances, ContainsSOPInstances,Encrypted,Anonymized) are present in this Participant Object. May be present if ParticipantObjectIDTypeCode is (110180, DCM, “Study Instance UID”) even though none of the optional fields are present.

AuditEvent MPPS

An MPPS Instance UID associated with this entity.

AuditEvent Alternative User ID

An AlternativeUserID Number associated with this participant object.

AuditEvent Accession

An Accession Number associated with this participant object.

Structure Definition Summary

Additional text for the summary presentation.

StructureDefinition Xml Has No Order

Whether elements can come in any order in XML.

StructureDefinition Table Name

A name to use to show mappings of this type in the generated summary tables.

StructureDefinition Interface

Marks that the resource definition represents an interface rather than a resource.

StructureDefinition Compiles With Profile

Asserts that instances that are valid against this profile are also automatically valid against the StructureDefinition referenced by this extension.

StructureDefinition FMM If No Warnings

The FMM level that would be assigned to the artifact if it had no warnings.

StructureDefinition Inheritance Control (for Extensions)

A code that controls how an extension is treated when snapshots are generated

StructureDefinition Dependent Profiles

Instances can only be valid against this profile, if they also successfully validate against the profile referenced by this extension.

StructureDefinition Security Category

Provides general guidance around the kind of access Control to Read, Search, Create, Update, or Delete the resource.

Structure Type Characterstics (Constraint Control)

A code that indicates that a particular type characteristic and it’s associated element definition aspects apply to this type

StructureDefinition Category

The category under which the resource type is presented on the official resource list.

StructureDefinition Template Status

Status code taken from HL7 template specification - allows for alignment with the template DSTU, and has more authoring status codes.

StructureDefinition Ancestor

A canonical reference to a StructureDefinition that this is derived from. This is a de-normalization of a chain of StructureDefinition.baseDefinition.

StructureDefinition Applicable Version

An additional version that this profile apples to, other than the version explicitly stated in StructureDefinition.fhirVersion.

StructureDefinition Codegen Super

A specific instruction to use an intermediate parent class when generating code for the classes.

CapabilityStatement Search Mode

Which search modes the server supports: GET, POST, or both

CapabilityStatement WebSocket

Where the server provides its web socket end-point.

OAuth URIs

Supports automated discovery of OAuth2 endpoints.

CapabilityStatement Search Parameter Use

This extension defines if a search parameter is only allowed in certain contexts

CapabilityStatement Declared Profile

This extension identifies a profile the system will recognize if it is declared in meta.profile. If the system supports the _profile search parameter, it will be capable of searching on the profile. The system may support validation against the profile.

Capabilities

A set of codes that defines what the server is capable of.

CapabilityStatement Supported CodeSystem

A code system that is supported by the system that is not defined in a value set resource.

supported cql version

Indicates that the server supports the given version of Clinical Quality Language (CQL). Valid values are major.minor and optionally the patch version of any published version of the CQL specification.

CapabilityStatement Search Parameter Combination

This extension defines a possible search parameter combination by listing a set of search parameters and indicating whether they are required or optional.

  • If a search combination is specified, clients should expect that they must submit a search that meets one of the required combinations or the search will be unsuccessful.
  • If multiple search parameter combinations are specified, a client may pick between them, and supply the minimal required parameters for any of the combinations.
  • If no parameters in the set of search parameters are listed as required, then at least one of the listed optional parameters must be present. This shorthand method is the same as repeating the entire extension for each combination of optional and required search parameters.
Flag details

Points to the Observation, AllergyIntolerance or other record that provides additional supporting information about this flag.

Flag Priority

A code that identifies the priority of the alert, for example the Alert Priority flags column in IHE PCD TF 2 Table B.8-4.

CarePlan Activity Title

Human-friendly name for the activity.

DocumentReference Thumbnail

True or False indicating whether this content is a thumbnail.

DocumentReference Source Patient

The Patient Information as known when the document was published. May be a reference to a version specific, or contained.

cds hooks endpoint

Specifies the URI of a CDS Hooks service that uses this PlanDefinition as its implementation.

QuestionnaireResponse Signature

Represents a wet or electronic signature for either the form overall or for the question or item it’s associated with.

max decimal places

Identifies the maximum number of decimal places that may be specified for the data element.

entry format

Additional instructions for the user to guide their input (i.e. a human readable version of a regular expression like “nnn-nnn-nnn”). In most UIs this is the placeholder (or ‘ghost’) text placed directly inside the edit controls and that disappear when the control gets the focus.

performer order

Identifies the relative preference of alternative performers when the request lists multiple performers.

Questionnaire Slider Step Value

For slider-based controls, indicates the step size to use when toggling the control up or down.

CapabilityStatement Expectation

Defines the level of expectation associated with a given system capability.

related artifact

Documents the ‘knowledge artifacts’ relevant to the base resource such as citations, supporting evidence, documentation of processes, caveats around testing methodology.

ValueSet Label

The label to list in front of a code when presenting a list of possible values in a questionnaire-like fashion.

research study

Indicates that this event is relevant to the specified research study(ies).

status reason

Captures the reason for the current state of the resource.

event history

Links to Provenance records for past versions of this resource that document key state transitions or updates that are deemed “relevant” or important to a user looking at the current version of the resource. E.g, when an observation was verified or corrected. This extension does not point to the Provenance associated with the current version of the resource - as it would be created after this version existed. The Provenance for the current version can be retrieved with a _revinclude.

shall comply with

In satisfying this request or instantiating this definition, the expectations defined in the Definition resource are expected to be met. (This allows requirements defined elsewhere to be brought into play by reference rather than providing all of the detail in-line necessary to satisfy the referenced Definition.).

referenceFilter

Identifies a filter to apply when looking up candidate answers for the question. This extension has been replaced by the Structured Data Capture candidateExpression extension.

follow on of

Points to a preceding event within a workflow that was a prerequisite for or provides other justification for the current action.

QuestionnaireResponse Unit Option

A unit that the user may choose when providing a quantity value.

CapabilityStatement Prohibition

If set to true, indicates that support for the specified behavior would make a system non-conformant with the specification.

Resource Last Review Date

The date on which the asset content was last reviewed. Review happens periodically after that, but doesn’t change the original approval date.

Questionnaire Option Restriction

Allows disabling certain questionnaire options for the containing item based on evaluating expressions.

Procedure Approach Body Structure

The approach body site used for this procedure. Multiple locations are allowed.

ValueSet Concept Order

Identifies the relative order in which concepts within the value set should be presented to a user.

Request Replaces

Completed or terminated request(s) whose function is taken by this new request.

Individual Pronouns

The pronouns to use when referring to an individual in verbal or written communication.

Permitted Value Conceptmap

Expresses the linkage between the internal codes used for storage and the codes used for exchange.

Questionnaire Reference Profile

Where the type for a question is “Reference”, indicates a profile that the resource instances pointed to in answers to this question must be valid against.

Namespace

Use this extension to indicate tha the element has an XML namespace different to http://hl7.org/fhir. The special value noNamespace indicates that there is no assigned XML namespace.

Resource Derivation Reference

References a location within a set of source text from which the discrete information described by this Resource/Element was extracted.

mime type

Identifies the kind(s) of attachment allowed to be sent for an element.

DiagnosticReport Risk

Provides a link to an assessment of prognosis or risk as informed by the diagnostic results (For example, genetic results and possibly by patient genetic family history information). This extension is used when need RiskAssessment as an alternate choice for Observation.hasMember or DiagnosticReport.result.

Practitioner Animal Species

This extension should be used to specifiy that a practitioner or RelatedPerson resource is a service animal.

Resource Satifies Requirement

References a requirement that this element satisfies.

Questionnaire FHIR Type

For questionnaires generated from FHIR profiles, indicates the FHIR data type or resource type that corresponds to this node.

Device Commercial Brand

The overall name of a collection of branded devices that an organization brings to market. It is typically not the same as, although can be derived from, the organization name that owns the name.

Questionnaire Signature Required

Indicates that a signature (of the specified type) is needed when completing the QuestionnaireResponse.

days of cycle

Days of a possibly repeating cycle on which the action is to be performed. The cycle is defined by the first action with a timing element that is a parent of the daysOfCycle.

Variable

Variable specifying a logic to generate a variable for use in subsequent logic. The name of the variable will be added to FHIRPath’s context when processing descendants of the element that contains this extension as well as extensions within the same element.

supporting info

Other resources from the patient record that may be relevant to the event. The information from these resources was either used to create the instance or is provided to help with its interpretation. This extension should not be used if more specific inline elements or extensions are available. For example, use Observation.hasMember instead of supportingInformation for representing the members of an Observation panel.

