US Core Implementation Guide (Release 1.1.0 Ballot )

This page is part of the US Core (v1.1.0: STU2 Ballot 1) based on FHIR R3. The current version which supercedes this version is 5.0.1. For a full list of available versions, see the Directory of published versions

US Core Patient Profile

Formats: Narrative, XML, JSON, Turtle

Raw xml


<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="us-core-patient"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/STU3/formats.html#table" title="The logical name of the element">Name</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/STU3/formats.html#table" title="Information about the use of the element">Flags</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/STU3/formats.html#table" title="Minimum and Maximum # of times the the element can appear in the instance">Card.</a></th><th style="width: 100px" class="hierarchy"><a href="http://hl7.org/fhir/STU3/formats.html#table" title="Reference to the type of the element">Type</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/STU3/formats.html#table" title="Additional information about the element">Description &amp; Constraints</a><span style="float: right"><a href="http://hl7.org/fhir/STU3/formats.html#table" title="Legend for this format"><img src="http://hl7.org/fhir/STU3/help16.png" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-us-core-patient-definitions.html#Patient" title="The US Core Patient Profile is based upon the core FHIR Patient Resource and designed to meet the applicable patient demographic data elements from the 2015 Edition Common Clinical Data Set.">Patient</a><a name="Patient"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.4">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.4">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">US Core Patient Profile</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-us-core-patient-definitions.html#Patient.identifier">identifier</a><a name="Patient.identifier"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..*</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.4" href="http://hl7.org/fhir/STU3/datatypes.html#Identifier">Identifier</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: white; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-us-core-patient-definitions.html#Patient.identifier.system">system</a><a name="Patient.identifier.system"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.4" href="http://hl7.org/fhir/STU3/datatypes.html#uri">uri</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: white; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-us-core-patient-definitions.html#Patient.identifier.value">value</a><a name="Patient.identifier.value"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.4" href="http://hl7.org/fhir/STU3/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">The value that is unique within the system.</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-us-core-patient-definitions.html#Patient.name">name</a><a name="Patient.name"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..*</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.4" href="http://hl7.org/fhir/STU3/datatypes.html#HumanName">HumanName</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: white; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-us-core-patient-definitions.html#Patient.name.family">family</a><a name="Patient.name.family"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.4" href="http://hl7.org/fhir/STU3/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: white; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-us-core-patient-definitions.html#Patient.name.given">given</a><a name="Patient.name.given"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..*</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.4" href="http://hl7.org/fhir/STU3/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: white; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-us-core-patient-definitions.html#Patient.gender">gender</a><a name="Patient.gender"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.4" href="http://hl7.org/fhir/STU3/datatypes.html#code">code</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="font-weight:bold">Binding: </span><a href="http://hl7.org/fhir/STU3/valueset-administrative-gender.html">AdministrativeGender</a> (<a href="http://hl7.org/fhir/STU3/terminologies.html#required" title="To be conformant, the concept in this element SHALL be from the specified value set">required</a>)</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: white; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-us-core-patient-definitions.html#Patient.birthDate">birthDate</a><a name="Patient.birthDate"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.4">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.4">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.4" href="http://hl7.org/fhir/STU3/datatypes.html#date">date</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <span style="text-decoration:line-through">animal</span><a name="Patient.animal"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="text-decoration:line-through"/><span style="text-decoration:line-through">0</span><span style="text-decoration:line-through">..</span><span style="text-decoration:line-through">0</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-us-core-patient-definitions.html#Patient.communication">communication</a><a name="Patient.communication"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.4">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.4">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.4" href="http://hl7.org/fhir/STU3/datatypes.html#BackboneElement">BackboneElement</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-us-core-patient-definitions.html#Patient.communication.language">language</a><a name="Patient.communication.language"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.4">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.4">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.4" href="http://hl7.org/fhir/STU3/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="font-weight:bold">Binding: </span><a href="ValueSet-simple-language.html">Language codes with language and optionally a region modifier</a> (<a href="http://hl7.org/fhir/STU3/terminologies.html#extensible" title="To be conformant, the concept in this element SHALL be from the specified value set if any of the codes within the value set can apply to the concept being communicated.  If the value set does not cover the concept (based on human review), alternate codings (or, data type allowing, text) may be included instead.">extensible</a>)</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_extension_complex.png" alt="." style="background-color: white; background-color: inherit" title="Complex Extension" class="hierarchy"/> <a href="StructureDefinition-us-core-patient-definitions.html#Patient.extension:race" title="Extension URL = http://hl7.org/fhir/us/core/StructureDefinition/us-core-race">us-core-race</a><a name="Patient.extension"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.4">0</span>..