2nd DSTU Draft For Comment

This page is part of the FHIR Specification (v0.4.0: DSTU 2 Draft). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions

Profile US Laboratory Patient Profile - Definitions

Todo

Definitions for the patient-uslab-uslabphpatient Profile.

Patient(USLabPHPatient)
Definition

Subject of lab test.

Control1..1
Requirements

Tracking patient is the center of the healthcare process.

Alternate NamesSubjectOfCare Client Resident, Subject
Comments
Patient.id
Definition

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

Control0..1
Typeid
Requirements
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. Bundles always have an id, though it is usually a generated UUID.

Patient.meta
Definition

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

Control0..1
TypeMeta
Requirements
Comments
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.

Control0..1
Typeuri
Is Modifiertrue
Requirements
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 as much as possible.

Patient.language
Definition

The base language in which the resource is written.

Control0..1
BindingA human language
The codes SHALL be taken from http://tools.ietf.org/html/bcp47
Typecode
Requirements
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).

Patient.text
Definition

A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "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.

Control1..1 This element is affected by the following invariants: dom-1
TypeNarrative
Must Supporttrue
Requirements
Alternate Namesnarrative, html, xhtml, display
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative.

Patient.text.id
Definition

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

Control0..1
Typeid
Requirements
Comments
Patient.text.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Requirements
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.

Patient.text.status
Definition

The status of the narrative - whether it's entirely generated (from just the defined data or the extensions too), or whether a human authored it and it may contain additional data.

Control1..1
BindingThe status of a resource narrative
The codes SHALL be taken from NarrativeStatus
Typecode
Must Supporttrue
Requirements
Comments
Fixed Valuegenerated
Patient.text.div
Definition

The actual narrative content, a stripped down version of XHTML.

Control1..1
Typexhtml
Requirements
Comments

The contents of the html element are an XHTML fragment containing only the basic html formatting elements described in chapters 7-11 and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained stylesheets. The XHTML content may not contain a head, a body, external stylesheet references, scripts, forms, base/link/xlink, frames, iframes and objects.

InvariantsDefined on this element
txt-1: The narrative SHALL contain only the basic html formatting elements described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes (xpath: not(descendant-or-self::*[not(local-name(.)=('a', 'abbr', 'acronym', 'b', 'big', 'blockquote', 'br', 'caption', 'cite', 'code', 'colgroup', 'dd', 'dfn', 'div', 'dl', 'dt', 'em', 'h1', 'h2', 'h3', 'h4', 'h5', 'h6', 'hr', 'i', 'img', 'li', 'ol', 'p', 'pre', 'q', 'samp', 'small', 'span', 'strong', 'table', 'tbody', 'td', 'tfoot', 'th', 'thead', 'tr', 'tt', 'ul', 'var'))]))
txt-2: The narrative SHALL have some non-whitespace content (xpath: descendant::text()[normalize-space(.)!=''] or descendant::h:img[@src])
txt-3: The narrative SHALL contain only the basic html formatting attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes (xpath: not(descendant-or-self::*/@*[not(name(.)=('abbr', 'accesskey', 'align', 'alt', 'axis', 'bgcolor', 'border', 'cellhalign', 'cellpadding', 'cellspacing', 'cellvalign', 'char', 'charoff', 'charset', 'cite', 'class', 'colspan', 'compact', 'coords', 'dir', 'frame', 'headers', 'height', 'href', 'hreflang', 'hspace', 'id', 'lang', 'longdesc', 'name', 'nowrap', 'rel', 'rev', 'rowspan', 'rules', 'scope', 'shape', 'span', 'src', 'start', 'style', 'summary', 'tabindex', 'title', 'type', 'valign', 'value', 'vspace', 'width'))]))
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
Requirements
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.

Patient.extension
Definition

May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Requirements
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.

SlicingThis element introduces a set of slices. The slicing rules are:
  • unordered
  • open
  • discriminators: url
Patient.extension (http://hl7.org/fhir/ExtensionDefinition/us-core-race)
Definition

A code classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.