Questionnaire Max Occurs

The maximum number of times the group must appear, or the maximum number of answers for a question - when greater than 1 and not unlimited.

Terminology Resource Identifier Metadata

Additional metadata in identifier elements for terminology resources.

Practitioner Job title

The job title may be independent of the role. For example, a surgeon (role) may have a title of Head of Surgery. Some titles may overlap with roles and could be represented as discrete PractitionerRoles, but some titles may be independent of role.

generated from

This artifact was algorithmically produced by applying the referenced artifact to the context relevant for this request.

Questionnaire ChoiceOrientation

Identifies the desired orientation when rendering a list of choices (typically radio-box or check-box lists).

performer function

Distinguishes the type of involvement of the performer in the event. For example, ‘author’, ‘verifier’ or ‘responsible party’.

Questionnaire Reference Resource

Where the type for a question is “Reference”, indicates a type of resource that is permitted.

Medication Manufacturing Batch
triggered by

This resource came into being as a result of expectations set in the referenced Definition resource. I.e. This resource represents a ‘step’ dictated within the protocol/order set/etc.

Procedure Target Body Structure

The target body site used for this procedure. Multiple locations are allowed.

QuestionnaireResponse Author

Allows capturing, on a specific question or group of questions, exactly who was responsible for providing the answer(s).

adheres to

The action represented by this resource has been determined to satisfy the expectations established by the referenced Definition resource.

StructureDefinition First Normative Version

If this StructureDefinition is normative, which was the first normative version.

Questionnaire Min Occurs

The minimum number of times the group must appear, or the minimum number of answers for a question - when greater than 1.

Event Location

The principal physical location where the event was performed.

Patient Proficiency

Proficiency level of the communication.

Questionnaire Unit

Provides a computable unit of measure associated with numeric questions to support subsequent computation on responses. This is for use on items of type integer and decimal, and its purpose is to support converting the integer or decimal answer into a Quantity when extracting the data into a resource. If a ‘display’ value is provided for valueCoding of this extension and the associated question item does not have a child ‘display’ item with an itemControl extension of ‘unit’, then form fillers SHOULD take the display value of this extension and use it as as the unit display.

complies with

The action requested by this resource is intended to satisfy the expectations established by the referenced Definition resource.

release date

Indicates the date on which request or event resource that has a status of ‘on-hold’ or ‘suspended’ should be moved back to an active state.

relevant history

Links to Provenance records for past versions of this resource or fulfilling request or event resources that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the resource.

Workflow Reason

References a resource or provides a code or text that explains why this event occurred or request was created.

Questionnaire Support Link

A URL that resolves to additional supporting information or guidance related to the question.

Questionnaire Hidden

If true, indicates that the extended item should not be displayed to the user.

Person Recorded Sex Or Gender

The recorded sex and gender is to be used to differentiate existing sex or gender data. This element is used for existing ‘sex’ or ‘gender’ elements in a document or record when the intent and meaning is unclear. For example, the individual’s birth certificate information, passport information, and national identity document information may all be present. This is necessary because an individual’s documents may be updated at different rates or for different reasons. Sex assigned at birth (SAAB), while very common and considered essential in some jurisdictions, is considered a recorded sex and gender entry.

episode of care

Identifies the episode(s) of care that this resource is relevant to. Establishes the EpisodeOfCare as a ‘grouper’ of resources that are relevant to that episode.

max size

For attachment answers, indicates the maximum size in bytes an attachment can be.

Observation Body Position

The position of the body when the observation was done, e.g. standing, sitting. To be used only when the body position in not precoordinated in the observation code.

Individual Gender Identity

An individual’s personal sense of being a man, woman, boy, girl, nonbinary, or something else. This represents an individual’s identity, ascertained by asking them what that identity is.

Questionnaire Base Type

This identifies the underlying type in a profile, when a questionnaire is generated from a profile.

Workflow Barrier

Any obstacle that limits or prevents obtaining care. Barriers in health and social care include, but are not limited to, physical barriers, psychological barriers, physiological barriers, financial barriers, geographical barriers, cultural/language barriers and resource barriers.

Item Weight

A numeric value that allows the comparison (less than, greater than) or other numerical manipulation of a concept (e.g. Adding up components of a score). Scores are usually a whole number, but occasionally decimals are encountered in scores. Note: This extension used to called http://hl7.org/fhir/StructureDefinition/ordinalValue

protective factor

Characteristics or strengths of individuals, families, community situations or societies that mitigate risks and promote positivewell-being and healthy development; attributes that help to successfully navigate difficult situations; factors that may contribute to or explain positive outcomes. A trait or habit that “protects” people and makes them less likely to get a chronic disease that include, but are not limited to exercise, healthy eating, managing weight, managing blood pressure and cholesterol, managing mental health, feeling happy, strong emotional support and social connections.

status reason

Captures the reason for the current state of the resource.

Design Note

Information captured by the author/maintainer of the questionnaire for development purposes, not intended to be seen by users.

Permitted Value Valueset

Allows expressing the value set that must be stored internally by the system (as distinct from the base value set which defines values for exchange).

QuestionnaireResponse Unit ValueSet

A set of units that the user may choose when providing a quantity value.

part of

A larger event of which this particular event is a component or step.

Conceptmap

This extension references a ConceptMap that maps to relevant terminologies used in an implementation.

StructureDefinition Status Derivation

Indicates one of the resources that was used to infer the specified maturity or standards status

Questionnaire Constraint

An invariant that must be satisfied before responses to the questionnaire can be considered “complete”.

Resource Approval Date

The date on which the asset content was approved by the publisher. Approval happens once when the content is officially approved for usage.

Questionnaire Display Category

Describes the intended purpose of the rendered text. For example - instructions, guidance on access control, maintenance information, etc.

based on

A plan, proposal or order that is fulfilled in whole or in part by this event.

Procedure Directed By

The target of the extension is a distinct actor from the requester and has decision-making authority over the service and takes direct responsibility to manage the service.

min length

The minimum number of characters that must be present in the simple data type to be considered a “valid” instance.

Resource Effective Period

The period during which the resource content was or is planned to be effective.

Questionnaire Item Control

The type of data entry control or structure that should be used to render the item. Certain item controls only make sense for certain types of items. For example, a radio button doesn’t make sense for a question where repeats=true; few systems will know how to implement a ‘slider’ control if the question type is ‘Attachment’, etc. Form fillers are allowed to ignore item controls that don’t make sense (or that they don’t know how to handle) for the type of item the extension appears on. If the extension is ignored, the form filler will use whatever display control it supports that works best for the type of item present. Similarly, form authoring tools may raise validation issues or prohibit the selection of certain control types based on the characteristics of the item.

QuestionnaireResponse Usage Mode

Identifies that the specified element should only appear in certain “modes” of operation.

ValueSet Special Status

A special note for implementers about the status of the resource.

Replaces

This indicates a separate conformance resource instance that is superseded by the current instance.

ValueSet Concept Definition

A definition that describes the meaning of this code when used as part of this value set.

Characteristic Expression

An expression that defines the criteria for group membership. This extension can only be used on a Group resource with a membership of definitional. When this expression is used, the Group resource cannot have any characteristic elements; this mechanism is exclusive with characteristics. The result of the expression SHALL be boolean-valued. The expression SHALL be parameterized with a %context variable that represents the subject being tested for membership. If evaluation of the expression results in true, the subject is considered a member of the group.

DeviceRequest Patient Directions

Simple concise instructions to be read by the patient. For example “twice a day” rather than “BID.”.

ResearchStudy Site Recruitment

Target and actual numbers of sites for a study.

ResearchStudy Study Registration

Dates for study registration activities.

Location Boundary (GeoJSON)

A boundary shape that represents the outside edge of the location (in GeoJSON format) This shape may have holes, and disconnected shapes.

Location Communication

A language that services are available in at this location.

MedicationDispense Refills Remaining

The number of refills allowed or remaining after a dispensing event. Does not include the current dispense.

MedicationDispense Quantity Remaining

The quanity left to be dispensed after a dispensing event.

EN use

A set of codes advising a system or user which name in a set of names to select for a given purpose.

References Contained

This indicates that the element containing this extension has an expression that makes reference to the specified contained resource.

StructureDefinition Display Hint

Hinting information for the narrative generator - a series of name: value; pairs.

Large Value

The value of an integer that exceeds the bounds of the base int type.