<span style="opacity: 0.4">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">(Complex)</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">US Core Race Extension<br/><span style="font-weight:bold">URL: </span><a href="http://hl7.org/fhir/STU3/StructureDefinition-us-core-race.html">http://hl7.org/fhir/us/core/StructureDefinition/us-core-race</a></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_extension_complex.png" alt="." style="background-color: white; background-color: inherit" title="Complex Extension" class="hierarchy"/> <a href="StructureDefinition-us-core-patient-definitions.html#Patient.extension:ethnicity" title="Extension URL = http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity">us-core-ethnicity</a><a name="Patient.extension"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.4">0</span>..<span style="opacity: 0.4">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">(Complex)</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">US Core ethnicity Extension<br/><span style="font-weight:bold">URL: </span><a href="http://hl7.org/fhir/STU3/StructureDefinition-us-core-ethnicity.html">http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity</a></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_extension_simple.png" alt="." style="background-color: white; background-color: inherit" title="Simple Extension" class="hierarchy"/> <a href="StructureDefinition-us-core-patient-definitions.html#Patient.extension:birthsex" title="Extension URL = http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex">us-core-birthsex</a><a name="Patient.extension"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.4">0</span>..<span style="opacity: 0.4">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/STU3/datatypes.html#code">code</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Extension<br/><span style="font-weight:bold">URL: </span><a href="http://hl7.org/fhir/STU3/StructureDefinition-us-core-birthsex.html">http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex</a><br/><span style="font-weight:bold">Binding: </span><a href="ValueSet-us-core-birthsex.html">US Core Birth Sex Value Set</a> (<a href="http://hl7.org/fhir/STU3/terminologies.html#required" title="To be conformant, the concept in this element SHALL be from the specified value set">required</a>)</td></tr>
<tr><td colspan="5" class="hierarchy"><br/><a href="http://hl7.org/fhir/STU3/formats.html#table" title="Legend for this format"><img src="http://hl7.org/fhir/STU3/help16.png" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
  </text>
  <url value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"/>
  <version value="1.1.0"/>
  <name value="US Core Patient Profile"/>
  <status value="draft"/>
  <date value="2016-08-01T00:00:00+10:00"/>
  <publisher value="HL7 US Realm Steering Committee"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://www.healthit.gov"/>
    </telecom>
  </contact>
  <description
               value="Defines constraints and extensions on the patient resource for the minimal set of data to query and retrieve patient demographic information."/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
      <display value="United States Minor Outlying Islands (the)"/>
    </coding>
  </jurisdiction>
  <fhirVersion value="3.0.1"/>
  <mapping>
    <identity value="argonaut-dq-dstu2"/>
    <uri value="http://unknown.org/Argonaut-DQ-DSTU2"/>
    <name value="Argonaut-DQ-DSTU2"/>
  </mapping>
  <mapping>
    <identity value="rim"/>
    <uri value="http://hl7.org/v3"/>
    <name value="RIM Mapping"/>
  </mapping>
  <mapping>
    <identity value="cda"/>
    <uri value="http://hl7.org/v3/cda"/>
    <name value="CDA (R2)"/>
  </mapping>
  <mapping>
    <identity value="w5"/>
    <uri value="http://hl7.org/fhir/w5"/>
    <name value="W5 Mapping"/>
  </mapping>
  <mapping>
    <identity value="v2"/>
    <uri value="http://hl7.org/v2"/>
    <name value="HL7 v2 Mapping"/>
  </mapping>
  <mapping>
    <identity value="loinc"/>
    <uri value="http://loinc.org"/>
    <name value="LOINC code for the element"/>
  </mapping>
  <kind value="resource"/>
  <abstract value="false"/>
  <type value="Patient"/>
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Patient"/>
  <derivation value="constraint"/>
  <snapshot>
    <element id="Patient">
      <path value="Patient"/>
      <short value="US Core Patient Profile"/>
      <definition
                  value="The US Core Patient Profile is based upon the core FHIR Patient Resource and designed to meet the applicable patient demographic data elements from the 2015 Edition Common Clinical Data Set."/>
      <alias value="SubjectOfCare Client Resident"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Patient"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <constraint>
        <key value="dom-2"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/>
        <expression value="contained.contained.empty()"/>
        <xpath value="not(parent::f:contained and f:contained)"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-1"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL NOT contain any narrative"/>
        <expression value="contained.text.empty()"/>
        <xpath value="not(parent::f:contained and f:text)"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-4"/>
        <severity value="error"/>
        <human
               value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated"/>
        <expression
                    value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/>
        <xpath
               value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-3"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource"/>
        <expression
                    value="contained.where((&#39;#&#39;+id in %resource.descendants().reference).not()).empty()"/>
        <xpath
               value="not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat(&#39;#&#39;, $id))]))"/>
        <source value="DomainResource"/>
      </constraint>
      <mustSupport value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="Entity. Role, or Act"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Patient[classCode=PAT]"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="ClinicalDocument.recordTarget.patientRole"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="administrative.individual"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient"/>
      </mapping>
    </element>
    <element id="Patient.id">
      <path value="Patient.id"/>
      <short value="Logical id of this artifact"/>
      <definition
                  value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/>
      <comment
               value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element id="Patient.meta">
      <path value="Patient.meta"/>
      <short value="Metadata about the resource"/>
      <definition
                  value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.meta"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Meta"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element id="Patient.implicitRules">
      <path value="Patient.implicitRules"/>
      <short value="A set of rules under which this content was created"/>
      <definition
                  value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content."/>
      <comment
               value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. 

