US Public Health Profiles Library
1.0.0 - STU1 United States of America flag

This page is part of the US Public Health Profiles Library (v1.0.0: STU 1) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Resource Profile: USPublicHealthPatient - Detailed Descriptions

Active as of 2023-08-17

Definitions for the us-ph-patient resource profile.

Guidance on how to interpret the contents of this table can be found here.

1. Patient
2. Patient.extension
Control20..*
3. Patient.extension:race
SliceNamerace
Control10..1
Must Supporttrue
4. Patient.extension:race.extension
Control1..?
5. Patient.extension:race.extension:dataAbsentReason
SliceNamedataAbsentReason
Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
6. Patient.extension:race.extension:dataAbsentReason.value[x]
Control0..?
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Fixed Valuemasked
7. Patient.extension:ethnicity
SliceNameethnicity
Control10..1
Must Supporttrue
8. Patient.extension:ethnicity.extension
Control1..?
9. Patient.extension:ethnicity.extension:dataAbsentReason
SliceNamedataAbsentReason
Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
10. Patient.extension:ethnicity.extension:dataAbsentReason.value[x]
Control0..?
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Fixed Valuemasked
11. Patient.extension:birthsex
SliceNamebirthsex
Must Supporttrue
12. Patient.extension:birthPlace
SliceNamebirthPlace
Control0..1
TypeExtension(birthPlace) (Extension Type: Address)
Must Supporttrue
13. Patient.extension:individualGenderIdentity
SliceNameindividualGenderIdentity
Control0..*
TypeExtension(PGenderIdentity) (Complex Extension)
Must Supporttrue
14. Patient.extension:tribalAffiliation
SliceNametribalAffiliation
Control0..*
TypeExtension(USPublicHealthTribalAffiliationExtension) (Complex Extension)
Must Supporttrue
15. Patient.identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..?
16. Patient.identifier.extension:dataAbsentReason
SliceNamedataAbsentReason
Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
17. Patient.identifier.extension:dataAbsentReason.value[x]
Control0..?
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Fixed Valuemasked
18. Patient.name
Control0..?
19. Patient.name.extension:dataAbsentReason
SliceNamedataAbsentReason
Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
20. Patient.name.extension:dataAbsentReason.value[x]
Control0..?
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Fixed Valuemasked
21. Patient.telecom
Control10..*
Must Supporttrue
SlicingThis element introduces a set of slices on Patient.telecom. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ system
22. Patient.telecom.extension:dataAbsentReason
SliceNamedataAbsentReason
Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
23. Patient.telecom.extension:dataAbsentReason.value[x]
Control0..?
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Fixed Valuemasked
24. Patient.telecom:phone
SliceNamephone
Control0..*
Must Supporttrue
25. Patient.telecom:phone.extension:dataAbsentReason
SliceNamedataAbsentReason
Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
26. Patient.telecom:phone.system
Control0..?
Fixed Valuephone
27. Patient.telecom:email
SliceNameemail
Control0..*
Must Supporttrue
28. Patient.telecom:email.extension:dataAbsentReason
SliceNamedataAbsentReason
Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
29. Patient.telecom:email.system
Control0..?
Fixed Valueemail
30. Patient.gender
Control0..?
31. Patient.gender.extension
Control0..?
SlicingThis element introduces a set of slices on Patient.gender.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
32. Patient.gender.extension:dataAbsentReason
SliceNamedataAbsentReason
Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
33. Patient.gender.extension:dataAbsentReason.value[x]
Control0..?
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Fixed Valuemasked
34. Patient.birthDate
Control10..1
35. Patient.birthDate.extension
Control0..?
SlicingThis element introduces a set of slices on Patient.birthDate.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
36. Patient.birthDate.extension:dataAbsentReason
SliceNamedataAbsentReason
Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
37. Patient.birthDate.extension:dataAbsentReason.value[x]
Control0..?
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Fixed Valuemasked
38. Patient.deceased[x]
Control10..1
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
39. Patient.address
Definition

If the patient is homeless, complete as much address information as possible (city, zip, county, etc.) and use the Characteristics of Home Environment profile in the Social History Section of the eICR Composition to indicate that the patient is homeless.

An address for the individual.

Control10..*
40. Patient.address.extension:dataAbsentReason
SliceNamedataAbsentReason
Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
41. Patient.address.extension:dataAbsentReason.value[x]
Control0..?
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Fixed Valuemasked
42. Patient.address.district
Must Supporttrue
43. Patient.contact
Must Supporttrue
44. Patient.contact.relationship
Control10..1*
Must Supporttrue
45. Patient.contact.name
Control10..1
Must Supporttrue
46. Patient.contact.name.extension:dataAbsentReason
SliceNamedataAbsentReason
Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
47. Patient.contact.name.extension:dataAbsentReason.value[x]
Control0..?
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Fixed Valuemasked
48. Patient.contact.telecom
Control10..*
Must Supporttrue
49. Patient.contact.telecom.extension:dataAbsentReason
SliceNamedataAbsentReason
Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
50. Patient.contact.telecom.extension:dataAbsentReason.value[x]
Control0..?
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Fixed Valuemasked
51. Patient.contact.address
Control10..1
Must Supporttrue
52. Patient.contact.address.extension:dataAbsentReason
SliceNamedataAbsentReason
Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
53. Patient.contact.address.extension:dataAbsentReason.value[x]
Control0..?
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Fixed Valuemasked
54. Patient.communication
Control10..*
Must Supporttrue
55. Patient.communication.language
Control0..?
56. Patient.communication.language.extension:dataAbsentReason
SliceNamedataAbsentReason
Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
57. Patient.communication.language.extension:dataAbsentReason.value[x]
Control0..?
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Fixed Valuemasked

Guidance on how to interpret the contents of this table can be found here.

1. Patient
Definition

-

Demographics and other administrative information about an individual or animal receiving care or other health-related services.

Control0..*
Summaryfalse
Alternate NamesSubjectOfCare Client Resident
Comments

-

InvariantsDefined on this element
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (: contained.contained.empty())
dom-3: 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-4: 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-5: If a resource is contained in another resource, it SHALL NOT have a security label (: contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (: text.`div`.exists())
us-core-6: Either Patient.name.given and/or Patient.name.family SHALL be present or a Data Absent Reason Extension SHALL be present. (: (name.family.exists() or name.given.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists())
2. Patient.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Control0..1
Typeuri
Is Modifiertrue
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Comments

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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
3. Patient.extension
Definition

An Extension

May be used to represent additional information that is not part of the basic definition of the resource. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control20..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
4. Patient.extension:race
SliceNamerace
Definition

Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The race codes used to represent these concepts are based upon the CDC Race and Ethnicity Code Set Version 1.0 which includes over 900 concepts for representing race and ethnicity of which 921 reference race. The race concepts are grouped by and pre-mapped to the 5 OMB race categories:

  • American Indian or Alaska Native
  • Asian
  • Black or African American
  • Native Hawaiian or Other Pacific Islander
  • White.

May be used to represent additional information that is not part of the basic definition of the resource. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control10..1* This element is affected by the following invariants: ele-1
TypeExtension(USCoreRaceExtension) (Complex Extension)
Must Supporttrue
InvariantsDefined on this element
ele-1: (: )
ext-1: (: )
5. Patient.extension:race.extension
Definition

An Extension

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control10..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
6. Patient.extension:race.extension:ombCategory
SliceNameombCategory
Definition

The 5 race category codes according to the OMB Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, Statistical Policy Directive No. 15, as revised, October 30, 1997.

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..5*
TypeExtension
Must Supporttrue
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
7. Patient.extension:race.extension:ombCategory.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed ValueombCategory
8. Patient.extension:race.extension:ombCategory.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control10..1
BindingThe codes SHALL be taken from OMB Race CategoriesFor codes, see (unbound) The 5 race category codes according to the OMB Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, Statistical Policy Directive No. 15, as revised, October 30, 1997
TypeChoice of: Coding, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
9. Patient.extension:race.extension:detailed
SliceNamedetailed
Definition

The 900+ CDC race codes that are grouped under one of the 5 OMB race category codes:.