ADXP Delivery Installation Qualifier

A number, letter or name identifying a delivery installation. For example, for Station A, the delivery installation qualifier would be ‘A’.

Own Prefix

The prefix portion (e.g. voorvoegsel) of the family name that is derived from the person’s own surname, as distinguished from any portion that is derived from the surname of the person’s partner or spouse.

Equivalence

The level of equivalence between the element containing the mapping and the element mapped to.

ValueSet Reference

A logical reference (e.g. a reference to ValueSet.url) that identifies the value set/version that identifies the set of possible coded values this coding was chosen from or constrained by.

Preferred

Flag denoting whether parent item is preferred - e.g., a preferred address or telephone number.

Pattern

A pattern that all the target resources follow - that is, a pattern that they all declare their relationship to.

EN Qualifier

A set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type.

StructureDefinition Explicit Type Name

A name to use for the type, in implementations. This is a suggestion; it’s not a normative part of the FHIR specification, but it does appear in the UML diagrams, and is used in generated code, schemas, etc.to identify the type.

Display Name

The title or other name to display when referencing a resource by canonical URL.

Valid date

Indicates a date on which this identifier value was deemed to apply to this instance.

Last source sync

Indicates when the data was last accessed from its original source.

Coding Conformance

Declares a profile that required the specific coding to be included in a list of Codings because of the binding. This allows reading applications to identify particular codings without processing the systems.

XHTML Representation

This is an equivalent of the string on which the extension is sent, but includes additional XHTML markup, such as bold, italics, styles, tables, etc. Existing restrictions on XHTML content apply. Note that using markdown allows for greater flexibility of display. Like the Resource Narrative, this extension may reference binary resources for image content (see note about referencing images)

ContactPoint Area

The area/zone/city code that, in some areas, may be omitted when dialing locally within the zone. This extension is used when a system wishes to designate specific parts of a phone number (and potentially place constraints on which components must be present and how they’re filled in).

Coding Purpose

A reason that this coding is present.

First created

Indicates when this resource ID was first associated with content on this server.

Assembly Order

A code that represents the preferred display order of the components of this human name.

Parameter definition

The definition of a parameter that is expected to be provided as part of the invocation of the trigger.

ADXP Post Box

A numbered box located in a post station.

Extended Contact Availability

The details provided in this contact may be used according to the attached availability guidelines.

StructureDefinition FHIR Type

The FHIR type of a property - used on the value property of a primitive type (for which there is no type in the FHIR typing system), and Element.id, Resource.id, and Extension.url. All of these have a non-FHIR type in thir structure definition, and this specifies the applicable FHIR type.

ADXP Direction

Direction (e.g., N, S, W, E).

Translation

Language translation from base language of resource to another language.

ADXP Care Of

The name of the party who will take receipt at the specified address, and will take on responsibility for ensuring delivery to the target recipient.

ADXP House Number Numeric

The numeric portion of a building number.

Patient No Fixed Address

This extension applies to the Address data type and is used to indicate that a location address is not a fixed address for an individual.

Profile Element

The specific element to use in the referenced profile. This is used when a backbone element is being profiled, rather than an established type.

ADXP Street Name Type

The designation given to the street. (e.g. Street, Avenue, Crescent, etc.).

ADXP Street Name

streetName.

Coded string

Provides a coded expression for the content represented in a string.

Max value set

This acts as an overall ‘required’ binding for an element that already has a less restrictive binding. It is used when there is a desire to have a ‘small’ enumerable binding that meets most needs and where the overall value set that the codes must be drawn from is ‘infinite’. The the base less restrictive binding SHALL be a proper subset of the max binding valueset. In most cases, this extension is used where the base binding is ‘extensible’.

ADXP Unit ID

The number or name of a specific unit contained within a building or complex, as assigned by that building or complex.

Suppress

If the extension is present on one of the named properties in a differential, the element property should be removed from the the corresponding snapshot.element during snapshot generation.

ContactPoint Comment

A comment associated with the ContactPoint such as usage notes or pronunciation.

Relative Date Criteria

Specifies that a date is relative to some event. The event happens [Duration] after [Event].

Partner Prefix

The prefix portion (e.g. voorvoegsel) of the family name that is derived from the person’s partner’s surname, as distinguished from any portion that is derived from the surname of the person’s own.

Alternate Codes

Indicates alternate codings and/or original text for the concept represented by the code.

SNOMED CT Description Id

The SNOMED CT Description ID for the display.

Identifier

External Identifiers associated with this element - these are identifiers that are associated with the concept this element represents.

ADXP Precinct

A subsection of a municipality.

Conditions

Conditions that apply to this set of dosing instructions.

ADXP Delivery Mode

Indicates the type of service offered, method of delivery. For example: post office box, rural route, general delivery, etc.

ADXP House Number

The number of a building, house or lot alongside the street. Also known as “primary street number”. This does not number the street but rather the building.

Best Practice Explanation

Explains why an invariant is labelled as a best practice invariant.

Inherited extensible value set

A reference to an extensible value set specified in a parent profie in order to allow a conformance checking tool to validate that a code not in the extensible value set of the profile is not violating rules defined by parent profile bindings.

ADXP Building Number Suffix

Any alphabetic character, fraction or other text that may appear after the numeric portion of a building number.

ADXP Additional Locator

This can be a unit designator, such as apartment number, suite number, or floor. There may be several unit designators in an address (e.g., “3rd floor, Appt. 342”). This can also be a designator pointing away from the location, rather than specifying a smaller location within some larger one (e.g., Dutch “t.o.” means “opposite to” for house boats located across the street facing houses).

Group

Defines the group in which this usage context is a member. Multiple groups are “OR’ed”, contexts within a group are “AND’ed”.

ContactPoint Extension

The number that may be dialed within a private phone network or after successfully connecting to a private phone network. This extension is used when a system wishes to designate specific parts of a phone number (and potentially place constraints on which components must be present and how they’re filled in).

Obligation

Documents obligations that apply to applications implementing this element. The obligations relate to application behaviour, not the content of the element itself in the resource instances that contain this element. See Obligation Extension for further detail

ADXP Delimiter

Delimiters are printed without framing white space. If no value component is provided, the delimiter appears as a line break.

ContactPoint Local

The local number that must be dialed to connect within the area/city/zone. This extension is used when a system wishes to designate specific parts of a phone number (and potentially place constraints on which components must be present and how they’re filled in).

Contribution time

When the contribution was made by this contributor.

Rendered Value

Provides a rendered version of the value intended for human display. For example, a sensitive identifier (e.g. social security number) partially obscured by asterisks; a drivers licence number with dashes inserted; a date formatted as MMM dd, yyyy; etc.

Timing day of month

When present, this extension indicates that the event actually only occurs on the specified days of the month, on the times as otherwise specified by the timing schedule.

Best Practice

Mark that an invariant represents ‘best practice’ rule - a rule that implementers may choose to enforce at error level in some or all circumstances.

Is common binding

Whether the binding is used on multiple resources, or only on this resource.

ADXP Delivery Installation Type

Indicates the type of delivery installation (the facility to which the mail will be delivered prior to final shipping via the delivery mode.) Example: post office, letter carrier depot, community mail center, station, etc.

ADXP Unit Type

Indicates the type of specific unit contained within a building or complex. E.g. Appartment, Floor.

Uncertain date

When present, this extension indicates that the date of a period start or end is uncertain and falls within its own period.

AD Use

Uses of Addresses - codes not defined as part of Address.use.

ID Check digit

allow for a check digit and a check digit scheme to be conveyed as part of Identifier. The rules of the ID Type determine if the check digit is part of the ID value or sent separately.

Allowed Units

Identifies the units of measure in which the element should be captured or expressed.

Is prefetch token

Allows an indication of whether this parameter can be used to parameterize prefetch templates (i.e. queries that can be used to identify data-of-interest to be sent as part of a triggered request.

Fathers Family

The portion of the family name that is derived from the person’s father.

Resolve as version specific

If true, indicates that the reference should be resolved to a version-specific reference rather than a version-agnostic reference.

TEL address

A V3 compliant, RFC 3966 conformant URI version of the telephone or fax number.

Uncertain period

Used to express an uncertain date(+time) value by specifying an allowed or observed upper and lower bound.

Default Type

The default type that applies if the instance doesn’t specify a particular type, and there is a choice of types.

Target element

Indicates that the reference has a particular focus in the target resource, a particular element of interest, identified by it’s element id.

period duration

Specifies the duration of the period, based on the starting date, rather than specifying the end date of the period.

Uncertainty type

A code specifying the type of probability distribution for the uncertainty.

ADXP Delivery Installation Area

The location of the delivery installation, usually a town or city, and is only required if the area is different from the municipality. Area to which mail delivery service is provided from any postal facility or service such as an individual letter carrier, rural route, or postal route.

Question

The default/suggested phrasing to use when prompting a human to capture the data element in question form (e.g. In a survey).

Type must support

If true indicates that the specified type, profile or targetProfile must be supported by implementations.

ADXP Delivery Mode Identifier

Represents the routing information such as a letter carrier route number. It is the identifying number of the designator (the box number or rural route number).

Partner Name

The portion of the family name that is derived from the person’s partner’s surname, as distinguished from any portion that is derived from the surname of the person’s own name.

ADXP Delivery Address Line

A delivery address line is frequently used instead of breaking out delivery mode, delivery installation, etc. An address generally has only a delivery address line or a street address line, but not both.

Selector

A FHIRPath statement that defines whether an element is in the slice.

ContactPoint Country

The country code as defined by the ITU. This extension is used when a system wishes to designate specific parts of a phone number (and potentially place constraints on which components must be present and how they’re filled in).

Graph constraint

Will cause a GraphDefinition to be executed and the referred-to instance be considered “valid” for that GraphDefinition if the instance is the start of a result of executing that GraphDefinition.

EN Representation

Name Representation.

ADXP Census Tract

A geographic sub-unit delineated for demographic purposes.

Timezone Offset

Timezone offset, for dates where timezone is not allowed as part of the base date.

Quantity Translation

An alternative representation of the same physical quantity expressed in a different unit from a different unit code system and possibly with a different value.

StructureDefinition Hierarchy

For circular references (references back to the same type of resource): whether they are allowed to transitively point back to the same instance (false), or whether the relationship must be a strict one-way hierarchy (true).

Timezone Code

An IANA timezone code for the timezone offset per BCP 175. The offset is specified as part of a dateTime/instant (or using the tzOffset extension on a date if necessary). The timezone code may also be provided to allow for human display of the location associated with the offset.

Precision

Explicit precision of the number. This is the number of significant decimal places after the decimal point, irrespective of how many are actually present in the explicitly represented decimal.

ADXP Street Name Base

The base name of a roadway or artery recognized by a municipality (excluding street type and direction).

Human Language

The Human Language of the item.

Min value set

The minimum allowable value set, for use when the binding strength is ‘required’ or ‘extensible’. This value set is the minimum value set that any conformant system SHALL support.

additional identifier

An additional identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

Geolocation

The absolute geographic location of the Location, expressed using the WGS84 datum (This is the same co-ordinate system used in KML).

Binding name

A name that can be used for code generation when generating named enumerations for the binding.

object class property

A quality common to all members of an object class. A property may be any feature that humans naturally use to distinguish one individual object from another. It is the human perception of a single quality of an object class in the real world. It is conceptual and thus has no particular associated means of representation by which the property can be communicated.

Alternate Reference

Used when the target of the reference has a type that is not allowed by the definition of the element. In general, this should only arise when wrangling between versions using cross-version extensions.

Translatable

Whether translations might be expected for this element in resource instances.

Contact Reference

A reference to a Person, Group, Device, or Organization that is the contact.

Uncertainty

The primary measure of variance/uncertainty of the value (the square root of the sum of the squares of the differences between all data points and the mean).

Contact address

The address of the contributor.

contact detail reference

A reference to a resource that is a more detailed representation of the contact detail information.

Target path

Indicates that the reference has a particular focus in the target resource, a particular element of interest, identified by a FHIRPath statement. The FHIRPath expression is limited to a the simple subset with the additional limitation that .resolve() that is not allowed.

Timing Exact

If true, indicates that the specified times, frequencies, periods are expected to be adhered to as precisely as possible. If false, indicates that a typical degree of variability based on institutional and/or patient convenience is acceptable.

Own Name

The portion of the family name that is derived from the person’s own surname, as distinguished from any portion that is derived from the surname of the person’s partner or spouse.

Alternative expression

Specifies an alternative, equivalent expression in another formal language. For example, given a condition expression in CQL, an alternative formulation in SQL could be provided.

Alternate Canonical

Used when the target of the reference has a type that is not allowed by the definition of the element. In general, this should only arise when wrangling between versions using cross-version extensions.

Markdown

This is an equivalent of the string on which the extension is sent, but includes additional markdown (see documentation about markdown. Note that using HTML xhtml can allow for greater precision of display.

StructureDefinition Extension Meaning

This extension allows conveying the coded meaning of the extension in instances of the extension

Mothers Family

The portion of the family name that is derived from the person’s mother.

object class

A concept that represents a set of ideas, abstractions, or things in the real world that can be identified with explicit boundaries and meaning and whose properties and behavior follow the same rules. It may be either a single concept or a group of associated concepts, abstractions, or things.

ADXP Street Address Line

A street address line is frequently used instead of breaking out building number, street name, street type, etc. An address generally has only a delivery address line or a street address line, but not both.

ConceptMap Bi-directional

Set to true if the concept map can be safely intepreted in reversse.

CanonicalResource Short Description

A single paragraph plain string short description alternative to CanonicalResource.description for display in lists etc.

Artifact Editor

An individual or organization primarily responsible for internal coherence of the .

Artifact Date

The date (and optionally time) when the was last significantly changed. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the changes.

knowledge capability

Defines a knowledge capability afforded by this knowledge artifact.

Artifact Endorser

An individual or organization responsible for officially endorsing the for use in some setting.

Artifact Version Algorithm

Indicates the mechanism used to compare versions to determine which is more current.

direct reference code

Defines a code directly referenced by artifact logic, as opposed to a value set. Direct reference codes may be the target of data requirements.

measure info

The measure criteria that resulted in the resource being included in a particular evaluatedResources bundle.

logic definition

Represents a specific logic definition used by the artifact.

Original Text

A human language representation of the concept (resource/element) as seen/selected/uttered by the user who entered the data and/or which represents the full intended meaning of the user. This can be provided either directly as text, or as a url that is a reference to a portion of the narrative of a resource (DomainResource.text or Composition.section.text). When it a url, the value should end with a #{id} where the id identifies a specific portion of the referenced content (via an XHTML id attribute).

input parameters

Specifies the input parameters to the operation (such as a test case description or a data requirements or evaluate operation).

Artifact Contact

Contact details to assist a user in finding and communicating with the publisher.

Artifact Jurisdiction

A legal or geographic region in which the is intended to be used.

StructureDefinition Standards Status

The Current HL7 ballot/Standards status of this artifact.

StructureDefinition Standards Status Reason

The Current HL7 ballot/Standards status of this artifact.

BodyStructure Reference

Record details about the anatomical location of a specimen or body part. This resource may be used when a coded concept does not provide the necessary detail needed for the use case.

ArtifactName

A natural language name identifying the . This name should be usable as an identifier for the module by machine processing applications such as code generation.

Artifact URL

An absolute URI that is used to identify this when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which an authoritative instance of this is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the is stored on different servers.

StructureDefinition FMM Level

The FMM level assigned to the artifact.

quality of evidence

The quality of the evidence described. The code system used specifies the quality scale used to grade this evidence source while the code specifies the actual quality score (represented as a coded value) associated with the evidence.

relative date time

A date/time value that is determined based on a duration offset from a target event.

Artifact Topic

Descriptive topics related to the content of the artifact. Topics provide a high-level categorization of the artifact that can be useful for filtering and searching.

knowledge representation level

Defines a knowledge representation level provided by this knowledge artifact.

Artifact Publisher

The name of the organization or individual responsible for the release and ongoing maintenance of the .

knowledge representation level

Defines a knowledge representation level provided by this knowledge artifact.

Rendering Style

Identifies how the specified element should be rendered when displayed.

Data Absent Reason

Provides a reason why the expected value or elements in the element that is extended are missing.

CQF Certainty

An assessment of certainty, confidence, or quality of the item on which it appears.

CQF Citation

A bibliographic citation for the related resource. This text SHOULD be formatted according to an accepted citation format.

calculated value

An expression that determines a calculated value. The expression may be simply the name of a expression in a referenced library, or it may be a complete inline expression.

Narrative Link

A human language representation of the concept (resource/element), as a url that is a reference to a portion of the narrative of a resource (DomainResource.text or or Composition.section.text).

Artifact related artifact

Related artifacts such as additional documentation, justification, dependencies, bibliographic references, and predecessor and successor artifacts.