Control0..1
BindingA code classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.
For codes, see v3 Code System Race
TypeCodeableConcept
Requirements
Comments
Patient.extension.id
Definition

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

Control0..1
Typeid
Requirements
Comments
Patient.extension.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Requirements
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.

Patient.extension.url
Definition

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

Control1..1
Typeuri
Requirements
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 should be version specific. This will ideally be the URI for the Resource Profile defining the extension, with the code for the extension after a #.

Patient.extension.value[x]
Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Control0..1
Type*
Requirements
Comments
Patient.extension (http://hl7.org/fhir/ExtensionDefinition/us-core-ethnicity)
Definition

A code classifying the person into a named category of humans sharing a common real or presumed heritage.

Control0..1
BindingA code classifying the person into a named category of humans sharing a common real or presumed heritage.
For codes, see v3 Code System Ethnicity
TypeCodeableConcept
Requirements
Comments
Patient.extension.id
Definition

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

Control0..1
Typeid
Requirements
Comments
Patient.extension.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Requirements
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.

Patient.extension.url
Definition

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

Control1..1
Typeuri
Requirements
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 should be version specific. This will ideally be the URI for the Resource Profile defining the extension, with the code for the extension after a #.

Patient.extension.value[x]
Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Control0..1
Type*
Requirements
Comments
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. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Control0..*
TypeExtension
Requirements
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.

Patient.identifier
Definition

An identifier that applies to this person as a patient.

Control1..*
TypeIdentifier
Must Supporttrue
Requirements

Patients are almost always assigned specific numerical identifiers.

Comments
Patient.identifier.id
Definition

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

Control0..1
Typeid
Requirements
Comments
Patient.identifier.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Requirements
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.

Patient.identifier.use
Definition

The purpose of this identifier.

Control1..1
BindingIdentifies the purpose for this identifier, if known
The codes SHALL be taken from IdentifierUse
Typecode
Is Modifiertrue
Must Supporttrue
Requirements

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

Comments

This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Patient.identifier.label
Definition

A text string for the identifier that can be displayed to a human so they can recognize the identifier.

Control0..1
Typestring
Requirements

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

Comments
Patient.identifier.system
Definition

URI of Organization or system that assigned the patient ID. This may be the same as the Placer URI.

Control1..1
Typeuri
Must Supporttrue
Requirements

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

Comments
Examplehttp://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the id itself is a full uri
Patient.identifier.value
Definition

Patient Identifier String.

Control1..1
Typestring
Must Supporttrue
Requirements
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.

Example123456
Patient.identifier.period
Definition

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

Control0..1
TypePeriod
Requirements
Comments
Patient.identifier.assigner
Definition

Organization that issued/manages the identifier.

Control0..1
TypeReference(Profile = (Profile = http://hl7.org/fhir/Profile/Organization))
Requirements
Comments

The reference may be just a text description of the assigner.

Patient.name
Definition

A name associated with the individual.

Control1..*
TypeHumanName
Must Supporttrue
Requirements

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

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.name.id
Definition

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

Control0..1
Typeid
Requirements
Comments
Patient.name.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Requirements
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.

Patient.name.use
Definition

Identifies the purpose for this name.

Control1..1
BindingThe name types for US Laboratory reporting to Public Health
The codes SHALL be taken from USLabPHNameUse
Typecode
Is Modifiertrue
Must Supporttrue
Requirements

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

Comments

This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc for a current/permanent one. Applications can assume that a name is current unless it explicitly says that it is temporary or old.

Patient.name.text
Definition

A full text representation of the name.

Control0..1
Typestring
Requirements

A renderable, unencoded form.

Comments

Can provide both a text representation and structured parts.

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.

Control1..1
Typestring
Must Supporttrue
Requirements
Alternate Namessurname
Comments

For family name, hyphenated names such as "Smith-Jones" are a single name, but names with spaces such as "Smith Jones" are broken into multiple parts.

Patient.name.given
Definition

Given name.

Control0..2
Typestring
Must Supporttrue
Requirements
Alternate Namesfirst name, middle name
Comments

If only initials are recorded, they may be used in place of the full name. Not called "first name" since given names do not always come first.

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..1
Typestring
Must Supporttrue
Requirements
Comments
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..1
Typestring
Must Supporttrue
Requirements
Comments
Patient.name.period
Definition

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

Control0..1
TypePeriod
Requirements

Allows names to be placed in historical context.

Comments
Patient.telecom
Definition

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

Control0..*
TypeContactPoint
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. 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).

SlicingThis element introduces a set of slices. The slicing rules are:
  • unordered
  • open
  • discriminators: use
Patient.telecom(USLabHomePhone)
Definition

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

Control0..*
TypeContactPoint
Must Supporttrue
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. 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.telecom.id
Definition

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

Control0..1
Typeid
Requirements
Comments
Patient.telecom.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Requirements
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.

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
BindingTelecommunications form for contact point
The codes SHALL be taken from ContactPointSystem
Typecode
Must Supporttrue
Requirements
Comments
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
Must Supporttrue
Requirements

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

Comments

Additional out of band data such as extensions, or notes about use of the contact are sometimes included in the value.

Patient.telecom.use
Definition

Identifies the purpose for the contact point.

Control1..1
BindingUse of contact point
The codes SHALL be taken from ContactPointUse
Typecode
Is Modifiertrue
Must Supporttrue
Requirements

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

Comments

This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc for a current/permanent one. Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

Fixed Valuehome
Patient.telecom.period
Definition

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

Control0..1
TypePeriod
Requirements
Comments
Patient.telecom(USLabWorkPhone)
Definition

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

Control0..*
TypeContactPoint
Must Supporttrue
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. 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.telecom.id
Definition

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

Control0..1
Typeid
Requirements
Comments
Patient.telecom.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Requirements
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.

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
BindingTelecommunications form for contact point
The codes SHALL be taken from ContactPointSystem
Typecode
Must Supporttrue
Requirements
Comments
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
Must Supporttrue
Requirements

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

Comments

Additional out of band data such as extensions, or notes about use of the contact are sometimes included in the value.

Patient.telecom.use
Definition

Identifies the purpose for the contact point.

Control1..1
BindingUse of contact point
The codes SHALL be taken from ContactPointUse
Typecode
Is Modifiertrue
Must Supporttrue
Requirements

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

Comments

This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc for a current/permanent one. Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

Fixed Valuework
Patient.telecom.period
Definition

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

Control0..1
TypePeriod
Requirements
Comments
Patient.gender
Definition

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

Control1..1
BindingThe gender of a person used for administrative purposes
The codes SHALL be taken from AdministrativeGender
Typecode
Must Supporttrue
Requirements

Needed for identification of the individual, in combination with (at least) name and birth date. Gender of individual drives many clinical processes.

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 of birth for the individual.

Control0..1
Typedate
Must Supporttrue
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.

Patient.birthTime
Definition

The time of birth for the individual.

Control0..1
Typetime
Requirements

In some cases birth time is important (e.g. multiple births). Hospitals will capture the time of birth in most cases.

Comments
Patient.deceased[x]
Definition

Indicates if the individual is deceased or not.

Control0..1
TypeChoice of: boolean, dateTime
Is Modifiertrue
Must Supporttrue
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.

Patient.address
Definition

Addresses for the individual.

Control0..*
TypeAddress
Must Supporttrue
Requirements

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

Comments

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

Patient.address.id
Definition

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

Control0..1
Typeid
Requirements
Comments
Patient.address.extension (http://hl7.org/fhir/ExtensionDefinition/us-core-county)
Definition

Name of county.

Control0..1
Typestring
Requirements
Comments
Patient.address.extension.id
Definition

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

Control0..1
Typeid
Requirements
Comments
Patient.address.extension.extension (http://hl7.org/fhir/ExtensionDefinition/iso21090-SC-coding)
Definition

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

Control0..*
BindingA coded representation for a string. Could be codes for country in a country address part, codes for prefixes in a name part, etc.
TypeCoding
Requirements
Comments
Patient.address.extension.extension.id
Definition

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

Control0..1
Typeid
Requirements
Comments
Patient.address.extension.extension.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Requirements
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.

Patient.address.extension.extension.url
Definition

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

Control1..1
Typeuri
Requirements
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 should be version specific. This will ideally be the URI for the Resource Profile defining the extension, with the code for the extension after a #.

Patient.address.extension.extension.value[x]
Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Control0..1
Type*
Requirements
Comments
Patient.address.extension.url
Definition

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

Control1..1
Typeuri
Requirements
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 should be version specific. This will ideally be the URI for the Resource Profile defining the extension, with the code for the extension after a #.

Patient.address.extension.value[x]
Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Control0..1
Type*
Requirements
Comments
Patient.address.use
Definition

The purpose of this address.

Control0..1
BindingThe use of an address
The codes SHALL be taken from AddressUse
Typecode
Is Modifiertrue
Must Supporttrue
Requirements

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

Comments

This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc for a current/permanent one. Applications can assume that an address is current unless it explicitly says that it is temporary or old.

Examplehome
Patient.address.text
Definition

A full text representation of the address.

Control0..1
Typestring
Requirements

A renderable, unencoded form.

Comments

Can provide both a text representation and parts.

Example137 Nowhere Street, Erewhon 9132
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..2
Typestring
Must Supporttrue
Requirements

home | work | temp | old - purpose of this address.

Comments
Example137 Nowhere Street
Patient.address.city
Definition

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

Control0..1
Typestring
Must Supporttrue
Requirements
Alternate NamesMuncipality
Comments
ExampleErewhon
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 (i.e. US 2 letter state codes).

Control0..1
BindingTwo letter USPS alphabetic codes.
The codes SHALL be taken from USPS Two Letter Alphabetic Codes; other codes may be used where these codes are not suitable
Typestring
Must Supporttrue
Requirements
Alternate NamesProvince, Territory
Comments
Patient.address.postalCode
Definition

US Zip Codes.

Control0..1
Typestring
Must Supporttrue
Requirements
Alternate NamesZip
Comments
Example9132
InvariantsDefined on this element
inv-1: (Zip or Postal Code) SHALL be formatted as 99999[-9999] for US Zip or ZIP +4 codes or as A9A9A9 for Canadian postal codes. (xpath: f:matches(issued,[0-9]{5}(-[0-9]{4}){0,1} ))
Patient.address.country
Definition

ISO 3166 3 letter Country Code.

Control0..1
BindingISO 3 letter codes
The codes SHALL be taken from USLabCountry; other codes may be used where these codes are not suitable
Typestring
Must Supporttrue
Requirements
Comments

ISO 3166 3 letter codes can be used in place of a full country name.

Patient.address.period
Definition

Time period when address was/is in use.

Control0..1
TypePeriod
Requirements

Allows addresses to be placed in historical context.

Comments
Example&lt;valuePeriod&nbsp;xmlns=&quot;http://hl7.org/fhir&quot;&gt;<br/>&nbsp;&nbsp;&lt;start&nbsp;value=&quot;2010-03-23&quot;/&gt;<br/>&nbsp;&nbsp;&lt;end&nbsp;value=&quot;2010-07-01&quot;/&gt;<br/>&lt;/valuePeriod&gt;<br/>
Patient.maritalStatus
Definition

This field contains a patient's most recent marital (civil) status.

Control0..1
BindingThe domestic partnership status of a person
The codes SHOULD be taken from Marital Status Codes; other codes may be used where these codes are not suitable
TypeCodeableConcept
Requirements

Most, if not all systems capture it.

Comments
Patient.multipleBirth[x]
Definition

Indicates whether the patient is part of a multiple or indicates the actual birth order.

Control0..1
TypeChoice of: boolean, integer
Requirements

For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs.

Comments
Patient.photo
Definition

Image of the person.

Control0..*
TypeAttachment
Requirements

Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too.

Comments
Patient.contact
Definition

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

Control0..*
Must Supporttrue
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
pat-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.id
Definition

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

Control0..1
Typeid
Requirements
Comments
Patient.contact.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Requirements
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.

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 that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Control0..*
TypeExtension
Requirements
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.

Patient.contact.relationship
Definition

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

Control0..1
BindingThe nature of the relationship between a patient and a contact person for that patient
The codes SHOULD be taken from PatientContactRelationship; other codes may be used where these codes are not suitable
TypeCodeableConcept
Must Supporttrue
Requirements

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

Comments
Patient.contact.relationship.id
Definition

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

Control0..1
Typeid
Requirements
Comments
Patient.contact.relationship.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Requirements
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.

Patient.contact.relationship.coding
Definition

A reference to a code defined by a terminology system.

Control1..1
TypeCoding
Must Supporttrue
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the V3 Core Principles for more information. Ordering of codings is undefined and SHALL not be used to infer meaning.

Patient.contact.relationship.coding.id
Definition

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

Control0..1
Typeid
Requirements
Comments
Patient.contact.relationship.coding.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Requirements
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.

Patient.contact.relationship.coding.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control0..1
Typeuri
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

Patient.contact.relationship.coding.version
Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Control0..1
Typestring
Requirements
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Patient.contact.relationship.coding.code
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Control1..1
Typecode
Must Supporttrue
Requirements

Need to refer to a particular code in the system.

Comments
Patient.contact.relationship.coding.display
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Control0..1
Typestring
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments
Patient.contact.relationship.coding.primary
Definition

Indicates that this code was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Control0..1
Typeboolean
Requirements

This has been identified as a clinical safety criterium - that this exact code was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations.

Patient.contact.relationship.coding.valueSet
Definition

The set of possible coded values this coding was chosen from or constrained by.

Control0..1
TypeReference(Profile = (Profile = http://hl7.org/fhir/Profile/ValueSet))
Requirements

The value set may influence the codes that the user can select. Also, referencing the value set directly makes it easier to share ad-hoc code systems used across healthcare.

Comments
Patient.contact.relationship.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
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.

Patient.contact.name
Definition

A name associated with the person.

Control0..*
TypeHumanName
Must Supporttrue
Requirements

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

Comments
Patient.contact.name.id
Definition

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

Control0..1
Typeid
Requirements
Comments
Patient.contact.name.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Requirements
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.

Patient.contact.name.use
Definition

Identifies the purpose for this name.

Control0..1
BindingThe use of a human name
The codes SHALL be taken from NameUse
Typecode
Is Modifiertrue
Requirements

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

Comments

This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc for a current/permanent one. Applications can assume that a name is current unless it explicitly says that it is temporary or old.

Patient.contact.name.text
Definition

A full text representation of the name.

Control0..1
Typestring
Requirements

A renderable, unencoded form.

Comments

Can provide both a text representation and structured parts.

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.

Control1..1
Typestring
Must Supporttrue
Requirements
Alternate Namessurname
Comments

For family name, hyphenated names such as "Smith-Jones" are a single name, but names with spaces such as "Smith Jones" are broken into multiple parts.

Patient.contact.name.given
Definition

Given name.

Control0..2
Typestring
Must Supporttrue
Requirements
Alternate Namesfirst name, middle name
Comments

If only initials are recorded, they may be used in place of the full name. Not called "first name" since given names do not always come first.

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
Requirements
Comments
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..1
Typestring
Must Supporttrue
Requirements
Comments
Patient.contact.name.period
Definition

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

Control0..1
TypePeriod
Requirements

Allows names to be placed in historical context.

Comments
Patient.contact.telecom
Definition

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

Control0..3
TypeContactPoint
Must Supporttrue
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.telecom.id
Definition

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

Control0..1
Typeid
Requirements
Comments
Patient.contact.telecom.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Requirements
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.

Patient.contact.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
BindingTelecommunications form for contact point
The codes SHALL be taken from ContactPointSystem
Typecode
Must Supporttrue
Requirements
Comments
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).

Control1..1
Typestring
Must Supporttrue
Requirements

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

Comments

Additional out of band data such as extensions, or notes about use of the contact are sometimes included in the value.

Patient.contact.telecom.use
Definition

Identifies the purpose for the contact point.

Control0..1
BindingUse of contact point
The codes SHALL be taken from ContactPointUse
Typecode
Is Modifiertrue
Requirements

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

Comments

This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc for a current/permanent one. Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

Patient.contact.telecom.period
Definition

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

Control0..1
TypePeriod
Requirements
Comments
Patient.contact.address
Definition

Address for the contact person.

Control0..*
TypeAddress
Must Supporttrue
Requirements

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

Comments
Patient.contact.address.id
Definition

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

Control0..1
Typeid
Requirements
Comments
Patient.contact.address.extension (http://hl7.org/fhir/ExtensionDefinition/us-core-county)
Definition

Name of county.

Control0..1
Typestring
Requirements
Comments
Patient.contact.address.extension.id
Definition

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

Control0..1
Typeid
Requirements
Comments
Patient.contact.address.extension.extension (http://hl7.org/fhir/ExtensionDefinition/iso21090-SC-coding)
Definition

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

Control0..*
BindingA coded representation for a string. Could be codes for country in a country address part, codes for prefixes in a name part, etc.
TypeCoding
Requirements
Comments
Patient.contact.address.extension.extension.id
Definition

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

Control0..1
Typeid
Requirements
Comments
Patient.contact.address.extension.extension.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Requirements
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.

Patient.contact.address.extension.extension.url
Definition

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

Control1..1
Typeuri
Requirements
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 should be version specific. This will ideally be the URI for the Resource Profile defining the extension, with the code for the extension after a #.

Patient.contact.address.extension.extension.value[x]
Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Control0..1
Type*
Requirements
Comments
Patient.contact.address.extension.url
Definition

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

Control1..1
Typeuri
Requirements
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 should be version specific. This will ideally be the URI for the Resource Profile defining the extension, with the code for the extension after a #.

Patient.contact.address.extension.value[x]
Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Control0..1
Type*
Requirements
Comments
Patient.contact.address.use
Definition

The purpose of this address.

Control1..1
BindingThe use of an address
The codes SHALL be taken from AddressUse
Typecode
Is Modifiertrue
Must Supporttrue
Requirements

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

Comments

This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc for a current/permanent one. Applications can assume that an address is current unless it explicitly says that it is temporary or old.

Examplehome
Patient.contact.address.text
Definition

A full text representation of the address.

Control0..1
Typestring
Requirements

A renderable, unencoded form.

Comments

Can provide both a text representation and parts.

Example137 Nowhere Street, Erewhon 9132
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..2
Typestring
Must Supporttrue
Requirements

home | work | temp | old - purpose of this address.

Comments
Example137 Nowhere Street
Patient.contact.address.city
Definition

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

Control0..1
Typestring
Must Supporttrue
Requirements
Alternate NamesMuncipality
Comments
ExampleErewhon
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 (i.e. US 2 letter state codes).

Control0..1
BindingTwo letter USPS alphabetic codes.
The codes SHALL be taken from USPS Two Letter Alphabetic Codes; other codes may be used where these codes are not suitable
Typestring
Must Supporttrue
Requirements
Alternate NamesProvince, Territory
Comments
Patient.contact.address.postalCode
Definition

US Zip Codes.

Control0..1
Typestring
Must Supporttrue
Requirements
Alternate NamesZip
Comments
Example9132
InvariantsDefined on this element
inv-2: (Zip or Postal Code) SHALL be formatted as 99999[-9999] for US Zip or ZIP +4 codes or as A9A9A9 for Canadian postal codes. (xpath: f:matches(issued,[0-9]{5}(-[0-9]{4}){0,1} ))
Patient.contact.address.country
Definition

ISO 3166 3 letter Country Code.

Control0..1
BindingISO 3 letter codes
The codes SHALL be taken from USLabCountry; other codes may be used where these codes are not suitable
Typestring
Must Supporttrue
Requirements
Comments

ISO 3166 3 letter codes can be used in place of a full country name.

Patient.contact.address.period
Definition

Time period when address was/is in use.

Control0..1
TypePeriod
Requirements

Allows addresses to be placed in historical context.

Comments
Example&lt;valuePeriod&nbsp;xmlns=&quot;http://hl7.org/fhir&quot;&gt;<br/>&nbsp;&nbsp;&lt;start&nbsp;value=&quot;2010-03-23&quot;/&gt;<br/>&nbsp;&nbsp;&lt;end&nbsp;value=&quot;2010-07-01&quot;/&gt;<br/>&lt;/valuePeriod&gt;<br/>
Patient.contact.gender
Definition

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

Control0..1
BindingThe gender of a person used for administrative purposes
The codes SHALL be taken from AdministrativeGender
Typecode
Requirements

Needed to address the person correctly.

Comments
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(Profile = (Profile = http://hl7.org/fhir/Profile/Organization))
Requirements

For guardians or business related contacts, the organization is relevant.

Comments
Patient.contact.period
Definition

The period during which this person or organization is valid to be contacted relating to this patient.

Control0..1
TypePeriod
Requirements
Comments
Patient.animal
Definition

This element has a value if the patient is an animal.

Control0..1
Is Modifiertrue
Requirements

Many clinical systems are extended to care for animal patients as well as human.

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.id
Definition

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

Control0..1
Typeid
Requirements
Comments
Patient.animal.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Requirements
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.

Patient.animal.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 that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Control0..*
TypeExtension
Requirements
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.

Patient.animal.species
Definition

Identifies the high level categorization of the kind of animal.

Control1..1
BindingThe species of an animal
For example codes, see AnimalSpecies
TypeCodeableConcept
Requirements

Need to know what kind of animal.

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.

Control0..1
BindingThe breed of an animal
For example codes, see AnimalBreeds
TypeCodeableConcept
Requirements

May need to know the specific kind within the species.

Comments
Patient.animal.genderStatus
Definition

Indicates the current state of the animal's reproductive organs.

Control0..1
BindingThe state of the animal's reproductive organs
For example codes, see GenderStatus
TypeCodeableConcept
Requirements

Gender status can affect housing and animal behavior.

Comments
Patient.communication
Definition

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

Control0..*
BindingA human language
The codes SHALL be taken from http://tools.ietf.org/html/bcp47
TypeCodeableConcept
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.

Control0..*
TypeChoice of: Reference(Profile = (Profile = http://hl7.org/fhir/Profile/Organization)), Reference(Profile = (Profile = http://hl7.org/fhir/Profile/Practitioner))
Requirements
Comments
Patient.managingOrganization
Definition

Organization that is the custodian of the patient record.

Control0..1
TypeReference(Profile = (Profile = http://hl7.org/fhir/Profile/Organization))
Requirements

Need to know who recognizes this patient record, manages and updates it.

Comments
Patient.link
Definition

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

Control0..*
Is Modifiertrue
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.

Comments

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

Patient.link.id
Definition

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

Control0..1
Typeid
Requirements
Comments
Patient.link.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Requirements
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.

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 that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Control0..*
TypeExtension
Requirements
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.

Patient.link.other
Definition

The other patient resource that the link refers to.

Control1..1
TypeReference(Profile = (Profile = http://hl7.org/fhir/Profile/Patient))
Is Modifiertrue
Requirements
Comments
Patient.link.type
Definition

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

Control1..1
BindingThe type of link between this patient resource and another patient resource.
The codes SHALL be taken from LinkType
Typecode
Is Modifiertrue
Requirements
Comments
Patient.active
Definition

Whether this patient record is in active use.

Control0..1
Typeboolean
Is Modifiertrue
Requirements

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

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.

Default Valuetrue