Patient - FHIR v0.0.82

This page is part of the FHIR Specification (v0.0.82: DSTU 1). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

5.1.8 Resource Patient - Formal Definitions

Formal definitions for the elements in the Patient resource.

Patient
Definition	Demographics and other administrative information about a person or animal receiving care or other health-related services.
Control	1..1
Requirements	Tracking patient is the center of the healthcare process.
Patient.identifier
Definition	An identifier that applies to this person as a patient.
Control	0..*
Type	Identifier
Requirements	Patients are almost always assigned specific numerical identifiers.
Summary	true
Patient.name
Definition	A name associated with the individual.
Control	0..*
Type	HumanName
Requirements	Need to be able to track the person by multiple names. Examples are your official name and a partner name.
Summary	true
Comments	Person may have multiple names with different uses or applicable periods.For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.
Patient.telecom
Definition	A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted.
Control	0..*
Type	Contact
Requirements	People have (primary) ways to contact them in some way such as phone, email.
Summary	true
Comments	Person may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address may not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).
Patient.gender
Definition	Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes.
Control	0..1
Binding	AdministrativeGender: (See http://hl7.org/fhir/vs/administrative-gender)
Type	CodeableConcept
Requirements	Needed for identification of the individual, in combination with (at least) name and birth date. Gender of individual drives many clinical processes.
Summary	true
Comments	The gender may not match the biological sex as determined by genetics, or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than M and F, though the vast majority of systems and contexts only support M and F.
Patient.birthDate
Definition	The date and time of birth for the individual.
Control	0..1
Type	dateTime
Requirements	Age of the individual drives many clinical processes. Next to the common use case of capturing someone birth date, also in some common cases time is registered.
Summary	true
Comments	At least an estimated year should be provided as a guess if the real dob is unknown.
Patient.deceased[x]
Definition	Indicates if the individual is deceased or not.
Control	0..1
Type	boolean\|dateTime
Is Modifier	true
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.
Summary	true
Comments	If there's no value in the instance it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.
Patient.address
Definition	Addresses for the individual.
Control	0..*
Type	Address
Requirements	May need to keep track of persons addresses for contacting, billing or reporting requirements and also to help with identification.
Summary	true
Comments	Person may have multiple addresses with different uses or applicable periods.
Patient.maritalStatus
Definition	This field contains a patient's most recent marital (civil) status.
Control	0..1
Binding	MaritalStatus: (See http://hl7.org/fhir/vs/marital-status)
Type	CodeableConcept
Requirements	Most, if not all systems capture it.
Summary	true
Patient.multipleBirth[x]
Definition	Indicates whether the patient is part of a multiple or indicates the actual birth order.
Control	0..1
Type	boolean\|integer
Requirements	For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs.
Summary	true
Patient.photo
Definition	Image of the person.
Control	0..*
Type	Attachment
Requirements	Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too.
Patient.contact
Definition	A contact party (e.g. guardian, partner, friend) for the patient.
Control	0..*
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.
Invariants	Defined on this element Inv-1: SHALL at least contain a contact's details or a reference to an organization (xpath: f:name or f:telecom or f:address or f:organization)
Patient.contact.relationship
Definition	The nature of the relationship between the patient and the contact person.
Control	0..*
Binding	ContactRelationship: (See http://hl7.org/fhir/vs/patient-contact-relationship)
Type	CodeableConcept
Requirements	Used to determine which contact person is the most relevant to approach, depending on circumstances.
Patient.contact.name
Definition	A name associated with the person.
Control	0..1
Type	HumanName
Requirements	Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that person.
Patient.contact.telecom
Definition	A contact detail for the person, e.g. a telephone number or an email address.
Control	0..*
Type	Contact