CQF Expression

An expression that, when evaluated, provides the value for the element on which it appears.

target invariant

Specifies an invariant that is enforced in the context of an instantiated resource.

StructureDefinition Work Group

The work group that owns and maintains this resource.

Artifact Author

An individiual or organization primarily involved in the creation and maintenance of the .

Artifact Copyright

A copyright statement relating to the and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the .

strength of recommendation

The strength of the recommendation assigned to this reference. The code system used specifies the rating scale used to rate this recommendation while the code specifies the actual recommendation rating (represented as a coded value) associated with this recommendation.

Artifact Copyright Label

A short string (<50 characters), suitable for inclusion in a page footer that identifies the copyright holder, effective period, and optionally whether rights are resctricted. (e.g. ‘All rights reserved’, ‘Some rights reserved’).

null flavor

If the value is not a proper value, indicates the reason.

Artifact use context

The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, …) or may be references to specific programs (insurance plans, studies, …) and may be used to assist with indexing and searching for appropriate instances.

CQF Library

A reference to a Library containing the formal logic used by the artifact.

StructureDefinition FMM Supporting Documentation

The documentation supporting the FMM level assigned to the artifact.

Artifact Experimental

A Boolean value to indicate that this is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage.

knowledge capability

Defines a knowledge capability afforded by this knowledge artifact.

Artifact Title

A short, descriptive, user-friendly title for the .

Artifact Identifier

A formal identifier that is used to identify this when it is represented in other formats, or referenced in a specification, model, design or an instance.

ArtifactVersion

The identifier that is used to identify this version of the when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence.

artifact comment

A comment containing additional documentation, a review comment, usage guidance, or other relevant information from a particular user.

Artifact Reviewer

An individual or organization primarily responsible for review of some aspect of the .

style sensitive

Indicates that the style extensions (style, markdown and xhtml) in this resource instance are essential to the interpretation of the instance and that systems that are not capable of rendering using those extensions should not be used to render the resource.

Artifact Status

The status of this . Enables tracking the life-cycle of the content.

Artifact Description

A free text natural language description of the from a consumer’s perspective.

Artifact Purpose

Explanation of why this is needed and why it has been designed as it has.

initial value

An expression that determines an initial value. The expression may be simply the name of a expression in a referenced library, or it may be a complete inline expression.

BiologicallyDerivedProduct Processing

Extension for processing of a biologically dervied prodcut

BiologicallyDerivedProduct Manipulation

Extension for manipulation of a biologically dervied prodcut

BiologicallyDerivedProduct Collection Procedure

Extension for the collection procedure of a biologically dervied product

system user language

Preferred language of the person using the system.

recipient language

Preferred language of the person that will consume the content.

recipient type

The type of individual that will consume the response content. This may be different from the requesting user type (e.g. if a clinician is getting disease management guidance for provision to a patient). E.g. patient, healthcare provider or specific type of healthcare provider (physician, nurse, etc.).

encounter class

The class of encounter (inpatient, outpatient, etc.).

initiating person

The person initiating the request.

receiving organization

The organization that will receive the response.

initiating organization

The organization initiating the request.

receiving person

The person in the receiving organization that will receive the response.

system user task context

The task the system user is performing, e.g. laboratory results review, medication list review, etc. This information can be used to tailor decision support outputs, such as recommended information resources.

system user type

The type of user initiating the request, e.g. patient, healthcare provider, or specific type of healthcare provider (physician, nurse, etc.).

encounter type

The type of the encounter.

CodeSystem Map

A reference to a concept map that is relevant for the interpretation of this value set.

CodeSystem Workflow Status

Workflow Status is used to represent details of the value set development process while the value set has an Activity Status of Preliminary. The development of a value set often follows a formal workflow process from initiation to completion, and this element carries the state variable for this state machine. The assumption is that when first created a value set would have a workflow state of Draft. Additional workflow states may be used.

CodeSystem Use Markdown

If true, the definitions of the concepts can be treated and rendered as markdown for improved presentation.

CodeSystem History

Information on changes made to the Value Set Definition over time, and also has a contained audit trail of all such changes.

CodeSystem Alternate

An additional code that may be used to represent the concept.

CodeSystem Source Reference

This text is intended to act as a citation to work done elsewhere that is not part of the current stewarding process where the referenced source is in some way a basis of the current value set definition.

CodeSystem Label

The label to list in front of a code when presenting a list of possible values in a questionnaire-like fashion.

CodeSystem Authoritative Source

A reference to the authoritative, human readable, source of truth for the code system information.

CodeSystem ConceptOrder

Identifies the relative order in which concepts within the value set should be presented to a user.

CodeSystem Usage

Consumers of the value set and the implementations, projects or standards that the author has utilized the value set in.

CodeSystem Replacedby

A code that replaces this - use this code instead.

CodeSystem Trusted Expansion

Indicates an authoritative source for performing value set expansions.

CodeSystem Warning

An extra warning about the correct use of the value set.

CodeSystem KeyWord

Word or words used in an information retrieval system to indicate the content of the value set. (deprecated)

CodeSystem Other Name

Human readable names for the codesystem.

CodeSystem Properties Mode

The extent to which the properties of the code system (including the filters) are represented in this resource instance.

CodeSystem Concept Comment

A comment that explains how this code is used in this context (where the value set is expected to be used).

Bundle HTTP Response header

In a transaction, every single interaction can have multiple HTTP response headers returned as a result of the interaction.

Bundle Match Grade

Assessment of resource match outcome - how likely this resource is to be a match.

Bundle Location Distance

A calculated distance between the resource and a provided location.

CQF CQL Options

Specifies a parameters (contained) resource that identifies the options for the CQL-to-ELM translator associated with the CQL content.

Composition Other Confidentiality

Carries additional confidentiality codes beyond the base fixed code specified in the CDA document.

Composition Section Subject

Specifies that the section has a different subject that the Composition, or it’s container section.

Composition Validity Period

The period in which the catalog is valid.

Composition Version Number

Version specific identifier for the composition, assigned when each version is created/updated.

ValueSet Deprecated

if true, indicates that the concept is deprecated from the value set - that is, it should not be used, and is planned to be withdrawn.

ValueSet Compose CreatedBy

User who created the compose for the ValueSet.

ValueSet System

Allows a direct reference to the code system for FHIR query.

ValueSet Compose Creation Date

Date the compose was created.

Valueset Trusted Expansion

Indicates an authoritative source for performing value set expansions.

ValueSet Rules Text

An expression that provides an alternative definition of the content of the value set in some form that is not computable - e.g instructions that could only be followed by a human.

ValueSet System Reference

The formal URI for the code system. I.e. ValueSet.codeSystem.system (or its equivalent).

ValueSet Expansion Source

The logical URL of the ValueSet definition that was used to generate this expansion.

ValueSet Keyword

Word or words used in an information retrieval system to indicate the content of the value set. (deprecated)

ValueSet System Name

The human-readable name for the code system.

ValueSet Warning

An extra warning about the correct use of the value set.

Value Set System Title

The human-readable name for the code system.

ValueSet Map

A reference to a concept map that is relevant for the interpretation of this value set.

ValueSet Extensible

Whether this is intended to be used with an extensible binding or not.

ValueSet Parameter Source

Declares what the source of this parameter is.

ValueSet Source Reference

This text is intended to act as a citation to work done elsewhere that is not part of the current stewarding process where the referenced source is in some way a basis of the current value set definition.

Valueset Too Costly (Expansion Truncated)

Marks that the expansion is incomplete, because the full value set is too large to represent, and the client asked for an incomplete fragment.

ValueSet Case Sensitive

If this a case sensitive code.

ValueSet Authoritative Source

A reference to the authoritative accessible, persisted source of truth of the entire Value Set Definition, including textual information and available versions.

ValueSet Unclosed

Marks that the expansion is incomplete, and values other than those listed may be valid. This may be used because post-coordinated codes are allowed, and no practical expansion can be produced.

Workflow Status Description

Workflow Status is used to represent details of the value set development process while in a single Activity Status.

ValueSet Include ValueSet Title

Human readable name for the included Value Set.

ValueSet Supplement

This extension declares that a value set depends on a particular CodeSystem supplement and should not be used in its absence.

ValueSet Concept Comments

A comment that explains how this code is used in this context (where the value set is expected to be used).

ValueSet Other Title

Human readable titles for the valueset.

ValueSet Usage

Consumers of the value set and the implementations, projects or standards that the author has utilized the value set in.

ValueSet Expression

An expression that provides an alternative definition of the content of the value set (compose). There are two different ways to use this expression extension: If both an expression (this extension) and a compose element is present, the compose is understood to the make the same statement as the expression. If there is no compose, the expression is the only definition of the value set, and the value set can only be processed by a server that understands the expression syntax, the expression is computable.

ValueSet Other Name

Natural language names identifying the value set. These names should be usable as an identifier for the module by machine processing applications such as code generation.

FamilyMemberHistory Observation

Allows capturing risk-relevant observations about the relative that aren’t themselves a specific health condition; e.g. Certain ethnic ancestries that are disease-relevant, presence of particular genetic markers, etc.

FamilyMemberHistory Patient Record

A link to one to more patient records for the relation.

FamilyMemberHistory Abatement

The approximate date, age, or flag indicating that the condition of the family member resolved. The abatement should only be specified if the condition is stated in the positive sense, i.e., the didNotHave flag is false.

FamilyMemberHistory Parent

Identifies a parent of the relative.

FamilyMemberHistory Sibling

Identifies a sibling of the relative.

FamilyMemberHistory Type

Purpose of the family member history or why it was created, such as when family member history is targeted for cardiovascular health, mental health, or genetic counseling.

FamilyMemberHistory Severity

A qualification of the seriousness or impact on health of the family member condition.

Questionnaire Option Prefix

The label to list in front of a code when presenting a list of possible values in a questionnaire-like fashion.

min value

The inclusive lower bound on the range of allowed values for the data element.

Questionnaire is Definition Based

If true, indicates that the Questionnaire relies on metadata from the ElementDefinitions referenced by item.definition and that rendering or validating the Questionnaire is likely to be unsafe if the system isn’t capable of resolving the definition and using the metadata found there.

Questionnaire Option Exclusive

If true, indicates that if this answerOption is selected, no other possible answers may be selected, even if the item is a repeating question.

max value

The inclusive upper bound on the range of allowed values for the data element.

NamingSystem Check Digit

allow for a check digit and a check digit scheme to be conveyed as part of Naming System. The rules of the ID Type determine if the check digit is part of the ID value or sent separately.

Encounter Mode Of Arrival

Identifies whether a patient arrives at the reporting facility via ambulance and the type of ambulance that was used.

Encounter Reason Cancelled

If the encountered was cancelled after it was planned, why? Applies only if the status is cancelled.

Encounter Associated Encounter

This encounter occurs within the scope of the referenced encounter.

Immunization Procedure

A record of the procedure associated with the immunization event.

Procedure Incision DateTime

The time of the first incision.

Procedure Caused By

This procedure is because of the related item.

Procedure Progress Status

A code to track a detailed progress of a procedure (e.g. In Recovery, Prepared for Surgery).

Procedure Method

The method used to perform this procedure.

AllergyIntolerance Administration

Link to an actual medication administration record with the full details of the administration, if a link is known.

AllergyIntolerance Location

The anatomical location / body site(s) where the symptoms manifested.

AllergyIntolerance Exposure Duration

The amount of time the individual was exposed to the Substance.

AllergyIntolerance Exposure Date

Record of the date and/or time of the first exposure to the Substance for this Reaction Event.

AllergyIntolerance Management

Text description about the clinical management provided.

Abatement

The date or estimated date that the allergy or intolerance resolved. This is called abatement because of the many overloaded connotations associated with resolution.

AllergyIntolerance Careplan

Additional details about the clinical management provided for this Reaction Event.

AllergyIntolerance Resolution Age

The estimated patient age at which the allergy or intolerance resolved. Should be specified only if the status is resolved.

AllergyIntolerance Reason Refuted

A code capturing the explanation of why the allergy or intolerance has been refuted. Should be specified only if the status is refuted.

AllergyIntolerance Duration

The amount of time that the Adverse Reaction persisted.

AllergyIntolerance Substance Exposure Risk

A complex extension allowing structured capture of the exposure risk of the patient for an adverse reaction (allergy or intolerance) to the specified substance/product.

AllergyIntolerance AssertedDate

The date on which the existence of the AllergyIntolerance was first asserted or acknowledged.

AllergyIntolerance ExposureDescription

Text description about exposure to the Substance.

AllergyIntolerance Certainty

Statement about the degree of clinical certainty that the specific substance was the cause of the manifestation in this reaction event.

CommunicationRequest Initiating Location

Location where the information being requested to be communicated happened.

Condition Ruled Out

Identifies what potential diagnoses have been ruled out for this condition.

Condition Disease Course

The clinical course of the disease (how the disease behaves over time), such as acute versus chronic.

Condition Due To

Further conditions, problems, diagnoses, procedures or events or the substance that caused/triggered this Condition.

Condition Occurred Following

Further conditions, problems, diagnoses, procedures or events or the substance that preceded this Condition.

Condition Related

This condition has an unspecified relationship with another condition.

Condition Asserted Date

The date on which the existence of the Condition was first asserted or acknowledged.

Condition Reviewed

The date on which the clinician indicates that the condition has been reviewed

Condition Outcome

A result of the condition. The “Cause of death” for a patient is typically captured as an Observation. The “outcome” doesn’t imply causality. Some outcomes might not be assessable until the condition.clinicalStatus is no longer active.

Consent Location of Access restriction

Restricts this exception to only apply a specific location as defined.

Consent Transcriber

Any person/thing who transcribed the consent into the system.

Consent Witness

Any witness to the consent.

Consent Research Study Context

When a Research scope Consent, this is the specific research study that is allowed to use the information (or not).

Consent Disclosure Notification Endpoint

Endpoint for sending Disclosure notifications in the form of FHIR AuditEvent records.

Patient Citizenship

The patient’s legal status as citizen of a country.

Patient Religion

The patient’s professed religious affiliations.

Patient Congregation

A group or place of religious practice that may provide services to the patient.

Patient Importance

The importance of the patient (e.g. VIP).

Patient Birth Time

The time of day that the Patient was born. This includes the date to ensure that the timezone information can be communicated effectively.

Patient Is-Cadaveric Donor

Flag indicating whether the patient authorized the donation of body parts after death.

Patient Animal

This patient is known to be an animal.

Patient Birth Place

The registered place of birth of the patient. A sytem may use the address.text if they don’t store the birthPlace address in discrete elements.

Patient Interpreter Required

This Patient requires an interpreter to communicate healthcare information to the practitioner.

Patient Mother's Maiden Name

Mother’s maiden (unmarried) name, commonly collected to help verify patient identity.

Patient Related Person

In some cases a Patient.contact will also be populated as a RelatedPerson resource. This linkage permits the linkage between the 2 resources to be able to accurately indicate a representation of the same individual, and updating details between could be appropriate.

Patient Nationality

The nationality of the patient.

Patient Preference Type

Indicates what mode of communication the patient prefers to use for the indicated language.

Patient Disability

Value(s) identifying physical or mental condition(s) that limits a person’s movements, senses, or activities.

Patient Multiple Birth Total

Where a patient is a part of a multiple birth, this is the total number of births that occurred in this pregnancy. This value is the 4 in ‘3 of 4’, and the 3 would be the Patient.multipleBirth value.

Patient Adoption Info

Code indication the adoption status of the patient.

List Category

A categorization for the type of the list - helps for indexing and searching

List Change Base

Reference to the List that a “change” list is asserting changes with respect to.

List For Extension

Reference to the entity that this List is for.

OperationOutcome Column of Issue

Identifies the source column for the issue

OperationOutcome Source of Issue

Identifies the logical module/software section responsible for identifying the issue

OperationOutcome Line of Issue

Identifies the source line of the issue

OperationOutcome Source of Issue

Identifies the id of the source message used to construct the actual error message

OperationOutcome Detected Clinical Issue

A reference to a stored contraindication that is the basis for this issue. A recipient can expect that the item referenced in this extension is being retained for record keeping purposes.

OperationOutcome Authority for Rule

A reference to where the rule is defined (based on the authoritative URLs in the applicable conformance resources).

OperationOutcome Source File

Identifies the source file where the issue is found (when there are multiple source files)

NutritionOrder Adaptive Feeding Device

Materials used or needed to feed the patient.

Request Insurance

Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be relevant in delivering the requested service.

do not perform

If true indicates that the request is asking for the specified action to not occur.

Task Replaces

Completed or terminated task(s) whose function is taken by this new task.

Parameters Definition for parameter

This specifies the definition for a parameter if needed. This is useful for communicating the type of a parameter when the parameter has no value.