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
10. Patient.extension:race.extension:detailed.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuedetailed
11. Patient.extension:race.extension:detailed.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control10..1
BindingThe codes SHALL be taken from Detailed RaceFor codes, see (unbound)
TypeChoice of: Coding, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
12. Patient.extension:race.extension:text
SliceNametext
Definition

Plain text representation of the race concept(s).

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control10..1*
TypeExtension
Must Supporttrue
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
13. Patient.extension:race.extension:text.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuetext
14. Patient.extension:race.extension:text.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control10..1
TypeChoice of: string, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
15. Patient.extension:race.extension:dataAbsentReason
SliceNamedataAbsentReason
Definition

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

Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
16. Patient.extension:race.extension:dataAbsentReason.extension
Definition

An Extension

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..0*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
17. Patient.extension:race.extension:dataAbsentReason.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/StructureDefinition/data-absent-reason
18. Patient.extension:race.extension:dataAbsentReason.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control10..1
BindingThe codes SHALL be taken from DataAbsentReasonFor codes, see (unbound) Used to specify why the normally expected content of the data element is missing
TypeChoice of: code, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Fixed Valuemasked
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
19. Patient.extension:race.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/us/core/StructureDefinition/us-core-race
20. Patient.extension:race.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control0..01
TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
21. Patient.extension:ethnicity
SliceNameethnicity
Definition

Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The ethnicity codes used to represent these concepts are based upon the CDC ethnicity and Ethnicity Code Set Version 1.0 which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity. The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories: - Hispanic or Latino - Not Hispanic or Latino.

May be used to represent additional information that is not part of the basic definition of the resource. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control10..1* This element is affected by the following invariants: ele-1
TypeExtension(USCoreEthnicityExtension) (Complex Extension)
Must Supporttrue
InvariantsDefined on this element
ele-1: (: )
ext-1: (: )
22. Patient.extension:ethnicity.extension
Definition

An Extension

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control10..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
23. Patient.extension:ethnicity.extension:ombCategory
SliceNameombCategory
Definition

The 2 ethnicity category codes according to the OMB Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, Statistical Policy Directive No. 15, as revised, October 30, 1997.

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..1*
TypeExtension
Must Supporttrue
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
24. Patient.extension:ethnicity.extension:ombCategory.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed ValueombCategory
25. Patient.extension:ethnicity.extension:ombCategory.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control10..1
BindingThe codes SHALL be taken from OMB Ethnicity CategoriesFor codes, see (unbound)
TypeChoice of: Coding, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
26. Patient.extension:ethnicity.extension:detailed
SliceNamedetailed
Definition

The 41 CDC ethnicity codes that are grouped under one of the 2 OMB ethnicity category codes.

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
27. Patient.extension:ethnicity.extension:detailed.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuedetailed
28. Patient.extension:ethnicity.extension:detailed.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control10..1
BindingThe codes SHALL be taken from Detailed ethnicityFor codes, see (unbound)
TypeChoice of: Coding, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
29. Patient.extension:ethnicity.extension:text
SliceNametext
Definition

Plain text representation of the ethnicity concept(s).

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control10..1*
TypeExtension
Must Supporttrue
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
30. Patient.extension:ethnicity.extension:text.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuetext
31. Patient.extension:ethnicity.extension:text.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control10..1
TypeChoice of: string, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
32. Patient.extension:ethnicity.extension:dataAbsentReason
SliceNamedataAbsentReason
Definition

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

Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
33. Patient.extension:ethnicity.extension:dataAbsentReason.extension
Definition

An Extension

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..0*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
34. Patient.extension:ethnicity.extension:dataAbsentReason.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/StructureDefinition/data-absent-reason
35. Patient.extension:ethnicity.extension:dataAbsentReason.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control10..1
BindingThe codes SHALL be taken from DataAbsentReasonFor codes, see (unbound) Used to specify why the normally expected content of the data element is missing
TypeChoice of: code, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Fixed Valuemasked
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
36. Patient.extension:ethnicity.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity
37. Patient.extension:ethnicity.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control0..01
TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
38. Patient.extension:birthsex
SliceNamebirthsex
Definition

A code classifying the person's sex assigned at birth as specified by the Office of the National Coordinator for Health IT (ONC).

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(USCoreBirthSexExtension) (Extension Type: code)
Must Supporttrue
Comments

The codes required are intended to present birth sex (i.e., the sex recorded on the patient’s birth certificate) and not gender identity or reassigned sex.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
39. Patient.extension:genderIdentity
SliceNamegenderIdentity
Definition

An Extension

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(USCoreGenderIdentityExtension) (Extension Type: CodeableConcept)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
40. Patient.extension:birthPlace
SliceNamebirthPlace
Definition

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

Control0..1
TypeExtension(birthPlace) (Extension Type: Address)
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
41. Patient.extension:individualGenderIdentity
SliceNameindividualGenderIdentity
Definition

An individual's personal sense of being a man, woman, boy, girl, nonbinary, or something else.

May be used to represent additional information that is not part of the basic definition of the resource. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

TypeExtension(PGenderIdentity) (Complex Extension)
Must Supporttrue
Comments

This represents an individual’s identity, ascertained by asking them what that identity is.

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.

InvariantsDefined on this element
ele-1: (: )
ext-1: (: )
42. Patient.extension:tribalAffiliation
SliceNametribalAffiliation
Definition

Affiliated tribe name and whether or not the patient is an enrolled member

May be used to represent additional information that is not part of the basic definition of the resource. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

TypeExtension(USPublicHealthTribalAffiliationExtension) (Complex Extension)
Must Supporttrue
InvariantsDefined on this element
ele-1: (: )
ext-1: (: )
43. Patient.modifierExtension
Definition

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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Summaryfalse
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
44. Patient.identifier
Definition

An identifier for this patient.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control10..*
TypeIdentifier
Must Supporttrue
Summarytrue
Requirements

Patients are almost always assigned specific numerical identifiers.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
45. Patient.identifier.extension:dataAbsentReason
SliceNamedataAbsentReason
Definition

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

Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
46. Patient.identifier.extension:dataAbsentReason.extension
Definition

An Extension

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..0*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.identifier.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
47. Patient.identifier.extension:dataAbsentReason.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/StructureDefinition/data-absent-reason
48. Patient.identifier.extension:dataAbsentReason.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control10..1
BindingThe codes SHALL be taken from DataAbsentReasonFor codes, see (unbound) Used to specify why the normally expected content of the data element is missing
TypeChoice of: code, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Fixed Valuemasked
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
49. Patient.identifier.use
Definition

The purpose of this identifier.

Control0..1
BindingThe codes SHALL be taken from IdentifierUse

Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
50. Patient.identifier.system
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Control10..1
Typeuri
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Example
General:http://www.acme.com/identifiers/patient
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
51. Patient.identifier.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Control10..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value'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. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Example
General:123456
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
52. Patient.active
Definition

Whether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules.

It is often used to filter patient lists to exclude inactive patients

Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death.

Control0..1
Typeboolean
Is Modifiertrue
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

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

Comments

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

Meaning if MissingThis resource is generally assumed to be active if no value is provided for the active element
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
53. Patient.name
Definition

A name associated with the individual.

Control10..*
TypeHumanName
Must Supporttrue
Summarytrue
Requirements

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

Comments

A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
54. Patient.name.extension:dataAbsentReason
SliceNamedataAbsentReason
Definition

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

Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
55. Patient.name.extension:dataAbsentReason.extension
Definition

An Extension

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..0*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.name.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
56. Patient.name.extension:dataAbsentReason.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/StructureDefinition/data-absent-reason
57. Patient.name.extension:dataAbsentReason.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control10..1
BindingThe codes SHALL be taken from DataAbsentReasonFor codes, see (unbound) Used to specify why the normally expected content of the data element is missing
TypeChoice of: code, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Fixed Valuemasked
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
58. Patient.name.use
Definition

Identifies the purpose for this name.