Requirements	People have (primary) ways to contact them in some way such as phone, email.
Comments	Person may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification.
Patient.contact.address
Definition	Address for the contact person.
Control	0..1
Type	Address
Requirements	Need to keep track where the contact person can be contacted per postal mail or visited.
Patient.contact.gender
Definition	Administrative Gender - the gender that the person is considered to have for administration and record keeping purposes.
Control	0..1
Binding	AdministrativeGender: (See http://hl7.org/fhir/vs/administrative-gender)
Type	CodeableConcept
Requirements	Needed to address the person correctly.
Patient.contact.organization
Definition	Organization on behalf of which the contact is acting or for which the contact is working.
Control	0..1
Type	Resource(Organization)
Requirements	For guardians or business related contacts, the organization is relevant.
Invariants	Affect this element Inv-1: SHALL at least contain a contact's details or a reference to an organization (xpath: f:name or f:telecom or f:address or f:organization)
Patient.animal
Definition	This element has a value if the patient is an animal.
Control	0..1
Is Modifier	true
Requirements	Many clinical systems are extended to care for animal patients as well as human.
Summary	true
Comments	The animal element is labeled "Is Modifier" since patients may be non-human. Systems SHALL either handle patient details appropriately (e.g. inform users patient is not human) or reject non-human patient records.
Patient.animal.species
Definition	Identifies the high level categorization of the kind of animal.
Control	1..1
Binding	AnimalSpecies: (See http://hl7.org/fhir/vs/animal-species)
Type	CodeableConcept
Requirements	Need to know what kind of animal.
Summary	true
Comments	If the patient is non-human, at least a species SHALL be specified.
Patient.animal.breed
Definition	Identifies the detailed categorization of the kind of animal.
Control	0..1
Binding	AnimalBreed: (See http://hl7.org/fhir/vs/animal-breeds)
Type	CodeableConcept
Requirements	May need to know the specific kind within the species.
Summary	true
Patient.animal.genderStatus
Definition	Indicates the current state of the animal's reproductive organs.
Control	0..1
Binding	AnimalGenderStatus: (See http://hl7.org/fhir/vs/animal-genderstatus)
Type	CodeableConcept
Requirements	Gender status can affect housing and animal behavior.
Summary	true
Patient.communication
Definition	Languages which may be used to communicate with the patient about his or her health.
Control	0..*
Binding	Language: see IETF language tag
Type	CodeableConcept
Requirements	If a patient does not speak the local language, interpreters may be required, so languages spoken is an important things to keep track of both for patient and other persons of interest.
Comments	If no language is specified, this implies that the default local language is spoken. For animals, language is not a relevant field, and should be absent from the instance.
Patient.careProvider
Definition	Patient's nominated care provider.
Control	0..*
Type	Resource(Organization \| Practitioner)
To Do	Need to rationalize this with circleOfCare from CarePlan.
Patient.managingOrganization
Definition	Organization that is the custodian of the patient record.
Control	0..1
Type	Resource(Organization)
Requirements	Need to know who recognizes this patient record, manages and updates it.
Summary	true
Patient.link
Definition	Link to another patient resource that concerns the same actual person.
Control	0..*
Is Modifier	true
Requirements	There are multiple usecases: * Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and * Distribution of patient information across multiple servers.
Summary	true
Comments	There is no assumption that linked patient records have mutual links.
Patient.link.other
Definition	The other patient resource that the link refers to.
Control	1..1
Type	Resource(Patient)
Is Modifier	true
Summary	true
Patient.link.type
Definition	The type of link between this patient resource and another patient resource.
Control	1..1
Binding	LinkType: The type of link between this patient resource and another patient resource. (see http://hl7.org/fhir/link-type for values)
Type	code
Is Modifier	true
Summary	true
Patient.active
Definition	Whether this patient record is in active use.
Control	0..1
Type	boolean
Is Modifier	true
Requirements	Need to be able to mark a patient record as not to be used because it was created in error.
Summary	true
Comments	Default is true. If a record is inactive, and linked to an active record, then future patient/person/record updates should occur on the other patient.