0.3.0 - Second STU ballot

This page is part of a downloaded copy of this specification. This page is part of the Da Vinci Coverage Requirements Discovery (CRD) FHIR IG (v0.3.0: STU 1 Ballot 2) based on FHIR R4. . For a full list of available versions, see the Directory of published versions

## StructureDefinition: PatientR4

The official URL for this profile is:

    http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-patient-r4

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

- Text Summary
- Differential Table
- Snapshot Table
- All

This structure is derived from US Core Patient Profile

Summary

Mandatory: 6 elements
Must-Support: 9 elements
Fixed Value: 2 elements

Slices

This structure defines the following Slices:

- The element Patient.identifier is sliced based on the values of value:type.coding.system, value:type.coding.code

This structure is derived from US Core Patient Profile

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Patient |  | 0..* |  |
identifier | S |  | Identifier | Slice: Unordered, Open by value:type.coding.system, value:type.coding.code
identifier | S | 1..1 | Identifier |
type | S | 1..1 | CodeableConcept |
coding | S | 1..1 | Coding |
system | S | 1..1 | uri | Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
code | S | 1..1 | code | Fixed Value: MR
address | S | 0..* | Address |
state | S | 0..1 | string |
country | S | 0..1 | string |
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Patient | I | 0..* |  | US Core Patient Profile
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
us-core-race | S | 0..1 | (Complex) | Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-race
us-core-ethnicity | S | 0..1 | (Complex) | Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity
us-core-birthsex | S | 0..1 | code | Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex Binding: Birth Sex (required)
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ |  | Identifier | An identifier for this patient Slice: Unordered, Open by value:type.coding.system, value:type.coding.code
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible)
system | S Σ | 1..1 | uri | The namespace for the identifier value Example General': http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique within the system. Example General': 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
identifier | S Σ | 1..1 | Identifier | An identifier for this patient
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
type | S Σ | 1..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | S Σ | 1..1 | Coding | Code defined by a terminology system
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version | Σ | 0..1 | string | Version of the system - if relevant
code | S Σ | 1..1 | code | Symbol in syntax defined by the system Fixed Value: MR
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
system | S Σ | 1..1 | uri | The namespace for the identifier value Example General': http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique within the system. Example General': 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
active | ?!Σ | 0..1 | boolean | Whether this patient's record is in active use
name | S Σ | 1..* | HumanName | A name associated with the patient
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required)
text | Σ | 0..1 | string | Text representation of the full name
family | S Σ | 1..1 | string | Family name (often called 'Surname')
given | S Σ | 1..* | string | Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name
prefix | Σ | 0..* | string | Parts that come before the name This repeating element order: Prefixes appear in the correct order for presenting the name
suffix | Σ | 0..* | string | Parts that come after the name This repeating element order: Suffixes appear in the correct order for presenting the name
period | Σ | 0..1 | Period | Time period when name was/is in use
telecom | Σ | 0..* | ContactPoint | A contact detail for the individual
gender | S Σ | 1..1 | code | male | female | other | unknown Binding: AdministrativeGender (required)
birthDate | S Σ | 0..1 | date | The date of birth for the individual
deceased[x] | ?!Σ | 0..1 | boolean, dateTime | Indicates if the individual is deceased or not
address | S Σ | 0..* | Address | An address for the individual
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | home | work | temp | old | billing - purpose of this address Binding: AddressUse (required) Example General': home
type | Σ | 0..1 | code | postal | physical | both Binding: AddressType (required) Example General': both
text | Σ | 0..1 | string | Text representation of the address Example General': 137 Nowhere Street, Erewhon 9132
line | Σ | 0..* | string | Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label Example General': 137 Nowhere Street
city | Σ | 0..1 | string | Name of city, town etc. Example General': Erewhon
district | Σ | 0..1 | string | District name (aka county) Example General': Madison
state | S Σ | 0..1 | string | Sub-unit of country (abbreviations ok)
postalCode | Σ | 0..1 | string | Postal code for area Example General': 9132
country | S Σ | 0..1 | string | Country (e.g. can be ISO 3166 2 or 3 letter code)
period | Σ | 0..1 | Period | Time period when address was/is in use Example General': {"start":"2010-03-23T00:00:00+11:00","end":"2010-07-01T00:00:00+10:00"}
maritalStatus |  | 0..1 | CodeableConcept | Marital (civil) status of a patient Binding: Marital Status Codes (extensible)
multipleBirth[x] |  | 0..1 | boolean, integer | Whether patient is part of a multiple birth
photo |  | 0..* | Attachment | Image of the patient
contact | I | 0..* | BackboneElement | A contact party (e.g. guardian, partner, friend) for the patient pat-1: SHALL at least contain a contact's details or a reference to an organization
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
relationship |  | 0..* | CodeableConcept | The kind of relationship Binding: PatientContactRelationship (extensible)
name |  | 0..1 | HumanName | A name associated with the contact person
telecom |  | 0..* | ContactPoint | A contact detail for the person
address |  | 0..1 | Address | Address for the contact person
gender |  | 0..1 | code | male | female | other | unknown Binding: AdministrativeGender (required)
organization | I | 0..1 | Reference(Organization) | Organization that is associated with the contact
period |  | 0..1 | Period | The period during which this contact person or organization is valid to be contacted relating to this patient
communication | S I | 0..* | BackboneElement | A language which may be used to communicate with the patient about his or her health
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
language | S | 1..1 | CodeableConcept | The language which can be used to communicate with the patient about his or her health Binding: Language codes with language and optionally a region modifier (extensible) Max Binding: Language codes with language and optionally a region modifier
preferred |  | 0..1 | boolean | Language preference indicator
generalPractitioner |  | 0..* | Reference(Organization | Practitioner | PractitionerRole) | Patient's nominated primary care provider
managingOrganization | Σ | 0..1 | Reference(Organization) | Organization that is the custodian of the patient record
link | ?!Σ I | 0..* | BackboneElement | Link to another patient resource that concerns the same actual person
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
other | Σ | 1..1 | Reference(Patient | RelatedPerson) | The other patient or related person resource that the link refers to
type | Σ | 1..1 | code | replaced-by | replaces | refer | seealso Binding: LinkType (required)
Documentation for this format