Control0..1
BindingThe codes SHALL be taken from NameUse

The use of a human name.

Typecode
Is Modifiertrue
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows the appropriate name for a particular context of use to be selected from among a set of names.

Comments

Applications can assume that a name is current unless it explicitly says that it is temporary or old.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
59. Patient.name.family
Definition

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.

Control0..1 This element is affected by the following invariants: us-core-6
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Alternate Namessurname
Comments

Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
60. Patient.name.given
Definition

Given name.

Control0..* This element is affected by the following invariants: us-core-6
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Alternate Namesfirst name, middle name
Comments

If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
61. Patient.telecom
Definition

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

Control10..*
TypeContactPoint
Must Supporttrue
Summarytrue
Requirements

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

Comments

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 might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Patient.telecom. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ system
62. Patient.telecom.extension:dataAbsentReason
SliceNamedataAbsentReason
Definition

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

Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
63. Patient.telecom.extension:dataAbsentReason.extension
Definition

An Extension

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..0*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.telecom.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
64. Patient.telecom.extension:dataAbsentReason.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/StructureDefinition/data-absent-reason
65. Patient.telecom.extension:dataAbsentReason.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control10..1
BindingThe codes SHALL be taken from DataAbsentReasonFor codes, see (unbound) Used to specify why the normally expected content of the data element is missing
TypeChoice of: code, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Fixed Valuemasked
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
66. Patient.telecom.system
Definition

Telecommunications form for contact point - what communications system is required to make use of the contact.

Control10..1 This element is affected by the following invariants: cpt-2
BindingThe codes SHALL be taken from ContactPointSystem

Telecommunications form for contact point.

Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
67. Patient.telecom.value
Definition

The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

Control10..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Requirements

Need to support legacy numbers that are not in a tightly controlled format.

Comments

Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
68. Patient.telecom.use
Definition

Identifies the purpose for the contact point.

Control0..1
BindingThe codes SHALL be taken from ContactPointUse
Typecode
Is Modifiertrue
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Requirements

Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

Comments

Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
69. Patient.telecom:phone
SliceNamephone
Definition

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

Control0..*
TypeContactPoint
Must Supporttrue
Summarytrue
Requirements

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

Comments

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 might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
70. Patient.telecom:phone.extension:dataAbsentReason
SliceNamedataAbsentReason
Definition

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

Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
71. Patient.telecom:phone.system
Definition

Telecommunications form for contact point - what communications system is required to make use of the contact.

Control10..1 This element is affected by the following invariants: cpt-2
BindingThe codes SHALL be taken from ContactPointSystem

Telecommunications form for contact point.

Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Fixed Valuephone
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
72. Patient.telecom:phone.value
Definition

The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

Control10..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Requirements

Need to support legacy numbers that are not in a tightly controlled format.

Comments

Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
73. Patient.telecom:phone.use
Definition

Identifies the purpose for the contact point.

Control0..1
BindingThe codes SHALL be taken from ContactPointUse
Typecode
Is Modifiertrue
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Requirements

Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

Comments

Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
74. Patient.telecom:email
SliceNameemail
Definition

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

Control0..*
TypeContactPoint
Must Supporttrue
Summarytrue
Requirements

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

Comments

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 might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
75. Patient.telecom:email.extension:dataAbsentReason
SliceNamedataAbsentReason
Definition

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

Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
76. Patient.telecom:email.system
Definition

Telecommunications form for contact point - what communications system is required to make use of the contact.

Control10..1 This element is affected by the following invariants: cpt-2
BindingThe codes SHALL be taken from ContactPointSystem

Telecommunications form for contact point.

Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Fixed Valueemail
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
77. Patient.telecom:email.value
Definition

The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

Control10..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Requirements

Need to support legacy numbers that are not in a tightly controlled format.

Comments

Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
78. Patient.telecom:email.use
Definition

Identifies the purpose for the contact point.

Control0..1
BindingThe codes SHALL be taken from ContactPointUse
Typecode
Is Modifiertrue
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Requirements

Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

Comments

Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
79. Patient.gender
Definition

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

Control10..1
BindingThe codes SHALL be taken from AdministrativeGender
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Requirements

Needed for identification of the individual, in combination with (at least) name and birth date.

Comments

The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, 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, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
80. Patient.gender.extension
Definition

An Extension

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.gender.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
81. Patient.gender.extension:dataAbsentReason
SliceNamedataAbsentReason
Definition

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

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
82. Patient.gender.extension:dataAbsentReason.extension
Definition

An Extension

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..0*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.gender.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
83. Patient.gender.extension:dataAbsentReason.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/StructureDefinition/data-absent-reason
84. Patient.gender.extension:dataAbsentReason.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control10..1
BindingThe codes SHALL be taken from DataAbsentReasonFor codes, see (unbound) Used to specify why the normally expected content of the data element is missing
TypeChoice of: code, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Fixed Valuemasked
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
85. Patient.birthDate
Definition

The date of birth for the individual.

Control10..1
Typedate
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Requirements

Age of the individual drives many clinical processes.

Comments

At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternity/infant care systems).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
LOINC Code21112-8
86. Patient.birthDate.extension
Definition

An Extension

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.birthDate.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
87. Patient.birthDate.extension:dataAbsentReason
SliceNamedataAbsentReason
Definition

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

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
88. Patient.birthDate.extension:dataAbsentReason.extension
Definition

An Extension

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..0*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.birthDate.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
89. Patient.birthDate.extension:dataAbsentReason.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/StructureDefinition/data-absent-reason
90. Patient.birthDate.extension:dataAbsentReason.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control10..1
BindingThe codes SHALL be taken from DataAbsentReasonFor codes, see (unbound) Used to specify why the normally expected content of the data element is missing
TypeChoice of: code, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Fixed Valuemasked
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
91. Patient.deceased[x]
Definition

Indicates if the individual is deceased or not.

Control10..1
TypeChoice of: boolean, dateTime
[x] NoteSee Choice of Data Types for further information about how to use [x]
Is Modifiertrue
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Summarytrue
Requirements

The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.

Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
92. Patient.address
Definition

If the patient is homeless, complete as much address information as possible (city, zip, county, etc.) and use the Characteristics of Home Environment profile in the Social History Section of the eICR Composition to indicate that the patient is homeless.

An address for the individual.

Control10..*
TypeAddress
Must Supporttrue
Summarytrue
Requirements

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

Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
93. Patient.address.extension:dataAbsentReason
SliceNamedataAbsentReason
Definition

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

Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
94. Patient.address.extension:dataAbsentReason.extension
Definition

An Extension

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..0*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.address.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
95. Patient.address.extension:dataAbsentReason.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/StructureDefinition/data-absent-reason
96. Patient.address.extension:dataAbsentReason.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control10..1
BindingThe codes SHALL be taken from DataAbsentReasonFor codes, see (unbound) Used to specify why the normally expected content of the data element is missing
TypeChoice of: code, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Fixed Valuemasked
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
97. Patient.address.use
Definition

The purpose of this address.

Control0..1
BindingThe codes SHALL be taken from AddressUse

The use of an address.

Typecode
Is Modifiertrue
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows an appropriate address to be chosen from a list of many.

Comments

Applications can assume that an address is current unless it explicitly says that it is temporary or old.

Example
General:home
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
98. Patient.address.line
Definition

This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.

Control0..*
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Example
General:137 Nowhere Street
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
99. Patient.address.city
Definition

The name of the city, town, suburb, village or other community or delivery center.

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Alternate NamesMunicpality
Example
General:Erewhon
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
100. Patient.address.district
Definition

The name of the administrative area (county).

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Alternate NamesCounty
Comments

District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.

Example
General:Madison
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
101. Patient.address.state
Definition

Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes).

Control0..1
BindingThe codes SHALL be taken from USPS Two Letter Alphabetic Codes; other codes may be used where these codes are not suitableFor codes, see (unbound) Two Letter USPS alphabetic codes
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Alternate NamesProvince, Territory
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
102. Patient.address.postalCode
Definition

A postal code designating a region defined by the postal service.