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it&#39;s meaning or interpretation."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.implicitRules"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
    </element>
    <element id="Patient.language">
      <path value="Patient.language"/>
      <short value="Language of the resource content"/>
      <definition value="The base language in which the resource is written."/>
      <comment
               value="Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.language"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueReference>
            <reference value="http://hl7.org/fhir/ValueSet/all-languages"/>
          </valueReference>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/>
        </extension>
        <strength value="extensible"/>
        <description value="A human language."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/languages"/>
        </valueSetReference>
      </binding>
    </element>
    <element id="Patient.text">
      <path value="Patient.text"/>
      <short value="Text summary of the resource, for human interpretation"/>
      <definition
                  value="A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety."/>
      <comment
               value="Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a &quot;text blob&quot; or where text is additionally entered raw or narrated and encoded in formation is added later."/>
      <alias value="narrative"/>
      <alias value="html"/>
      <alias value="xhtml"/>
      <alias value="display"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Narrative"/>
      </type>
      <condition value="dom-1"/>
      <mapping>
        <identity value="rim"/>
        <map value="Act.text?"/>
      </mapping>
    </element>
    <element id="Patient.contained">
      <path value="Patient.contained"/>
      <short value="Contained, inline Resources"/>
      <definition
                  value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope."/>
      <comment
               value="This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again."/>
      <alias value="inline resources"/>
      <alias value="anonymous resources"/>
      <alias value="contained resources"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.contained"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Resource"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Patient.extension">
      <path value="Patient.extension"/>
      <slicing id="1">
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
    </element>
    <element id="Patient.extension:race">
      <path value="Patient.extension"/>
      <sliceName value="race"/>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.extension"/>
      </mapping>
    </element>
    <element id="Patient.extension:ethnicity">
      <path value="Patient.extension"/>
      <sliceName value="ethnicity"/>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.extension"/>
      </mapping>
    </element>
    <element id="Patient.extension:birthsex">
      <path value="Patient.extension"/>
      <sliceName value="birthsex"/>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.extension"/>
      </mapping>
    </element>
    <element id="Patient.modifierExtension">
      <path value="Patient.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Patient.identifier">
      <path value="Patient.identifier"/>
      <short value="An identifier for this patient"/>
      <definition value="An identifier for this patient."/>
      <requirements
                    value="Patients are almost always assigned specific numerical identifiers."/>
      <min value="1"/>
      <max value="*"/>
      <base>
        <path value="Patient.identifier"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Identifier"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="PID-3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="id"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value=".id"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="id"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.identifier"/>
      </mapping>
    </element>
    <element id="Patient.identifier.id">
      <path value="Patient.identifier.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.identifier.extension">
      <path value="Patient.identifier.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.identifier.use">
      <path value="Patient.identifier.use"/>
      <short value="usual | official | temp | secondary (If known)"/>
      <definition value="The purpose of this identifier."/>
      <comment
               value="This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary."/>
      <requirements
                    value="Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Identifier.use"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="IdentifierUse"/>
        </extension>
        <strength value="required"/>
        <description
                     value="Identifies the purpose for this identifier, if known ."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/identifier-use"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="N/A"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Role.code or implied by context"/>
      </mapping>
    </element>
    <element id="Patient.identifier.type">
      <path value="Patient.identifier.type"/>
      <short value="Description of identifier"/>
      <definition
                  value="A coded type for the identifier that can be used to determine which identifier to use for a specific purpose."/>
      <comment
               value="This element deals only with general categories of identifiers.  It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. 

Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type."/>
      <requirements
                    value="Allows users to make use of identifiers when the identifier system is not known."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Identifier.type"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="IdentifierType"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/>
        </extension>
        <strength value="extensible"/>
        <description
                     value="A coded type for an identifier that can be used to determine which identifier to use for a specific purpose."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/identifier-type"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="CX.5"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Role.code or implied by context"/>
      </mapping>
    </element>
    <element id="Patient.identifier.system">
      <path value="Patient.identifier.system"/>
      <short value="The namespace for the identifier value"/>
      <definition
                  value="Establishes the namespace for the value - that is, a URL that describes a set values that are unique."/>
      <requirements
                    value="There are many sets  of identifiers.  To perform matching of two identifiers, we need to know what set we&#39;re dealing with. The system identifies a particular set of unique identifiers."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Identifier.system"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <example>
        <label value="General"/>
        <valueUri
                  value="http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri"/>
      </example>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="CX.4 / EI-2-4"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="II.root or Role.id.root"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="./IdentifierType"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.identifier.system"/>
      </mapping>
    </element>
    <element id="Patient.identifier.value">
      <path value="Patient.identifier.value"/>
      <short value="The value that is unique within the system."/>
      <definition
                  value="The portion of the identifier typically relevant to the user and which is unique within the context of the system."/>
      <comment
               value="If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.  The value&#39;s primary purpose is computational mapping.  As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.)  A value formatted for human display can be conveyed using the [Rendered Value extension](extension-rendered-value.html)."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Identifier.value"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <example>
        <label value="General"/>
        <valueString value="123456"/>
      </example>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="CX.1 / EI.1"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="./Value"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.identifier.value"/>
      </mapping>
    </element>
    <element id="Patient.identifier.period">
      <path value="Patient.identifier.period"/>
      <short value="Time period when id is/was valid for use"/>
      <definition
                  value="Time period during which identifier is/was valid for use."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Identifier.period"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Period"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="CX.7 + CX.8"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Role.effectiveTime or implied by context"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="./StartDate and ./EndDate"/>
      </mapping>
    </element>
    <element id="Patient.identifier.assigner">
      <path value="Patient.identifier.assigner"/>
      <short value="Organization that issued id (may be just text)"/>
      <definition value="Organization that issued/manages the identifier."/>
      <comment
               value="The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Identifier.assigner"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Organization"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="CX.4 / (CX.4,CX.9,CX.10)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="./IdentifierIssuingAuthority"/>
      </mapping>
    </element>
    <element id="Patient.active">
      <path value="Patient.active"/>
      <short value="Whether this patient&#39;s record is in active use"/>
      <definition value="Whether this patient record is in active use."/>
      <comment
               value="Default is true. If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient

This element is labeled as a modifier because when the patient record is marked as not active it is not expected to be used/referenced without being changed back to active."/>
      <requirements
                    value="Need to be able to mark a patient record as not to be used because it was created in error."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Patient.active"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="boolean"/>
      </type>
      <defaultValueBoolean value="true"/>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="statusCode"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="status"/>
      </mapping>
    </element>
    <element id="Patient.name">
      <path value="Patient.name"/>
      <short value="A name associated with the patient"/>
      <definition value="A name associated with the individual."/>
      <comment
               value="A patient may have multiple names with different uses or applicable periods. For animals, the name is a &quot;HumanName&quot; in the sense that is assigned and used by humans and has the same patterns."/>
      <requirements
                    value="Need to be able to track the patient by multiple names. Examples are your official name and a partner name."/>
      <min value="1"/>
      <max value="*"/>
      <base>
        <path value="Patient.name"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="HumanName"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="PID-5, PID-9"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="name"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value=".patient.name"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.name"/>
      </mapping>
    </element>
    <element id="Patient.name.id">
      <path value="Patient.name.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.name.extension">
      <path value="Patient.name.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.name.use">
      <path value="Patient.name.use"/>
      <short
             value="usual | official | temp | nickname | anonymous | old | maiden"/>
      <definition value="Identifies the purpose for this name."/>
      <comment
               value="This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary or old name etc.for a current/permanent one. Applications can assume that a name is current unless it explicitly says that it is temporary or old."/>
      <requirements
                    value="Allows the appropriate name for a particular context of use to be selected from among a set of names."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="HumanName.use"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="NameUse"/>
        </extension>
        <strength value="required"/>
        <description value="The use of a human name"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/name-use"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="XPN.7, but often indicated by which field contains the name"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="unique(./use)"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="./NamePurpose"/>
      </mapping>
    </element>
    <element id="Patient.name.text">
      <path value="Patient.name.text"/>
      <short value="Text representation of the full name"/>
      <definition value="A full text representation of the name."/>
      <comment
               value="Can provide both a text representation and structured parts."/>
      <requirements value="A renderable, unencoded form."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="HumanName.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="implied by XPN.11"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./formatted"/>
      </mapping>
    </element>
    <element id="Patient.name.family">
      <path value="Patient.name.family"/>
      <short value="Family name (often called &#39;Surname&#39;)"/>
      <definition
                  value="The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father."/>
      <comment
               value="Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures)."/>
      <alias value="surname"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="HumanName.family"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="XPN.1/FN.1"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./part[partType = FAM]"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="./FamilyName"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.name.family"/>
      </mapping>
    </element>
    <element id="Patient.name.given">
      <path value="Patient.name.given"/>
      <short
             value="Given names (not always &#39;first&#39;). Includes middle names"/>
      <definition value="Given name."/>
      <comment