This structure is derived from US Core Patient Profile

Summary

Mandatory: 6 elements
Must-Support: 9 elements
Fixed Value: 2 elements

Slices

This structure defines the following Slices:

- The element Patient.identifier is sliced based on the values of value:type.coding.system, value:type.coding.code

Differential View

This structure is derived from US Core Patient Profile

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Patient |  | 0..* |  |
identifier | S |  | Identifier | Slice: Unordered, Open by value:type.coding.system, value:type.coding.code
identifier | S | 1..1 | Identifier |
type | S | 1..1 | CodeableConcept |
coding | S | 1..1 | Coding |
system | S | 1..1 | uri | Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
code | S | 1..1 | code | Fixed Value: MR
address | S | 0..* | Address |
state | S | 0..1 | string |
country | S | 0..1 | string |
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Patient | I | 0..* |  | US Core Patient Profile
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
us-core-race | S | 0..1 | (Complex) | Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-race
us-core-ethnicity | S | 0..1 | (Complex) | Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity
us-core-birthsex | S | 0..1 | code | Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex Binding: Birth Sex (required)
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ |  | Identifier | An identifier for this patient Slice: Unordered, Open by value:type.coding.system, value:type.coding.code
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible)
system | S Σ | 1..1 | uri | The namespace for the identifier value Example General': http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique within the system. Example General': 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
identifier | S Σ | 1..1 | Identifier | An identifier for this patient
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
type | S Σ | 1..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | S Σ | 1..1 | Coding | Code defined by a terminology system
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version | Σ | 0..1 | string | Version of the system - if relevant
code | S Σ | 1..1 | code | Symbol in syntax defined by the system Fixed Value: MR
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
system | S Σ | 1..1 | uri | The namespace for the identifier value Example General': http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique within the system. Example General': 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
active | ?!Σ | 0..1 | boolean | Whether this patient's record is in active use
name | S Σ | 1..* | HumanName | A name associated with the patient
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required)
text | Σ | 0..1 | string | Text representation of the full name
family | S Σ | 1..1 | string | Family name (often called 'Surname')
given | S Σ | 1..* | string | Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name
prefix | Σ | 0..* | string | Parts that come before the name This repeating element order: Prefixes appear in the correct order for presenting the name
suffix | Σ | 0..* | string | Parts that come after the name This repeating element order: Suffixes appear in the correct order for presenting the name
period | Σ | 0..1 | Period | Time period when name was/is in use
telecom | Σ | 0..* | ContactPoint | A contact detail for the individual
gender | S Σ | 1..1 | code | male | female | other | unknown Binding: AdministrativeGender (required)
birthDate | S Σ | 0..1 | date | The date of birth for the individual
deceased[x] | ?!Σ | 0..1 | boolean, dateTime | Indicates if the individual is deceased or not
address | S Σ | 0..* | Address | An address for the individual
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | home | work | temp | old | billing - purpose of this address Binding: AddressUse (required) Example General': home
type | Σ | 0..1 | code | postal | physical | both Binding: AddressType (required) Example General': both
text | Σ | 0..1 | string | Text representation of the address Example General': 137 Nowhere Street, Erewhon 9132