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Alternate NamesZip, Zip Code
Example
General:9132
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
103. Patient.address.period
Definition

Time period when address was/is in use.

Control0..1
TypePeriod
Must Supporttrue
Summarytrue
Requirements

Allows addresses to be placed in historical context.

Example
General:<valuePeriod xmlns="http://hl7.org/fhir">
  <start value="2010-03-23"/>
  <end value="2010-07-01"/>
</valuePeriod>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
104. Patient.contact
Definition

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

Control0..*
TypeBackboneElement
Must Supporttrue
Summaryfalse
Requirements

Need to track people you can contact about the patient.

Comments

Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
pat-1: 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())
105. Patient.contact.modifierExtension
Definition

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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
106. Patient.contact.relationship
Definition

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

Control10..1*
BindingThe codes SHALL be taken from PatientContactRelationship; other codes may be used where these codes are not suitable

The nature of the relationship between a patient and a contact person for that patient.

TypeCodeableConcept
Must Supporttrue
Summaryfalse
Requirements

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
107. Patient.contact.name
Definition

A name associated with the contact person.

Control10..1
TypeHumanName
Must Supporttrue
Summaryfalse
Requirements

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
108. Patient.contact.name.extension:dataAbsentReason
SliceNamedataAbsentReason
Definition

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

Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
109. Patient.contact.name.extension:dataAbsentReason.extension
Definition

An Extension

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..0*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.contact.name.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
110. Patient.contact.name.extension:dataAbsentReason.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/StructureDefinition/data-absent-reason
111. Patient.contact.name.extension:dataAbsentReason.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control10..1
BindingThe codes SHALL be taken from DataAbsentReasonFor codes, see (unbound) Used to specify why the normally expected content of the data element is missing
TypeChoice of: code, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Fixed Valuemasked
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
112. Patient.contact.name.use
Definition

Identifies the purpose for this name.

Control0..1
BindingThe codes SHALL be taken from NameUse

The use of a human name.

Typecode
Is Modifiertrue
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows the appropriate name for a particular context of use to be selected from among a set of names.

Comments

Applications can assume that a name is current unless it explicitly says that it is temporary or old.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
113. Patient.contact.telecom
Definition

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

Control10..*
TypeContactPoint
Must Supporttrue
Summaryfalse
Requirements

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

Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
114. Patient.contact.telecom.extension:dataAbsentReason
SliceNamedataAbsentReason
Definition

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

Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
115. Patient.contact.telecom.extension:dataAbsentReason.extension
Definition

An Extension

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..0*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.contact.telecom.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
116. Patient.contact.telecom.extension:dataAbsentReason.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/StructureDefinition/data-absent-reason
117. Patient.contact.telecom.extension:dataAbsentReason.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control10..1
BindingThe codes SHALL be taken from DataAbsentReasonFor codes, see (unbound) Used to specify why the normally expected content of the data element is missing
TypeChoice of: code, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Fixed Valuemasked
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
118. Patient.contact.telecom.use
Definition

Identifies the purpose for the contact point.

Control0..1
BindingThe codes SHALL be taken from ContactPointUse

Use of contact point.

Typecode
Is Modifiertrue
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

Comments

Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
119. Patient.contact.address
Definition

Address for the contact person.

Control10..1
TypeAddress
Must Supporttrue
Summaryfalse
Requirements

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
120. Patient.contact.address.extension:dataAbsentReason
SliceNamedataAbsentReason
Definition

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

Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
121. Patient.contact.address.extension:dataAbsentReason.extension
Definition

An Extension

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..0*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.contact.address.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
122. Patient.contact.address.extension:dataAbsentReason.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/StructureDefinition/data-absent-reason
123. Patient.contact.address.extension:dataAbsentReason.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control10..1
BindingThe codes SHALL be taken from DataAbsentReasonFor codes, see (unbound) Used to specify why the normally expected content of the data element is missing
TypeChoice of: code, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Fixed Valuemasked
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
124. Patient.contact.address.use
Definition

The purpose of this address.

Control0..1
BindingThe codes SHALL be taken from AddressUse

The use of an address.

Typecode
Is Modifiertrue
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows an appropriate address to be chosen from a list of many.

Comments

Applications can assume that an address is current unless it explicitly says that it is temporary or old.

Example
General:home
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
125. Patient.communication
Definition

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

Control10..*
TypeBackboneElement
Must Supporttrue
Summaryfalse
Requirements

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

Comments

If no language is specified, this implies that the default local language is spoken. 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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
126. Patient.communication.modifierExtension
Definition

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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
127. Patient.communication.language
Definition

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. "en" for English, or "en-US" for American English versus "en-EN" for England English.

Control1..1
BindingThe codes SHALL be taken from Language codes with language and optionally a region modifier; other codes may be used where these codes are not suitableThe codes SHOULD be taken from CommonLanguages
TypeCodeableConcept
Must Supporttrue
Summaryfalse
Requirements

Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.

Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
128. Patient.communication.language.extension:dataAbsentReason
SliceNamedataAbsentReason
Definition

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

Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
129. Patient.communication.language.extension:dataAbsentReason.extension
Definition

An Extension

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..0*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.communication.language.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
130. Patient.communication.language.extension:dataAbsentReason.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/StructureDefinition/data-absent-reason
131. Patient.communication.language.extension:dataAbsentReason.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control10..1
BindingThe codes SHALL be taken from DataAbsentReasonFor codes, see (unbound) Used to specify why the normally expected content of the data element is missing
TypeChoice of: code, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Fixed Valuemasked
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
132. Patient.link
Definition

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

Control0..*
TypeBackboneElement
Is Modifiertrue
Summarytrue
Requirements

There are multiple use cases:

  • Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and
  • Distribution of patient information across multiple servers.
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
133. Patient.link.modifierExtension
Definition

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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
134. Patient.link.other
Definition

The other patient resource that the link refers to.

Control1..1
TypeReference(Patient|RelatedPerson)
Summarytrue
Comments

Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
135. Patient.link.type
Definition

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

Control1..1
BindingThe codes SHALL be taken from LinkType

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

Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))

Guidance on how to interpret the contents of this table can be found here.

1. Patient
Definition

-

Control0..*
Summaryfalse
Alternate NamesSubjectOfCare Client Resident
Comments

-

2. Patient.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Control0..1
Typeid
Summarytrue
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

3. Patient.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

Control0..1
TypeMeta
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
4. Patient.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Control0..1
Typeuri
Is Modifiertrue
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Comments

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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
5. Patient.language
Definition

The base language in which the resource is written.

Control0..1
BindingThe codes SHOULD be taken from CommonLanguages A human language
Additional BindingsPurpose
AllLanguagesMax Binding
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Comments

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).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
6. Patient.text
Definition

A human-readable narrative that contains a summary of the resource and can 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 "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Control0..1
TypeNarrative
Summaryfalse
Alternate Namesnarrative, html, xhtml, display
Comments

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 "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
7. Patient.contained
Definition

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.

Control0..*
TypeResource
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
Comments

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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

8. Patient.extension
Definition

An Extension

Control2..*
TypeExtension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
9. Patient.extension:race
SliceNamerace
Definition

Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The race codes used to represent these concepts are based upon the CDC Race and Ethnicity Code Set Version 1.0 which includes over 900 concepts for representing race and ethnicity of which 921 reference race. The race concepts are grouped by and pre-mapped to the 5 OMB race categories:

  • American Indian or Alaska Native
  • Asian
  • Black or African American
  • Native Hawaiian or Other Pacific Islander
  • White.
Control1..1 This element is affected by the following invariants: ele-1
TypeExtension(USCoreRaceExtension) (Complex Extension)
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
10. Patient.extension:race.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
11. Patient.extension:race.extension
Definition

An Extension

Control1..*
TypeExtension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
12. Patient.extension:race.extension:ombCategory
SliceNameombCategory
Definition

The 5 race category codes according to the OMB Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, Statistical Policy Directive No. 15, as revised, October 30, 1997.