Parameters FullUrl for resource

This specifies the fullUrl for the resource in parameters.resource, if there is one. When fullUrl is provided, ithe resource resolution method described for Bundle.

ImplementationGuide Source File

Identifies files used as part of the the publication process other than resources referenced in definition.resource.

Device Implantable Status

Codes to represent the functional status of a device implanted in a patient. Both overall device status and an implant status need to be considered. The implant status should only be used when the device status is active .

OperationDefinition Profile

Identifies a profile structure or implementation Guide that applies to the datatype this element refers to. If any profiles are specified, then the content must conform to at least one of them. The URL can be a local reference - to a contained StructureDefinition, or a reference to another StructureDefinition or Implementation Guide by a canonical URL. When an implementation guide is specified, the type SHALL conform to at least one profile defined in the implementation guide.

DocumentReference Summary Of

A summary report that points to subordinate target reports.

DiagnosticReport Delta

Focus of DiagnosticReport

DiagnosticReport Replaces

The report replaces the target resource. For example, when a final anatomic pathology report replaces a preliminary anatomic pathology report replaces where the subsequent observation of case and report may be on more or different material (specimen). Note that this is not same concept as DiagnosticReport.status = preliminary of final, but industry definition of preliminary and final.

DiagnosticReport Extends

The report references related (“sibling”) reports.

DiagnosticReport Location Performed

Facility location where this report was prepared.

DiagnosticReport Addendum Of

The supplements or provides additional information for the target report.

Specimen Processing Time

Period or duration of processing.

Specimen Collection Priority

The urgency of sample collection, such as STAT, ASAP, ASAP-ED, ROUTINE, ROUTINE-AM, etc….

Specimen Is Dry Weight

If the recorded quantity of the specimen is reported as a weight, if it is a dry weight.

Specimen Special handling

Special handling during the collection, transport, or storage of the specimen.

Specimen Sequence Number

An assigned number on the specimen denoting the order of collection.

Communication Media

It contains enriched media representation of the alert message, such as a voice recording. This may be used, for example for compliance with jurisdictional accessibility requirements, literacy issues, or translations of the unstructured text content in other languages.

CareTeam Alias

Alternate names by which the team is also known.

QuestionnaireResponse Completion Mode

Indicates how the individual completing the QuestionnaireResponse provided their responses.

QuestionnaireResponse Reviewer

Individual responsible for ensuring that the questionnaire response have been completed appropriately and signs off on the content.

QuestionnaireResponse Reason

The factor(s) that caused the questionnaire to be answered.

QuestionnaireResponse Attester

Allows capturing the individual(s) who attest to the accuracy of the information within the QuestionnaireResponse

Patient Sex For Clinical Use

Sex for Clinical Use (SFCU) Overview

Sex for Clinical Use is a categorization of sex derived from observable information such as an organ inventory, recent hormone lab tests, genetic testing, menstrual status, obstetric history, etc. This property is intended for use in clinical decision making and indicates that treatment or diagnostic tests should consider best practices associated with the relevant reference population.

While clinical decision-making processes could account for the specific physiological or anatomical attributes of the patient, there are several practical considerations, such as patient privacy and limited capabilities of existing systems which create the need for a categorization that is easy to exchange. The Sex for Clinical Use categorization is intended to bridge the gap between the hypothetical ideal and the practical needs of operational systems.

Sex for Clinical Use (SFCU) Contexts

Sex for Clinical Use is a contextual concept. For example, a patient may generally be categorized as male, but for a specific lab test, the resulting lab should use the reference ranges associated with a female reference population. In this case, systems may provide a patient-context sexForClinicalUse that acts as a ‘default’ for most care and annotate the lab order with a context-specific sexForClinicalUse. Systems may determine what enclosing contexts are useful, but Patient, Encounter and EpisodeOfCare are three enclosing contexts that may often apply.

The sexForClinicalUse extension can be used to communicate a clinical sex category on the on relevant clinical resources (e.g., DiagnosticReport, ServiceRequest) or enclosing contexts (e.g., Patient, Encounter, EpisodeOfCare).

Sex for Clinical Use (SFCU) Categorization

For ease of interoperability, a patient’s sex for clinical use is constrained to four possible categories. Any patient for which special considerations apply should be categorized as ‘Specified’. The ‘Specified’ category is often represented as ‘Other’ in existing systems.

Female - Available data indicates that diagnostics, analytics, and treatments should consider best practices associated with female reference populations.

Male - Available data indicates that diagnostics, analytics, and treatments should consider best practices associated with male reference populations.

Specified - Available data indicates that diagnostics, analytics, and treatment best practices may be undefined or not aligned with existing sex-derived reference populations. Individuals or systems providing care should either use default behavior that is safe for both male and female populations, individually review treatment options with the patient, or carefully inspect relevant observations before proceeding with treatment.

Unknown - The sex for clinical use cannot be determined because there are no relevant evidence or documentation, or the evidence or documentation are not sufficient to determine a value. Sex for Clinical Use (SFCU) History and Practices

Prior to the definition of Sex for Clinical Use as a concept, systems may have used administrative gender as an approximation of patient-level sex for clinical use. This practice required pre-coordination among exchange parters to explicitly overload the administrative sex concept for use as a clinical sex concept. In cases where there was no pre-coordination, some systems may have incorrectly inferred information about a patient’s clinical sex from administrative gender.

In the context of ordering workflows, systems may use Ask at Order Entry (AOE) questions to collect concepts similar to sex for clinical use.

Resource instance description

A natural language description for non-conformance and non-terminology resource instances that is represented in the resource for publication use.

Resource instance name

A natural language name for non-conformance and non-terminology resource instances that is represented in the resource for publication use.

ServiceRequest Pertains To Goal

Indicates that the resource is related to either the measurement, achievement or progress towards the referenced goal. For example, a Procedure to exercise pertainsToGoal of losing weight.

MessageHeader Response Request

This extension enables the capability currently available through MSH-16 (Application Level acknowledgement) in HL7 Version 2 to declare at a message instance level whether a response is required or only upon error or success, or never.

ServiceRequest Precondition

The condition or state of the patient, prior or during the diagnostic procedure or test, for example, fasting, at-rest, or post-operative. This captures circumstances that may influence the measured value and have bearing on the interpretation of the result.

ServiceRequest Questionnaire Requested

Reference to a specific Questionnaire Resource as an ordered item. Allows for ordering a specific questionnaire to be completed.

PractitionerRole Primary Indicator

Flag indicating if the specialty is the primary specialty of the provider. Normally, a practitioner will have one primary specialty, but in some cases more than one can be primary.

Datatype

Used when the actual type is not allowed by the definition of the element. In general, this should only arise when wrangling between versions using cross-version extensions - see Cross Version Extensions.

Organization Primary Indicator

Flag indicating if the specialty is the primary specialty of the provider. Normally, a practitioner will have one primary specialty, but in some cases more than one can be primary.

Observation Focal Subject Code

A code representing the focus of an observation when the focus is not the patient of record. In other words, the focus of the observation is different from Observation.subject. An example use case would be using the Observation resource to capture whether the mother is trained to change her child’s tracheostomy tube. In this example, the child is the patient of record and the mother is focal subject referenced using this extension. Other example focal subjects include spouses, related persons, feti, or donors.

Observation Replaces

This observation replaces a previous observation (i.e. a revised value).

Observation Secondary Finding

Secondary findings are genetic test results that provide information about variants in a gene unrelated to the primary purpose for the testing, most often discovered when Whole Exome Sequencing (WES) or Whole Genome Sequencing (WGS) is performed. This extension should be used to denote when a genetic finding is being shared as a secondary finding, and ideally refer to a corresponding guideline or policy statement.

For more detail, please see: https://ghr.nlm.nih.gov/primer/testing/secondaryfindings.

Observation Reagent

Reference to reagents used to generate this observation. This is intended for this for in-lab transactions between instruments and Laboratory Information Systems (LIS).

Observation Specimen Code

A code representing the the type of specimen used for this observation. Should only be used if not implicit in the code found in Observation.code.

Observation Sequel To

This observation follows the target observation (e.g. timed tests such as Glucose Tolerance Test).

Observation Delta

The qualitative change in the value relative to the previous measurement. Usually only recorded if the change is clinically significant.

Observation Time Offset

A specific offset time in milliseconds from the stated time in the Observation.appliesDateTime to allow for representation of sequential recording of sampled data from the same lead or data stream. For example, an ECG recorder may record sequentially 3 leads four time to receive 12-lead ECG, see ISO 22077.

Observation Precondition

Other preceding or concurrent observations that must be known to correctly interpret the observation. For example, an fiO2 measure taken alongside of a SpO2 measurement. See the Observation notes section for additional guidance.

Observation Device Code

A code representing the the type of device used for this observation. Should only be used if not implicit in the code found in Observation.code.

Observation Gateway Device

The Provenance/AuditEvent resources can represent the same information. Note that the Provenance/AuditEvent resources can represent the same information.

Goal acceptance

Information about the acceptance and relative priority assigned to the goal by the patient, practitioners and other stake-holders.

Goal: Related Goal

Establishes a relationship between this goal and other goals.

Goal Reason Rejected

The reason the goal was not accepted. Applies only if the status of the goal is rejected.

Terminology: Value Sets

These define sets of codes used by systems conforming to this implementation guide.

ObjectLifecycleEvents

This FHIR value set is comprised of lifecycle event codes. The FHIR Actor value set is based on DICOM Audit Message, ParticipantObjectDataLifeCycle; ISO Standard, TS 21089-2017;

Inheritance Control Codes

Description Needed Here

template status code

Description Needed Here

Type Characteristic Codes

Description Needed Here

resource security category

Description Needed Here

CapabilityStatement Search Mode ValueSet

Which search modes a server supports: GET, POST, or both

Flag Priority Codes

This value set is provided as an exemplar. The value set is driven by IHE Table B.8-4: Abnormal Flags, Alert Priority.

questionnaire item usage mode

Description Needed Here

All FHIR Types

All fhir datatypes

Questionnaire Item UI Control Codes

Starter set of user interface control/display mechanisms that might be used when rendering an item in a questionnaire.

Barrier

Example codes indicating barriers. Note that these are in no way complete and might not even be appropriate for some uses.

Protective Factor

Example codes indicating protective factors. Note that these are in no way complete and might not even be appropriate for some uses.

animal species

This example value set defines a set of codes that can be used to indicate species of animal patients.

practitioner job title

This example value set defines a set of sample job titles.

Questionnaire Display Categories

Codes defining the purpose of a Questionnaire item of type ‘display’.

choice list orientation

Description Needed Here

Condition Cause Codes

Example value set for Cause of Condition codes

ResearchStudyRegistrationActivity

Codes for study registration activities.

Obligation Codes ValueSet

Obligation Codes

PostalAddressUse

Uses of an address not included in Address.use.

DataElement SDC Object Class

The allowed codes for identifying the ISO 11179 ObjectClass Property for a particular data element if intended for registration/use within the U.S. Structured Data Capture (SDC) project.

Coding Purpose ValueSet

The reason a coding is present.

EntityNamePartQualifier

A set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type.

ConceptMapEquivalence

The degree of equivalence between concepts.

HumanNameAssemblyOrder

A code that represents the preferred display order of the components of a human name.

NameRepresentationUse

A set of codes for each different representation of a name.

DataElement SDC Object Class

The allowed codes for identifying the ISO 11179 ObjectClass for a particular data element if intended for registration/use within the U.S. Structured Data Capture (SDC) project.

ProbabilityDistributionType

Codes specifying the type of probability distribution.

standards status

Description Needed Here

Artifact comment type

The type of artifact comment (documentation, review, guidance)

h l7 workgroup

Description Needed Here

Knowledge Capability

A capability afforded by a knowledge artifact, e.g. shareable, computable, publishable, executable

alternative code kind

Description Needed Here

code system properties mode

Description Needed Here

match grade

Description Needed Here

expansion parameter source

Description Needed Here

Sibling Relationship Codes

The value set includes the v3 RoleCode SIB (sibling) and all of its specializations. It covers the relationships needed to establish genetic pedigree relationships between family members.

Parent Relationship Codes

The value set includes the v3 RoleCode PRN (parent), TWIN (twin) and all of their specializations. It covers the relationships needed to establish genetic pedigree relationships between family members.

Procedure Progress Status Codes

This value set is provided as an example. The value set to instantiate this attribute should be drawn from a robust terminology code system that consists of or contains concepts to support the procedure performance process.

AllergyIntolerance certainty

Description Needed Here

AllergyIntolerance substance exposure risk

Description Needed Here

Condition Predecessor Codes

Example value set for condition predecessor codes.

Condition Course Codes

Value set for clinical course of a disease (how the disease behaves over time).

gender status

This example value set defines a set of codes that can be used to indicate the current state of the animal’s reproductive organs.

animal breeds

This example value set defines a set of codes that can be used to indicate breeds of species.

language preference type

This value set defines the set of codes for describing the type or mode of the patient’s preferred language.

Feeding Device Codes

Materials used or needed to feed the patient.

Implant Status

Description Needed Here

specimen collection priority

This example value set defines a set of codes that can be used to indicate the priority of collection of a specimen.

Questionnaire Response Mode

Codes describing how the QuestionnaireResponse was populated

Focal Subject Codes

Example value set composed from SNOMED CT and HL7 V3 codes for observation targets such as donor, fetus or spouse. As use cases are discovered, more values may be added.

Genetic Observation Secondary Findings

Codes to denote a guideline or policy statement when a genetic test result is being shared as a secondary finding.

goal acceptance status

Description Needed Here

goal relationship type

Description Needed Here

Terminology: Code Systems

These define new code systems used by systems conforming to this implementation guide.

Inheritance Control Codes

Inheritance Control Codes

Type Characteristic Codes

Type Characteristic Codes

resource security category

ResourceSecurityCategory

template status code

TemplateStatusCode

CapabilityStatement Search Mode CodeSystem

Which search modes a server supports: GET, POST, or both

Flag Priority Codes

This value set is provided as an exemplar. The value set is driven by IHE Table B.8-4: Abnormal Flags, Alert Priority.

questionnaire item usage mode

QuestionnaireItemUsageMode

choice list orientation

ChoiceListOrientation

Questionnaire Display Categories

Codes defining the purpose of a Questionnaire item of type ‘display’.

Practitioner Job Title

This example value set defines a set of codes that can be used to indicate the specialty of a Practitioner.

Questionnaire Item UI Control Codes

Starter set of user interface control/display mechanisms that might be used when rendering an item in a questionnaire.

ConceptMapEquivalence

The degree of equivalence between concepts.

Coding Purpose Code System

The reason a coding is present.

Obligation Codes

Codes that describe application obligations for handling FHIR content. There are three kinds of codes in this code system:

  • Qualifier codes: SHALL/SHOULD/MAY
  • Functional codes - these describe a functional behavior applications may implement, and have the concept property qualify = true, and must be qualified by one of SHALL, SHOULD, or MAY
  • Composite codes - these specialise AggregateConcepts, and have an concept property ‘expression’ that defines them in terms of a set of functional codes

Functional and Qualifier codes are combined using the syntax [modifierCode] ":" [obligationCode] e.g. SHALL:will-send

The functional codes are grouped into three different high level categories:

  • ResourceProducerObligations - functions that pertain to applications that produce resources (typically from databases or forms)
  • ExchangerObligations - functions that pertain to applications that transfer resources between other applications (including FHIR repositories)
  • ResourceConsumerObligations - functions that pertain to applications that consume the content of resources and do something with them

Note that applications typically produce and consume resources, whether client, server or something else again, and many applications transfer resources as well

standards status

StandardsStatus

Knowledge Capability

A capability afforded by a knowledge artifact.

h l7 workgroup

HL7Workgroup

Artifact comment type

The type of artifact comment (documentation, review, guidance)

code system properties mode

CodeSystemPropertiesMode

alternative code kind

AlternativeCodeKind

match grade

MatchGrade

expansion parameter source

ExpansionParameterSource

Procedure Progress Status Codes

This value set is provided as an exemplar. The value set to instantiate this attribute should be drawn from a terminologically robust code system that consists of or contains concepts to support the procedure performance process.

AllergyIntolerance certainty

AllergyIntoleranceCertainty

AllergyIntolerance substance exposure risk

AllergyIntoleranceSubstanceExposureRisk

language preference type

This code system defines a defines the set of codes for describing the type or mode of the patient’s preferred language.

gender status

This example value set defines a set of codes that can be used to indicate the current state of the animal’s reproductive organs.

Feeding Device Codes

Materials used or needed to feed the patient. These values are provided as a suggestive example.

Implant Status

Implant Status

Genetic Observation Secondary Findings

Codes to denote a guideline or policy statement when a genetic test result is being shared as a secondary finding.

goal acceptance status

GoalAcceptanceStatus

goal relationship type

GoalRelationshipType