               value="If only initials are recorded, they may be used in place of the full name.  Not called &quot;first name&quot; since given names do not always come first."/>
      <alias value="first name"/>
      <alias value="middle name"/>
      <min value="1"/>
      <max value="*"/>
      <base>
        <path value="HumanName.given"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <orderMeaning
                    value="Given Names appear in the correct order for presenting the name"/>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="XPN.2 + XPN.3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./part[partType = GIV]"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="./GivenNames"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.name.given"/>
      </mapping>
    </element>
    <element id="Patient.name.prefix">
      <path value="Patient.name.prefix"/>
      <short value="Parts that come before the name"/>
      <definition
                  value="Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="HumanName.prefix"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <orderMeaning
                    value="Prefixes appear in the correct order for presenting the name"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="XPN.5"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./part[partType = PFX]"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="./TitleCode"/>
      </mapping>
    </element>
    <element id="Patient.name.suffix">
      <path value="Patient.name.suffix"/>
      <short value="Parts that come after the name"/>
      <definition
                  value="Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="HumanName.suffix"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <orderMeaning
                    value="Suffixes appear in the correct order for presenting the name"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="XPN/4"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./part[partType = SFX]"/>
      </mapping>
    </element>
    <element id="Patient.name.period">
      <path value="Patient.name.period"/>
      <short value="Time period when name was/is in use"/>
      <definition
                  value="Indicates the period of time when this name was valid for the named person."/>
      <requirements value="Allows names to be placed in historical context."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="HumanName.period"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Period"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="XPN.13 + XPN.14"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./usablePeriod[type=&quot;IVL&lt;TS&gt;&quot;]"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="./StartDate and ./EndDate"/>
      </mapping>
    </element>
    <element id="Patient.telecom">
      <path value="Patient.telecom"/>
      <short value="A contact detail for the individual"/>
      <definition
                  value="A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted."/>
      <comment
               value="A Patient may have multiple ways to be contacted with different uses or applicable periods.  May need to have options for contacting the person urgently and also to help with identification. The address may not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner&#39;s phone)."/>
      <requirements
                    value="People have (primary) ways to contact them in some way such as phone, email."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Patient.telecom"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="ContactPoint"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="PID-13, PID-14, PID-40"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="telecom"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value=".telecom"/>
      </mapping>
    </element>
    <element id="Patient.gender">
      <path value="Patient.gender"/>
      <short value="male | female | other | unknown"/>
      <definition
                  value="Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes."/>
      <comment
               value="The gender may not match the biological sex as determined by genetics, or the individual&#39;s preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than M and F, though the vast majority of systems and contexts only support M and F.  Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific gender aspect of interest (anatomical, chromosonal, social, etc.)  However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice.  Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosonal and other gender aspects.  For example, an alert about a hysterectomy on a male should be handled as a warning or overrideable error, not a &quot;hard&quot; error."/>
      <requirements
                    value="Needed for identification of the individual, in combination with (at least) name and birth date. Gender of individual drives many clinical processes."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Patient.gender"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <binding>
        <strength value="required"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/administrative-gender"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="PID-8"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value=".patient.administrativeGenderCode"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.gender"/>
      </mapping>
    </element>
    <element id="Patient.birthDate">
      <path value="Patient.birthDate"/>
      <short value="The date of birth for the individual"/>
      <definition value="The date of birth for the individual."/>
      <comment
               value="At least an estimated year should be provided as a guess if the real DOB is unknown  There is a standard extension &quot;patient-birthTime&quot; available that should be used where Time is required (such as in maternaty/infant care systems)."/>
      <requirements
                    value="Age of the individual drives many clinical processes."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Patient.birthDate"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="date"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="PID-7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/birthTime"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value=".patient.birthTime"/>
      </mapping>
      <mapping>
        <identity value="loinc"/>
        <map value="21112-8"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.birthDate"/>
      </mapping>
    </element>
    <element id="Patient.deceased[x]">
      <path value="Patient.deceased[x]"/>
      <short value="Indicates if the individual is deceased or not"/>
      <definition value="Indicates if the individual is deceased or not."/>
      <comment
               value="If there&#39;s no value in the instance it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.

This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different."/>
      <requirements
                    value="The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Patient.deceased[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="boolean"/>
      </type>
      <type>
        <code value="dateTime"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="PID-30  (bool) and PID-29 (datetime)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedTime"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.address">
      <path value="Patient.address"/>
      <short value="Addresses for the individual"/>
      <definition value="Addresses for the individual."/>
      <comment
               value="Patient may have multiple addresses with different uses or applicable periods."/>
      <requirements
                    value="May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Patient.address"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Address"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="PID-11"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="addr"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value=".addr"/>
      </mapping>
    </element>
    <element id="Patient.maritalStatus">
      <path value="Patient.maritalStatus"/>
      <short value="Marital (civil) status of a patient"/>
      <definition
                  value="This field contains a patient&#39;s most recent marital (civil) status."/>
      <requirements value="Most, if not all systems capture it."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Patient.maritalStatus"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MaritalStatus"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/>
        </extension>
        <strength value="extensible"/>
        <description value="The domestic partnership status of a person."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/marital-status"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="PID-16"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="player[classCode=PSN]/maritalStatusCode"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value=".patient.maritalStatusCode"/>
      </mapping>
    </element>
    <element id="Patient.multipleBirth[x]">
      <path value="Patient.multipleBirth[x]"/>
      <short value="Whether patient is part of a multiple birth"/>
      <definition
                  value="Indicates whether the patient is part of a multiple (bool) or indicates the actual birth order (integer)."/>
      <comment
               value="Where the valueInteger is provided, the number is the birth number in the sequence.
E.g. The middle birth in tripplets would be valueInteger=2 and the third born would have valueInteger=3
If a bool value was provided for this tripplets examle, then all 3 patient records would have valueBool=true (the ordering is not indicated)."/>
      <requirements
                    value="For disambiguation of multiple-birth children, especially relevant where the care provider doesn&#39;t meet the patient, such as labs."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Patient.multipleBirth[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="boolean"/>
      </type>
      <type>
        <code value="integer"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="PID-24 (bool), PID-25 (integer)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthInd,  player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.photo">
      <path value="Patient.photo"/>
      <short value="Image of the patient"/>
      <definition value="Image of the patient."/>
      <requirements
                    value="Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Patient.photo"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Attachment"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-5 - needs a profile"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/desc"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.contact">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
        <valueString value="Contact"/>
      </extension>
      <path value="Patient.contact"/>
      <short
             value="A contact party (e.g. guardian, partner, friend) for the patient"/>
      <definition
                  value="A contact party (e.g. guardian, partner, friend) for the patient."/>
      <comment
               value="Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact."/>
      <requirements
                    value="Need to track people you can contact about the patient."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Patient.contact"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() | (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="Element"/>
      </constraint>
      <constraint>
        <key value="pat-1"/>
        <severity value="error"/>
        <human
               value="SHALL at least contain a contact&#39;s details or a reference to an organization"/>
        <expression
                    value="name.exists() or telecom.exists() or address.exists() or organization.exists()"/>
        <xpath
               value="exists(f:name) or exists(f:telecom) or exists(f:address) or exists(f:organization)"/>
      </constraint>
      <mapping>
        <identity value="rim"/>
        <map
             value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON]"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.contact.id">
      <path value="Patient.contact.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.contact.extension">
      <path value="Patient.contact.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.contact.modifierExtension">
      <path value="Patient.contact.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Patient.contact.relationship">
      <path value="Patient.contact.relationship"/>
      <short value="The kind of relationship"/>
      <definition
                  value="The nature of the relationship between the patient and the contact person."/>
      <requirements
                    value="Used to determine which contact person is the most relevant to approach, depending on circumstances."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Patient.contact.relationship"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ContactRelationship"/>
        </extension>
        <strength value="extensible"/>
        <description
                     value="The nature of the relationship between a patient and a contact person for that patient."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/v2-0131"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="NK1-7, NK1-3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="code"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.contact.name">
      <path value="Patient.contact.name"/>
      <short value="A name associated with the contact person"/>
      <definition value="A name associated with the contact person."/>
      <requirements
                    value="Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Patient.contact.name"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="HumanName"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="NK1-2"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="name"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.contact.telecom">
      <path value="Patient.contact.telecom"/>
      <short value="A contact detail for the person"/>
      <definition
                  value="A contact detail for the person, e.g. a telephone number or an email address."/>
      <comment
               value="Contact may have multiple ways to be contacted with different uses or applicable periods.  May need to have options for contacting the person urgently, and also to help with identification."/>
      <requirements
                    value="People have (primary) ways to contact them in some way such as phone, email."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Patient.contact.telecom"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="ContactPoint"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="NK1-5, NK1-6, NK1-40"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="telecom"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.contact.address">
      <path value="Patient.contact.address"/>
      <short value="Address for the contact person"/>
      <definition value="Address for the contact person."/>
      <requirements
                    value="Need to keep track where the contact person can be contacted per postal mail or visited."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Patient.contact.address"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Address"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="NK1-4"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="addr"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.contact.gender">
      <path value="Patient.contact.gender"/>
      <short value="male | female | other | unknown"/>
      <definition
                  value="Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes."/>
      <requirements value="Needed to address the person correctly."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Patient.contact.gender"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="AdministrativeGender"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/>
        </extension>
        <strength value="required"/>
        <description
                     value="The gender of a person used for administrative purposes."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/administrative-gender"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="NK1-15"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.contact.organization">
      <path value="Patient.contact.organization"/>
      <short value="Organization that is associated with the contact"/>
      <definition
                  value="Organization on behalf of which the contact is acting or for which the contact is working."/>
      <requirements
                    value="For guardians or business related contacts, the organization is relevant."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Patient.contact.organization"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Organization"/>
      </type>
      <condition value="pat-1"/>
      <mapping>
        <identity value="v2"/>
        <map value="NK1-13, NK1-30, NK1-31, NK1-32, NK1-41"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="scoper"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.contact.period">
      <path value="Patient.contact.period"/>
      <short
             value="The period during which this contact person or organization is valid to be contacted relating to this patient"/>
      <definition
                  value="The period during which this contact person or organization is valid to be contacted relating to this patient."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Patient.contact.period"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Period"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="effectiveTime"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.animal">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
        <valueString value="Animal"/>
      </extension>
      <path value="Patient.animal"/>
      <short value="This patient is known to be an animal (non-human)"/>
      <definition value="This patient is known to be an animal."/>
      <comment
               value="The animal element is labeled &quot;Is Modifier&quot; since patients may be non-human. Systems SHALL either handle patient details appropriately (e.g. inform users patient is not human) or reject declared animal records.   The absense of the animal element does not imply that the patient is a human. If a system requires such a positive assertion that the patient is human, an extension will be required.  (Do not use a species of homo-sapiens in animal species, as this would incorrectly infer that the patient is an animal)."/>
      <requirements
                    value="Many clinical systems are extended to care for animal patients as well as human."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Patient.animal"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() | (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="Element"/>
      </constraint>
      <mustSupport value="false"/>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="player[classCode=ANM]"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.animal"/>
      </mapping>
    </element>
    <element id="Patient.animal.id">
      <path value="Patient.animal.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.animal.extension">
      <path value="Patient.animal.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.animal.modifierExtension">
      <path value="Patient.animal.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Patient.animal.species">
      <path value="Patient.animal.species"/>
      <short value="E.g. Dog, Cow"/>
      <definition
                  value="Identifies the high level taxonomic categorization of the kind of animal."/>
      <comment
               value="If the patient is non-human, at least a species SHALL be specified. Species SHALL be a widely recognised taxonomic classification.  It may or may not be Linnaean taxonomy and may or may not be at the level of species. If the level is finer than species--such as a breed code--the code system used SHALL allow inference of the species.  (The common example is that the word &quot;Hereford&quot; does not allow inference of the species Bos taurus, because there is a Hereford pig breed, but the SNOMED CT code for &quot;Hereford Cattle Breed&quot; does.)."/>
      <requirements value="Need to know what kind of animal."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Patient.animal.species"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="AnimalSpecies"/>
        </extension>
        <strength value="example"/>
        <description value="The species of an animal."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/animal-species"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="PID-35"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="code"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.animal.breed">
      <path value="Patient.animal.breed"/>
      <short value="E.g. Poodle, Angus"/>
      <definition
                  value="Identifies the detailed categorization of the kind of animal."/>
      <comment
               value="Breed MAY be used to provide further taxonomic or non-taxonomic classification.  It may involve local or proprietary designation--such as commercial strain--and/or additional information such as production type."/>
      <requirements
                    value="May need to know the specific kind within the species."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Patient.animal.breed"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="AnimalBreed"/>
        </extension>
        <strength value="example"/>
        <description value="The breed of an animal."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/animal-breeds"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="PID-37"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="playedRole[classCode=GEN]/scoper[classCode=ANM, determinerCode=KIND]/code"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.animal.genderStatus">
      <path value="Patient.animal.genderStatus"/>
      <short value="E.g. Neutered, Intact"/>
      <definition
                  value="Indicates the current state of the animal&#39;s reproductive organs."/>
      <requirements
                    value="Gender status can affect housing and animal behavior."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Patient.animal.genderStatus"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="AnimalGenderStatus"/>
        </extension>
        <strength value="example"/>
        <description value="The state of the animal&#39;s reproductive organs."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/animal-genderstatus"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="N/A"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="genderStatusCode"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.communication">
      <path value="Patient.communication"/>
      <short
             value="A list of Languages which may be used to communicate with the patient about his or her health"/>
      <definition
                  value="Languages which may be used to communicate with the patient about his or her health."/>
      <comment
               value="If no language is specified, this *implies* that the default local language is spoken.  If you need to convey proficiency for multiple modes then you need multiple Patient.Communication associations.   For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required."/>
      <requirements
                    value="If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency is an important things to keep track of both for patient and other persons of interest."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Patient.communication"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() | (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="Element"/>
      </constraint>
      <mustSupport value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="LanguageCommunication"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="patient.languageCommunication"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.communication"/>
      </mapping>
    </element>
    <element id="Patient.communication.id">
      <path value="Patient.communication.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.communication.extension">
      <path value="Patient.communication.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.communication.modifierExtension">
      <path value="Patient.communication.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Patient.communication.language">
      <path value="Patient.communication.language"/>
      <short
             value="The language which can be used to communicate with the patient about his or her health"/>
      <definition
                  value="The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. &quot;en&quot; for English, or &quot;en-US&quot; for American English versus &quot;en-EN&quot; for England English."/>
      <comment
               value="The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type."/>
      <requirements
                    value="Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Patient.communication.language"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mustSupport value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueReference>
            <reference
                       value="http://hl7.org/fhir/us/core/ValueSet/simple-language"/>
          </valueReference>
        </extension>
        <strength value="extensible"/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/us/core/ValueSet/simple-language"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="PID-15, LAN-2"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/languageCommunication/code"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value=".languageCode"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.communication.language"/>
      </mapping>
    </element>
    <element id="Patient.communication.preferred">
      <path value="Patient.communication.preferred"/>
      <short value="Language preference indicator"/>
      <definition
                  value="Indicates whether or not the patient prefers this language (over other languages he masters up a certain level)."/>
      <comment
               value="This language is specifically identified for communicating healthcare information."/>
      <requirements
                    value="People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Patient.communication.preferred"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="boolean"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="PID-15"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="preferenceInd"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value=".preferenceInd"/>
      </mapping>
    </element>
    <element id="Patient.generalPractitioner">
      <path value="Patient.generalPractitioner"/>
      <short value="Patient&#39;s nominated primary care provider"/>
      <definition value="Patient&#39;s nominated care provider."/>
      <comment
               value="This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disablity setting, or even organization that will provide people to perform the care provider roles.

It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources."/>
      <alias value="careProvider"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Patient.generalPractitioner"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Organization"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="PD1-4"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="subjectOf.CareEvent.performer.AssignedEntity"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.managingOrganization">
      <path value="Patient.managingOrganization"/>
      <short value="Organization that is the custodian of the patient record"/>
      <definition
                  value="Organization that is the custodian of the patient record."/>
      <comment
               value="There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association)."/>
      <requirements
                    value="Need to know who recognizes this patient record, manages and updates it."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Patient.managingOrganization"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Organization"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="scoper"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value=".providerOrganization"/>
      </mapping>
    </element>
    <element id="Patient.link">
      <path value="Patient.link"/>
      <short
             value="Link to another patient resource that concerns the same actual person"/>
      <definition
                  value="Link to another patient resource that concerns the same actual patient."/>
      <comment
               value="There is no assumption that linked patient records have mutual links. 

This element is labelled as a modifier because it may not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is &#39;replaced-by&#39;."/>
      <requirements
                    value="There are multiple usecases: 

* Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and * Distribution of patient information across multiple servers."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Patient.link"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() | (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="Element"/>
      </constraint>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="outboundLink"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.link.id">
      <path value="Patient.link.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.link.extension">
      <path value="Patient.link.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.link.modifierExtension">
      <path value="Patient.link.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Patient.link.other">
      <path value="Patient.link.other"/>
      <short
             value="The other patient or related person resource that the link refers to"/>
      <definition value="The other patient resource that the link refers to."/>
      <comment
               value="Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Patient.link.other"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="PID-3, MRG-1"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="id"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Patient.link.type">
      <path value="Patient.link.type"/>
      <short value="replaced-by | replaces | refer | seealso - type of link"/>
      <definition
                  value="The type of link between this patient resource and another patient resource."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Patient.link.type"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="LinkType"/>
        </extension>
        <strength value="required"/>
        <description
                     value="The type of link between this patient resource and another patient resource."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/link-type"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="typeCode"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <map value="n/a"/>
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element id="Patient">
      <path value="Patient"/>
      <short value="US Core Patient Profile"/>
      <definition
                  value="The US Core Patient Profile is based upon the core FHIR Patient Resource and designed to meet the applicable patient demographic data elements from the 2015 Edition Common Clinical Data Set."/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient"/>
      </mapping>
    </element>
    <element id="Patient.extension:race">
      <path value="Patient.extension"/>
      <sliceName value="race"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.extension"/>
      </mapping>
    </element>
    <element id="Patient.extension:ethnicity">
      <path value="Patient.extension"/>
      <sliceName value="ethnicity"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.extension"/>
      </mapping>
    </element>
    <element id="Patient.extension:birthsex">
      <path value="Patient.extension"/>
      <sliceName value="birthsex"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <binding>
        <strength value="required"/>
        <description value="Code for sex assigned at birth"/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/us/core/ValueSet/us-core-birthsex"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.extension"/>
      </mapping>
    </element>
    <element id="Patient.identifier">
      <path value="Patient.identifier"/>
      <min value="1"/>
      <max value="*"/>
      <type>
        <code value="Identifier"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.identifier"/>
      </mapping>
    </element>
    <element id="Patient.identifier.system">
      <path value="Patient.identifier.system"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="uri"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.identifier.system"/>
      </mapping>
    </element>
    <element id="Patient.identifier.value">
      <path value="Patient.identifier.value"/>
      <short value="The value that is unique within the system."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.identifier.value"/>
      </mapping>
    </element>
    <element id="Patient.name">
      <path value="Patient.name"/>
      <min value="1"/>
      <max value="*"/>
      <type>
        <code value="HumanName"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.name"/>
      </mapping>
    </element>
    <element id="Patient.name.family">
      <path value="Patient.name.family"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.name.family"/>
      </mapping>
    </element>
    <element id="Patient.name.given">
      <path value="Patient.name.given"/>
      <min value="1"/>
      <max value="*"/>
      <type>
        <code value="string"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.name.given"/>
      </mapping>
    </element>
    <element id="Patient.gender">
      <path value="Patient.gender"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <binding>
        <strength value="required"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/administrative-gender"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.gender"/>
      </mapping>
    </element>
    <element id="Patient.birthDate">
      <path value="Patient.birthDate"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="date"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.birthDate"/>
      </mapping>
    </element>
    <element id="Patient.animal">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
        <valueString value="Animal"/>
      </extension>
      <path value="Patient.animal"/>
      <min value="0"/>
      <max value="0"/>
      <type>
        <code value="BackboneElement"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.animal"/>
      </mapping>
    </element>
    <element id="Patient.communication">
      <path value="Patient.communication"/>
      <min value="0"/>
      <max value="*"/>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.communication"/>
      </mapping>
    </element>
    <element id="Patient.communication.language">
      <path value="Patient.communication.language"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueReference>
            <reference
                       value="http://hl7.org/fhir/us/core/ValueSet/simple-language"/>
          </valueReference>
        </extension>
        <strength value="extensible"/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/us/core/ValueSet/simple-language"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Patient.communication.language"/>
      </mapping>
    </element>
  </differential>
</StructureDefinition>