Control0..5
TypeExtension
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
13. Patient.extension:race.extension:ombCategory.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
14. Patient.extension:race.extension:ombCategory.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
15. Patient.extension:race.extension:ombCategory.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed ValueombCategory
16. Patient.extension:race.extension:ombCategory.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control1..1
BindingThe codes SHALL be taken from OMB Race Categories The 5 race category codes according to the OMB Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, Statistical Policy Directive No. 15, as revised, October 30, 1997
TypeCoding
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
17. Patient.extension:race.extension:detailed
SliceNamedetailed
Definition

The 900+ CDC race codes that are grouped under one of the 5 OMB race category codes:.

Control0..*
TypeExtension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
18. Patient.extension:race.extension:detailed.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
19. Patient.extension:race.extension:detailed.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
20. Patient.extension:race.extension:detailed.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuedetailed
21. Patient.extension:race.extension:detailed.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control1..1
BindingThe codes SHALL be taken from Detailed Race
TypeCoding
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
22. Patient.extension:race.extension:text
SliceNametext
Definition

Plain text representation of the race concept(s).

Control1..1
TypeExtension
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
23. Patient.extension:race.extension:text.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
24. Patient.extension:race.extension:text.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
25. Patient.extension:race.extension:text.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuetext
26. Patient.extension:race.extension:text.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control1..1
Typestring
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
27. Patient.extension:race.extension:dataAbsentReason
SliceNamedataAbsentReason
Definition

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

Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
28. Patient.extension:race.extension:dataAbsentReason.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
29. Patient.extension:race.extension:dataAbsentReason.extension
Definition

An Extension

Control0..0
TypeExtension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
30. Patient.extension:race.extension:dataAbsentReason.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/StructureDefinition/data-absent-reason
31. Patient.extension:race.extension:dataAbsentReason.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control1..1
BindingThe codes SHALL be taken from DataAbsentReason Used to specify why the normally expected content of the data element is missing
Typecode
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Fixed Valuemasked
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
32. Patient.extension:race.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/us/core/StructureDefinition/us-core-race
33. Patient.extension:race.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control0..0
TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
34. Patient.extension:ethnicity
SliceNameethnicity
Definition

Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The ethnicity codes used to represent these concepts are based upon the CDC ethnicity and Ethnicity Code Set Version 1.0 which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity. The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories: - Hispanic or Latino - Not Hispanic or Latino.

Control1..1 This element is affected by the following invariants: ele-1
TypeExtension(USCoreEthnicityExtension) (Complex Extension)
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
35. Patient.extension:ethnicity.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
36. Patient.extension:ethnicity.extension
Definition

An Extension

Control1..*
TypeExtension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
37. Patient.extension:ethnicity.extension:ombCategory
SliceNameombCategory
Definition

The 2 ethnicity category codes according to the OMB Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, Statistical Policy Directive No. 15, as revised, October 30, 1997.

Control0..1
TypeExtension
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
38. Patient.extension:ethnicity.extension:ombCategory.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
39. Patient.extension:ethnicity.extension:ombCategory.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
40. Patient.extension:ethnicity.extension:ombCategory.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed ValueombCategory
41. Patient.extension:ethnicity.extension:ombCategory.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control1..1
BindingThe codes SHALL be taken from OMB Ethnicity Categories
TypeCoding
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
42. Patient.extension:ethnicity.extension:detailed
SliceNamedetailed
Definition

The 41 CDC ethnicity codes that are grouped under one of the 2 OMB ethnicity category codes.

Control0..*
TypeExtension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
43. Patient.extension:ethnicity.extension:detailed.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
44. Patient.extension:ethnicity.extension:detailed.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
45. Patient.extension:ethnicity.extension:detailed.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuedetailed
46. Patient.extension:ethnicity.extension:detailed.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control1..1
BindingThe codes SHALL be taken from Detailed ethnicity
TypeCoding
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
47. Patient.extension:ethnicity.extension:text
SliceNametext
Definition

Plain text representation of the ethnicity concept(s).

Control1..1
TypeExtension
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
48. Patient.extension:ethnicity.extension:text.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
49. Patient.extension:ethnicity.extension:text.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
50. Patient.extension:ethnicity.extension:text.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuetext
51. Patient.extension:ethnicity.extension:text.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control1..1
Typestring
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
52. Patient.extension:ethnicity.extension:dataAbsentReason
SliceNamedataAbsentReason
Definition

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

Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
53. Patient.extension:ethnicity.extension:dataAbsentReason.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
54. Patient.extension:ethnicity.extension:dataAbsentReason.extension
Definition

An Extension

Control0..0
TypeExtension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
55. Patient.extension:ethnicity.extension:dataAbsentReason.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/StructureDefinition/data-absent-reason
56. Patient.extension:ethnicity.extension:dataAbsentReason.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control1..1
BindingThe codes SHALL be taken from DataAbsentReason Used to specify why the normally expected content of the data element is missing
Typecode
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Fixed Valuemasked
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
57. Patient.extension:ethnicity.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity
58. Patient.extension:ethnicity.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control0..0
TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
59. Patient.extension:birthsex
SliceNamebirthsex
Definition

A code classifying the person's sex assigned at birth as specified by the Office of the National Coordinator for Health IT (ONC).

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(USCoreBirthSexExtension) (Extension Type: code)
Must Supporttrue
Comments

The codes required are intended to present birth sex (i.e., the sex recorded on the patient’s birth certificate) and not gender identity or reassigned sex.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
60. Patient.extension:genderIdentity
SliceNamegenderIdentity
Definition

An Extension

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(USCoreGenderIdentityExtension) (Extension Type: CodeableConcept)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
61. Patient.extension:birthPlace
SliceNamebirthPlace
Definition

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

Control0..1
TypeExtension(birthPlace) (Extension Type: Address)
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
62. Patient.extension:individualGenderIdentity
SliceNameindividualGenderIdentity
Definition

An individual's personal sense of being a man, woman, boy, girl, nonbinary, or something else.

Control0..*
TypeExtension(PGenderIdentity) (Complex Extension)
Must Supporttrue
Comments

This represents an individual’s identity, ascertained by asking them what that identity is.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
63. Patient.extension:tribalAffiliation
SliceNametribalAffiliation
Definition

Affiliated tribe name and whether or not the patient is an enrolled member

Control0..*
TypeExtension(USPublicHealthTribalAffiliationExtension) (Complex Extension)
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
64. Patient.modifierExtension
Definition

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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Summaryfalse
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
65. Patient.identifier
Definition

An identifier for this patient.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control1..*
TypeIdentifier
Must Supporttrue
Summarytrue
Requirements

Patients are almost always assigned specific numerical identifiers.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
66. Patient.identifier.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
67. Patient.identifier.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
68. Patient.identifier.extension:dataAbsentReason
SliceNamedataAbsentReason
Definition

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

Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
Summaryfalse
69. Patient.identifier.extension:dataAbsentReason.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
70. Patient.identifier.extension:dataAbsentReason.extension
Definition

An Extension

Control0..0
TypeExtension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.identifier.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
71. Patient.identifier.extension:dataAbsentReason.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/StructureDefinition/data-absent-reason
72. Patient.identifier.extension:dataAbsentReason.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control1..1
BindingThe codes SHALL be taken from DataAbsentReason Used to specify why the normally expected content of the data element is missing
Typecode
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Fixed Valuemasked
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
73. Patient.identifier.use
Definition

The purpose of this identifier.

Control0..1
BindingThe codes SHALL be taken from IdentifierUse Identifies the purpose for this identifier, if known
Typecode
Is Modifiertrue
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
74. Patient.identifier.type
Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Control0..1
BindingThe codes SHALL be taken from Identifier Type Codes; other codes may be used where these codes are not suitable A coded type for an identifier that can be used to determine which identifier to use for a specific purpose
TypeCodeableConcept
Summarytrue
Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
75. Patient.identifier.system
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Control1..1
Typeuri
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Example
General:http://www.acme.com/identifiers/patient
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
76. Patient.identifier.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Control1..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value'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. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Example
General:123456
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
77. Patient.identifier.period
Definition

Time period during which identifier is/was valid for use.

Control0..1
TypePeriod
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
78. Patient.identifier.assigner
Definition

Organization that issued/manages the identifier.

Control0..1
TypeReference(Organization)
Summarytrue
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
79. Patient.active
Definition

Whether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules.

It is often used to filter patient lists to exclude inactive patients

Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death.

Control0..1
Typeboolean
Is Modifiertrue
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

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

Comments

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

Meaning if MissingThis resource is generally assumed to be active if no value is provided for the active element
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
80. Patient.name
Definition

A name associated with the individual.

Control1..*
TypeHumanName
Must Supporttrue
Summarytrue
Requirements

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

Comments

A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
81. Patient.name.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
82. Patient.name.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.name.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
83. Patient.name.extension:dataAbsentReason
SliceNamedataAbsentReason
Definition

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

Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
84. Patient.name.extension:dataAbsentReason.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
85. Patient.name.extension:dataAbsentReason.extension
Definition

An Extension

Control0..0
TypeExtension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.name.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
86. Patient.name.extension:dataAbsentReason.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/StructureDefinition/data-absent-reason
87. Patient.name.extension:dataAbsentReason.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control1..1
BindingThe codes SHALL be taken from DataAbsentReason Used to specify why the normally expected content of the data element is missing
Typecode
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Fixed Valuemasked
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
88. Patient.name.use
Definition

Identifies the purpose for this name.

Control0..1
BindingThe codes SHALL be taken from NameUse The use of a human name
Typecode
Is Modifiertrue
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows the appropriate name for a particular context of use to be selected from among a set of names.

Comments

Applications can assume that a name is current unless it explicitly says that it is temporary or old.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
89. Patient.name.text
Definition

Specifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts.

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

A renderable, unencoded form.

Comments

Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
90. Patient.name.family
Definition

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.

Control0..1 This element is affected by the following invariants: us-core-6
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Alternate Namessurname
Comments

Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
91. Patient.name.given
Definition

Given name.

Control0..* This element is affected by the following invariants: us-core-6
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Alternate Namesfirst name, middle name
Comments

If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
92. Patient.name.prefix
Definition

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.

Control0..*
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
93. Patient.name.suffix
Definition

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.

Control0..*
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
94. Patient.name.period
Definition

Indicates the period of time when this name was valid for the named person.

Control0..1
TypePeriod
Summarytrue
Requirements

Allows names to be placed in historical context.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
95. Patient.telecom
Definition

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

Control1..*
TypeContactPoint
Must Supporttrue
Summarytrue
Requirements

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

Comments

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 might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Patient.telecom. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ system
96. Patient.telecom.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
97. Patient.telecom.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.telecom.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
98. Patient.telecom.extension:dataAbsentReason
SliceNamedataAbsentReason
Definition

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

Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
99. Patient.telecom.extension:dataAbsentReason.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
100. Patient.telecom.extension:dataAbsentReason.extension
Definition

An Extension

Control0..0
TypeExtension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.telecom.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
101. Patient.telecom.extension:dataAbsentReason.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/StructureDefinition/data-absent-reason
102. Patient.telecom.extension:dataAbsentReason.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control1..1
BindingThe codes SHALL be taken from DataAbsentReason Used to specify why the normally expected content of the data element is missing
Typecode
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Fixed Valuemasked
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
103. Patient.telecom.system
Definition

Telecommunications form for contact point - what communications system is required to make use of the contact.

Control1..1 This element is affected by the following invariants: cpt-2
BindingThe codes SHALL be taken from ContactPointSystem Telecommunications form for contact point
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
104. Patient.telecom.value
Definition

The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

Control1..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Requirements

Need to support legacy numbers that are not in a tightly controlled format.

Comments

Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
105. Patient.telecom.use
Definition

Identifies the purpose for the contact point.

Control0..1
BindingThe codes SHALL be taken from ContactPointUse
Typecode
Is Modifiertrue
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Requirements

Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

Comments

Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
106. Patient.telecom.rank
Definition

Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.

Control0..1
TypepositiveInt
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Comments

Note that rank does not necessarily follow the order in which the contacts are represented in the instance.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
107. Patient.telecom.period
Definition

Time period when the contact point was/is in use.

Control0..1
TypePeriod
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
108. Patient.telecom:phone
SliceNamephone
Definition

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

Control0..*
TypeContactPoint
Must Supporttrue
Summarytrue
Requirements

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

Comments

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 might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
109. Patient.telecom:phone.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
110. Patient.telecom:phone.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.telecom.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
111. Patient.telecom:phone.extension:dataAbsentReason
SliceNamedataAbsentReason
Definition

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

Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
112. Patient.telecom:phone.system
Definition

Telecommunications form for contact point - what communications system is required to make use of the contact.

Control1..1 This element is affected by the following invariants: cpt-2
BindingThe codes SHALL be taken from ContactPointSystem Telecommunications form for contact point
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Fixed Valuephone
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
113. Patient.telecom:phone.value
Definition

The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

Control1..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Requirements

Need to support legacy numbers that are not in a tightly controlled format.

Comments

Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
114. Patient.telecom:phone.use
Definition

Identifies the purpose for the contact point.

Control0..1
BindingThe codes SHALL be taken from ContactPointUse
Typecode
Is Modifiertrue
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Requirements

Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

Comments

Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
115. Patient.telecom:phone.rank
Definition

Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.

Control0..1
TypepositiveInt
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Comments

Note that rank does not necessarily follow the order in which the contacts are represented in the instance.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
116. Patient.telecom:phone.period
Definition

Time period when the contact point was/is in use.

Control0..1
TypePeriod
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
117. Patient.telecom:email
SliceNameemail
Definition

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

Control0..*
TypeContactPoint
Must Supporttrue
Summarytrue
Requirements

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

Comments

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 might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
118. Patient.telecom:email.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
119. Patient.telecom:email.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.telecom.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
120. Patient.telecom:email.extension:dataAbsentReason
SliceNamedataAbsentReason
Definition

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

Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
121. Patient.telecom:email.system
Definition

Telecommunications form for contact point - what communications system is required to make use of the contact.

Control1..1 This element is affected by the following invariants: cpt-2
BindingThe codes SHALL be taken from ContactPointSystem Telecommunications form for contact point
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Fixed Valueemail
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
122. Patient.telecom:email.value
Definition

The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

Control1..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Requirements

Need to support legacy numbers that are not in a tightly controlled format.

Comments

Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
123. Patient.telecom:email.use
Definition

Identifies the purpose for the contact point.

Control0..1
BindingThe codes SHALL be taken from ContactPointUse
Typecode
Is Modifiertrue
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Requirements

Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

Comments

Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
124. Patient.telecom:email.rank
Definition

Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.

Control0..1
TypepositiveInt
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Comments

Note that rank does not necessarily follow the order in which the contacts are represented in the instance.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
125. Patient.telecom:email.period
Definition

Time period when the contact point was/is in use.

Control0..1
TypePeriod
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
126. Patient.gender
Definition

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

Control1..1
BindingThe codes SHALL be taken from AdministrativeGender
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Requirements

Needed for identification of the individual, in combination with (at least) name and birth date.

Comments

The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, 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, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
127. Patient.gender.id
Definition

unique id for the element within a resource (for internal references)

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
128. Patient.gender.extension
Definition

An Extension

Control0..*
TypeExtension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.gender.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
129. Patient.gender.extension:dataAbsentReason
SliceNamedataAbsentReason
Definition

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

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
130. Patient.gender.extension:dataAbsentReason.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
131. Patient.gender.extension:dataAbsentReason.extension
Definition

An Extension

Control0..0
TypeExtension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.gender.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
132. Patient.gender.extension:dataAbsentReason.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/StructureDefinition/data-absent-reason
133. Patient.gender.extension:dataAbsentReason.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control1..1
BindingThe codes SHALL be taken from DataAbsentReason Used to specify why the normally expected content of the data element is missing
Typecode
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Fixed Valuemasked
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
134. Patient.gender.value
Definition

Primitive value for code

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
135. Patient.birthDate
Definition

The date of birth for the individual.

Control1..1
Typedate
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Requirements

Age of the individual drives many clinical processes.

Comments

At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternity/infant care systems).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
LOINC Code21112-8
136. Patient.birthDate.id
Definition

unique id for the element within a resource (for internal references)

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
137. Patient.birthDate.extension
Definition

An Extension

Control0..*
TypeExtension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.birthDate.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
138. Patient.birthDate.extension:dataAbsentReason
SliceNamedataAbsentReason
Definition

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

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
139. Patient.birthDate.extension:dataAbsentReason.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
140. Patient.birthDate.extension:dataAbsentReason.extension
Definition

An Extension

Control0..0
TypeExtension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.birthDate.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
141. Patient.birthDate.extension:dataAbsentReason.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/StructureDefinition/data-absent-reason
142. Patient.birthDate.extension:dataAbsentReason.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control1..1
BindingThe codes SHALL be taken from DataAbsentReason Used to specify why the normally expected content of the data element is missing
Typecode
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Fixed Valuemasked
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
143. Patient.birthDate.value
Definition

The actual value

Control0..1
Typedate
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
144. Patient.deceased[x]
Definition

Indicates if the individual is deceased or not.

Control1..1
TypeChoice of: boolean, dateTime
[x] NoteSee Choice of Data Types for further information about how to use [x]
Is Modifiertrue
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Summarytrue
Requirements

The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.

Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
145. Patient.address
Definition

If the patient is homeless, complete as much address information as possible (city, zip, county, etc.) and use the Characteristics of Home Environment profile in the Social History Section of the eICR Composition to indicate that the patient is homeless.

Control1..*
TypeAddress
Must Supporttrue
Summarytrue
Requirements

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

Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
146. Patient.address.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
147. Patient.address.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.address.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
148. Patient.address.extension:dataAbsentReason
SliceNamedataAbsentReason
Definition

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

Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
149. Patient.address.extension:dataAbsentReason.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
150. Patient.address.extension:dataAbsentReason.extension
Definition

An Extension

Control0..0
TypeExtension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.address.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
151. Patient.address.extension:dataAbsentReason.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/StructureDefinition/data-absent-reason
152. Patient.address.extension:dataAbsentReason.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control1..1
BindingThe codes SHALL be taken from DataAbsentReason Used to specify why the normally expected content of the data element is missing
Typecode
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Fixed Valuemasked
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
153. Patient.address.use
Definition

The purpose of this address.

Control0..1
BindingThe codes SHALL be taken from AddressUse The use of an address
Typecode
Is Modifiertrue
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows an appropriate address to be chosen from a list of many.

Comments

Applications can assume that an address is current unless it explicitly says that it is temporary or old.

Example
General:home
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
154. Patient.address.type
Definition

Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both.

Control0..1
BindingThe codes SHALL be taken from AddressType The type of an address (physical / postal)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Comments

The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource).

Example
General:both
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
155. Patient.address.text
Definition

Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts.

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

A renderable, unencoded form.

Comments

Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

Example
General:137 Nowhere Street, Erewhon 9132
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
156. Patient.address.line
Definition

This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.

Control0..*
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Example
General:137 Nowhere Street
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
157. Patient.address.city
Definition

The name of the city, town, suburb, village or other community or delivery center.

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Alternate NamesMunicpality
Example
General:Erewhon
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
158. Patient.address.district
Definition

The name of the administrative area (county).

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Alternate NamesCounty
Comments

District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.

Example
General:Madison
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
159. Patient.address.state
Definition

Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes).

Control0..1
BindingThe codes SHALL be taken from USPS Two Letter Alphabetic Codes; other codes may be used where these codes are not suitable Two Letter USPS alphabetic codes
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Alternate NamesProvince, Territory
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
160. Patient.address.postalCode
Definition

A postal code designating a region defined by the postal service.

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Alternate NamesZip, Zip Code
Example
General:9132
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
161. Patient.address.country
Definition

Country - a nation as commonly understood or generally accepted.

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Comments

ISO 3166 3 letter codes can be used in place of a human readable country name.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
162. Patient.address.period
Definition

Time period when address was/is in use.

Control0..1
TypePeriod
Must Supporttrue
Summarytrue
Requirements

Allows addresses to be placed in historical context.

Example
General:<valuePeriod xmlns="http://hl7.org/fhir">
  <start value="2010-03-23"/>
  <end value="2010-07-01"/>
</valuePeriod>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
163. Patient.maritalStatus
Definition

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

Control0..1
BindingThe codes SHALL be taken from Marital Status Codes; other codes may be used where these codes are not suitable The domestic partnership status of a person
TypeCodeableConcept
Summaryfalse
Requirements

Most, if not all systems capture it.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
164. Patient.multipleBirth[x]
Definition

Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer).

Control0..1
TypeChoice of: boolean, integer
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Requirements

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

Comments

Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in triplets would be valueInteger=2 and the third born would have valueInteger=3 If a boolean value was provided for this triplets example, then all 3 patient records would have valueBoolean=true (the ordering is not indicated).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
165. Patient.photo
Definition

Image of the patient.

Control0..*
TypeAttachment
Summaryfalse
Requirements

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

Comments

Guidelines:

  • Use id photos, not clinical photos.
  • Limit dimensions to thumbnail.
  • Keep byte count low to ease resource updates.
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
166. Patient.contact
Definition

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

Control0..*
TypeBackboneElement
Must Supporttrue
Summaryfalse
Requirements

Need to track people you can contact about the patient.

Comments

Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
pat-1: 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())
167. Patient.contact.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
168. Patient.contact.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
169. Patient.contact.modifierExtension
Definition

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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
170. Patient.contact.relationship
Definition

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

Control1..1
BindingThe codes SHALL be taken from PatientContactRelationship; other codes may be used where these codes are not suitable The nature of the relationship between a patient and a contact person for that patient
TypeCodeableConcept
Must Supporttrue
Summaryfalse
Requirements

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
171. Patient.contact.name
Definition

A name associated with the contact person.

Control1..1
TypeHumanName
Must Supporttrue
Summaryfalse
Requirements

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
172. Patient.contact.name.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
173. Patient.contact.name.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.contact.name.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
174. Patient.contact.name.extension:dataAbsentReason
SliceNamedataAbsentReason
Definition

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

Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
175. Patient.contact.name.extension:dataAbsentReason.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
176. Patient.contact.name.extension:dataAbsentReason.extension
Definition

An Extension

Control0..0
TypeExtension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.contact.name.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
177. Patient.contact.name.extension:dataAbsentReason.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/StructureDefinition/data-absent-reason
178. Patient.contact.name.extension:dataAbsentReason.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control1..1
BindingThe codes SHALL be taken from DataAbsentReason Used to specify why the normally expected content of the data element is missing
Typecode
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Fixed Valuemasked
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
179. Patient.contact.name.use
Definition

Identifies the purpose for this name.

Control0..1
BindingThe codes SHALL be taken from NameUse The use of a human name
Typecode
Is Modifiertrue
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows the appropriate name for a particular context of use to be selected from among a set of names.

Comments

Applications can assume that a name is current unless it explicitly says that it is temporary or old.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
180. Patient.contact.name.text
Definition

Specifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts.

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

A renderable, unencoded form.

Comments

Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
181. Patient.contact.name.family
Definition

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.

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Alternate Namessurname
Comments

Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
182. Patient.contact.name.given
Definition

Given name.

Control0..*
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Alternate Namesfirst name, middle name
Comments

If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
183. Patient.contact.name.prefix
Definition

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.

Control0..*
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
184. Patient.contact.name.suffix
Definition

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.

Control0..*
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
185. Patient.contact.name.period
Definition

Indicates the period of time when this name was valid for the named person.

Control0..1
TypePeriod
Summarytrue
Requirements

Allows names to be placed in historical context.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
186. Patient.contact.telecom
Definition

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

Control1..*
TypeContactPoint
Must Supporttrue
Summaryfalse
Requirements

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

Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
187. Patient.contact.telecom.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
188. Patient.contact.telecom.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.contact.telecom.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
189. Patient.contact.telecom.extension:dataAbsentReason
SliceNamedataAbsentReason
Definition

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

Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
190. Patient.contact.telecom.extension:dataAbsentReason.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
191. Patient.contact.telecom.extension:dataAbsentReason.extension
Definition

An Extension

Control0..0
TypeExtension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.contact.telecom.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
192. Patient.contact.telecom.extension:dataAbsentReason.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/StructureDefinition/data-absent-reason
193. Patient.contact.telecom.extension:dataAbsentReason.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control1..1
BindingThe codes SHALL be taken from DataAbsentReason Used to specify why the normally expected content of the data element is missing
Typecode
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Fixed Valuemasked
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
194. Patient.contact.telecom.system
Definition

Telecommunications form for contact point - what communications system is required to make use of the contact.

Control0..1 This element is affected by the following invariants: cpt-2
BindingThe codes SHALL be taken from ContactPointSystem Telecommunications form for contact point
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
195. Patient.contact.telecom.value
Definition

The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Need to support legacy numbers that are not in a tightly controlled format.

Comments

Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
196. Patient.contact.telecom.use
Definition

Identifies the purpose for the contact point.

Control0..1
BindingThe codes SHALL be taken from ContactPointUse Use of contact point
Typecode
Is Modifiertrue
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

Comments

Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
197. Patient.contact.telecom.rank
Definition

Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.

Control0..1
TypepositiveInt
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Comments

Note that rank does not necessarily follow the order in which the contacts are represented in the instance.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
198. Patient.contact.telecom.period
Definition

Time period when the contact point was/is in use.

Control0..1
TypePeriod
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
199. Patient.contact.address
Definition

Address for the contact person.

Control1..1
TypeAddress
Must Supporttrue
Summaryfalse
Requirements

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
200. Patient.contact.address.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
201. Patient.contact.address.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.contact.address.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
202. Patient.contact.address.extension:dataAbsentReason
SliceNamedataAbsentReason
Definition

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

Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
203. Patient.contact.address.extension:dataAbsentReason.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
204. Patient.contact.address.extension:dataAbsentReason.extension
Definition

An Extension

Control0..0
TypeExtension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.contact.address.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
205. Patient.contact.address.extension:dataAbsentReason.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/StructureDefinition/data-absent-reason
206. Patient.contact.address.extension:dataAbsentReason.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control1..1
BindingThe codes SHALL be taken from DataAbsentReason Used to specify why the normally expected content of the data element is missing
Typecode
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Fixed Valuemasked
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
207. Patient.contact.address.use
Definition

The purpose of this address.

Control0..1
BindingThe codes SHALL be taken from AddressUse The use of an address
Typecode
Is Modifiertrue
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows an appropriate address to be chosen from a list of many.

Comments

Applications can assume that an address is current unless it explicitly says that it is temporary or old.

Example
General:home
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
208. Patient.contact.address.type
Definition

Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both.

Control0..1
BindingThe codes SHALL be taken from AddressType The type of an address (physical / postal)
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Comments

The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource).

Example
General:both
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
209. Patient.contact.address.text
Definition

Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts.

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

A renderable, unencoded form.

Comments

Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

Example
General:137 Nowhere Street, Erewhon 9132
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
210. Patient.contact.address.line
Definition

This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.

Control0..*
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Example
General:137 Nowhere Street
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
211. Patient.contact.address.city
Definition

The name of the city, town, suburb, village or other community or delivery center.

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Alternate NamesMunicpality
Example
General:Erewhon
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
212. Patient.contact.address.district
Definition

The name of the administrative area (county).

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Alternate NamesCounty
Comments

District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.

Example
General:Madison
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
213. Patient.contact.address.state
Definition

Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes).

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Alternate NamesProvince, Territory
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
214. Patient.contact.address.postalCode
Definition

A postal code designating a region defined by the postal service.

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Alternate NamesZip
Example
General:9132
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
215. Patient.contact.address.country
Definition

Country - a nation as commonly understood or generally accepted.

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Comments

ISO 3166 3 letter codes can be used in place of a human readable country name.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
216. Patient.contact.address.period
Definition

Time period when address was/is in use.

Control0..1
TypePeriod
Summarytrue
Requirements

Allows addresses to be placed in historical context.

Example
General:<valuePeriod xmlns="http://hl7.org/fhir">
  <start value="2010-03-23"/>
  <end value="2010-07-01"/>
</valuePeriod>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
217. Patient.contact.gender
Definition

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

Control0..1
BindingThe codes SHALL be taken from AdministrativeGender The gender of a person used for administrative purposes
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Requirements

Needed to address the person correctly.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
218. Patient.contact.organization
Definition

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

Control0..1 This element is affected by the following invariants: pat-1
TypeReference(Organization)
Summaryfalse
Requirements

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
219. Patient.contact.period
Definition

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

Control0..1
TypePeriod
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
220. Patient.communication
Definition

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

Control1..*
TypeBackboneElement
Must Supporttrue
Summaryfalse
Requirements

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

Comments

If no language is specified, this implies that the default local language is spoken. 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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
221. Patient.communication.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
222. Patient.communication.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
223. Patient.communication.modifierExtension
Definition

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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
224. Patient.communication.language
Definition

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. "en" for English, or "en-US" for American English versus "en-EN" for England English.

Control1..1
BindingThe codes SHALL be taken from Language codes with language and optionally a region modifier; other codes may be used where these codes are not suitable
TypeCodeableConcept
Must Supporttrue
Summaryfalse
Requirements

Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.

Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
225. Patient.communication.language.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
226. Patient.communication.language.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.communication.language.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
227. Patient.communication.language.extension:dataAbsentReason
SliceNamedataAbsentReason
Definition

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

Control0..1
TypeExtension(Data Absent Reason) (Extension Type: code)
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
228. Patient.communication.language.extension:dataAbsentReason.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
229. Patient.communication.language.extension:dataAbsentReason.extension
Definition

An Extension

Control0..0
TypeExtension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.communication.language.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
230. Patient.communication.language.extension:dataAbsentReason.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/StructureDefinition/data-absent-reason
231. Patient.communication.language.extension:dataAbsentReason.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control1..1
BindingThe codes SHALL be taken from DataAbsentReason Used to specify why the normally expected content of the data element is missing
Typecode
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summaryfalse
Fixed Valuemasked
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
232. Patient.communication.language.coding
Definition

A reference to a code defined by a terminology system.

Control0..*
TypeCoding
Summarytrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
233. Patient.communication.language.text
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
234. Patient.communication.preferred
Definition

Indicates whether or not the patient prefers this language (over other languages he masters up a certain level).

Control0..1
Typeboolean
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Requirements

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.

Comments

This language is specifically identified for communicating healthcare information.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
235. Patient.generalPractitioner
Definition

Patient's nominated care provider.

Control0..*
TypeReference(Organization|Practitioner|PractitionerRole)
Summaryfalse
Alternate NamescareProvider
Comments

This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability 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. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues.

Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
236. Patient.managingOrganization
Definition

Organization that is the custodian of the patient record.

Control0..1
TypeReference(Organization)
Summarytrue
Requirements

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

Comments

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).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
237. Patient.link
Definition

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

Control0..*
TypeBackboneElement
Is Modifiertrue
Summarytrue
Requirements

There are multiple use cases:

  • Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and
  • Distribution of patient information across multiple servers.
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
238. Patient.link.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
239. Patient.link.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
240. Patient.link.modifierExtension
Definition

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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
241. Patient.link.other
Definition

The other patient resource that the link refers to.

Control1..1
TypeReference(Patient|RelatedPerson)
Summarytrue
Comments

Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
242. Patient.link.type
Definition

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

Control1..1
BindingThe codes SHALL be taken from LinkType The type of link between this patient resource and another patient resource
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))