line | Σ | 0..* | string | Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label Example General': 137 Nowhere Street
city | Σ | 0..1 | string | Name of city, town etc. Example General': Erewhon
district | Σ | 0..1 | string | District name (aka county) Example General': Madison
state | S Σ | 0..1 | string | Sub-unit of country (abbreviations ok)
postalCode | Σ | 0..1 | string | Postal code for area Example General': 9132
country | S Σ | 0..1 | string | Country (e.g. can be ISO 3166 2 or 3 letter code)
period | Σ | 0..1 | Period | Time period when address was/is in use Example General': {"start":"2010-03-23T00:00:00+11:00","end":"2010-07-01T00:00:00+10:00"}
maritalStatus |  | 0..1 | CodeableConcept | Marital (civil) status of a patient Binding: Marital Status Codes (extensible)
multipleBirth[x] |  | 0..1 | boolean, integer | Whether patient is part of a multiple birth
photo |  | 0..* | Attachment | Image of the patient
contact | I | 0..* | BackboneElement | A contact party (e.g. guardian, partner, friend) for the patient pat-1: SHALL at least contain a contact's details or a reference to an organization
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
relationship |  | 0..* | CodeableConcept | The kind of relationship Binding: PatientContactRelationship (extensible)
name |  | 0..1 | HumanName | A name associated with the contact person
telecom |  | 0..* | ContactPoint | A contact detail for the person
address |  | 0..1 | Address | Address for the contact person
gender |  | 0..1 | code | male | female | other | unknown Binding: AdministrativeGender (required)
organization | I | 0..1 | Reference(Organization) | Organization that is associated with the contact
period |  | 0..1 | Period | The period during which this contact person or organization is valid to be contacted relating to this patient
communication | S I | 0..* | BackboneElement | A language which may be used to communicate with the patient about his or her health
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
language | S | 1..1 | CodeableConcept | The language which can be used to communicate with the patient about his or her health Binding: Language codes with language and optionally a region modifier (extensible) Max Binding: Language codes with language and optionally a region modifier
preferred |  | 0..1 | boolean | Language preference indicator
generalPractitioner |  | 0..* | Reference(Organization | Practitioner | PractitionerRole) | Patient's nominated primary care provider
managingOrganization | Σ | 0..1 | Reference(Organization) | Organization that is the custodian of the patient record
link | ?!Σ I | 0..* | BackboneElement | Link to another patient resource that concerns the same actual person
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
other | Σ | 1..1 | Reference(Patient | RelatedPerson) | The other patient or related person resource that the link refers to
type | Σ | 1..1 | code | replaced-by | replaces | refer | seealso Binding: LinkType (required)
Documentation for this format

Other representations of profile: Schematron

### Terminology Bindings

Path | Conformance | ValueSet
Patient.identifier:MRIdentifier.type | extensible | Identifier Type Codes
Patient.gender | required | AdministrativeGender
Patient.communication.language | extensible | Language_codes_with_language_and_optionally_a_region_modifier Max Binding: Language codes with language and optionally a region modifier

### Constraints

Id | Path | Details | Requirements
dom-2 | Patient | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-4 | Patient | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-3 | Patient | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-6 | Patient | A resource should have narrative for robust management : text.div.exists() |
dom-5 | Patient | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
ele-1 | Patient.contact | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
pat-1 | Patient.contact | SHALL at least contain a contact's details or a reference to an organization : name.exists() or telecom.exists() or address.exists() or organization.exists() |
ele-1 | Patient.communication | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Patient.link | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |