Interweave Implementation Guide
0.1.0 - ci-build

Interweave Implementation Guide - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the R4 profiles here.

Resource Profile: CareConnectPatient1 - Detailed Descriptions

Draft as of 2019-05-31

Definitions for the CareConnect-Patient-1 resource profile.

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

1. Patient
2. Patient.extension
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
3. Patient.extension:ethnicCategory
SliceNameethnicCategory
Control0..1
TypeExtension(Extension-CareConnect-EthnicCategory-1) (Extension Type: CodeableConcept)
4. Patient.extension:religiousAffiliation
SliceNamereligiousAffiliation
Control0..1
TypeExtension(Extension-CareConnect-ReligiousAffiliation-1) (Extension Type: CodeableConcept)
5. Patient.extension:patient-cadavericDonor
SliceNamepatient-cadavericDonor
Control0..1
TypeExtension(cadavericDonor) (Extension Type: boolean)
6. Patient.extension:residentialStatus
SliceNameresidentialStatus
Control0..1
TypeExtension(Extension-CareConnect-ResidentialStatus-1) (Extension Type: CodeableConcept)
7. Patient.extension:treatmentCategory
SliceNametreatmentCategory
Control0..1
TypeExtension(Extension-CareConnect-TreatmentCategory-1) (Extension Type: CodeableConcept)
8. Patient.extension:nhsCommunication
SliceNamenhsCommunication
Control0..*
TypeExtension(Extension-CareConnect-NHSCommunication-1) (Complex Extension)
9. Patient.extension:birthPlace
SliceNamebirthPlace
Control0..1
TypeExtension(ExtensionCareConnectbirthPlace) (Extension Type: Address)
10. Patient.extension:nominatedPharmacy
SliceNamenominatedPharmacy
Control0..1
TypeExtension(Extension-CareConnect-NominatedPharmacy-1) (Extension Type: Reference)
11. Patient.extension:deathNotificationStatus
SliceNamedeathNotificationStatus
Control0..1
TypeExtension(Extension-CareConnect-DeathNotificationStatus-1) (Complex Extension)
12. Patient.identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
SlicingThis element introduces a set of slices on Patient.identifier. The slices are unordered and Open at End, and can be differentiated using the following discriminators:
  • value @ system
13. Patient.identifier:nhsNumber
SliceNamenhsNumber
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..1
14. Patient.identifier:nhsNumber.extension
Control1..?
15. Patient.identifier:nhsNumber.extension:nhsNumberVerificationStatus
SliceNamenhsNumberVerificationStatus
Control1..1
TypeExtension(Extension-CareConnect-NHSNumberVerificationStatus-1) (Extension Type: CodeableConcept)
16. Patient.identifier:nhsNumber.system
Control1..?
Fixed Valuehttps://fhir.nhs.uk/Id/nhs-number
17. Patient.identifier:nhsNumber.value
Control1..?
Example
General:1234567890
18. Patient.identifier:nhsNumber.assigner
Control0..?
TypeReference(CareConnect-Organization-1)
19. Patient.name
Control10..*
SlicingThis element introduces a set of slices on Patient.name. The slices are unordered and Open at End, and can be differentiated using the following discriminators:
  • value @ use
20. Patient.name:official
SliceNameofficial
Control1..1
21. Patient.name:official.use
Control1..?
Binding

The use of a human name.

Fixed Valueofficial
22. Patient.name:official.family
Control1..?
23. Patient.telecom
Control0..?
24. Patient.telecom.system
Control1..?
25. Patient.telecom.value
Control1..?
26. Patient.gender
27. Patient.birthDate
Control0..?
28. 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
29. Patient.birthDate.extension:patient-birthTime
SliceNamepatient-birthTime
Control0..1
TypeExtension(birthTime) (Extension Type: dateTime)
30. Patient.address
Control0..?
31. Patient.address.text
Control0..?
Example
General:42 Grove Street, Overtown, West Yorkshire, LS21 1PF
32. Patient.address.line
Control0..?
Example
General:42 Grove Street
33. Patient.address.city
Control0..?
Example
General:Overtown
34. Patient.address.district
Control0..?
Example
General:West Yorkshire
35. Patient.address.postalCode
Control0..?
Example
General:LS21 1PF
36. Patient.address.country
Control0..?
Example
General:GBR
37. Patient.maritalStatus
38. Patient.maritalStatus.coding
Control1..1
39. Patient.maritalStatus.coding.system
Control1..?
Example
General:http://hl7.org/fhir/v3/MaritalStatus
40. Patient.maritalStatus.coding.code
Control1..?
41. Patient.maritalStatus.coding.display
Control1..?
42. Patient.contact
Control0..?
43. Patient.contact.name
Control10..1
44. Patient.contact.name.use
Control1..?
45. Patient.contact.address
Control0..?
46. Patient.contact.address.text
Control0..?
Example
General:120, Grove Street, Overtown, West Yorkshire, LS21 1PT
47. Patient.contact.address.line
Control0..?
Example
General:120, Grove Street
48. Patient.contact.address.city
Control0..?
Example
General:Overtown
49. Patient.contact.address.district
Control0..?
Example
General:West Yorkshire
50. Patient.contact.address.postalCode
Control0..?
Example
General:LS21 1PT
51. Patient.contact.address.country
Control0..?
Example
General:GBR
52. Patient.contact.gender
53. Patient.contact.organization
TypeReference(CareConnect-Organization-1|Organization)
54. Patient.animal
Control0..01
55. Patient.communication
Control0..0*
56. Patient.managingOrganization
TypeReference(CareConnect-Organization-1|Organization)

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..*
Alternate NamesSubjectOfCare Client Resident
InvariantsDefined on this element
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (: contained.text.empty())
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 (: contained.where(('#'+id in %resource.descendants().reference).not()).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())
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.

Control0..1
Typeuri
Is Modifiertrue
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.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

3. Patient.extension
Definition

An Extension

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
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 on Patient.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
4. Patient.extension:ethnicCategory
SliceNameethnicCategory
Definition

The ethnicity of the subject.

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

The religious affiliation of the subject.

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

Flag indicating whether the patient authorized the donation of body parts after death.

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

The residential status of the patient. For example if this patient is a UK resident.

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

The treatment category for this patient. For example if this patient is entitled to free healthcare treatment.

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

Communication preferences including a list of Languages which may be used for communication

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.

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

Birth Place: 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 This element is affected by the following invariants: ele-1
TypeExtension(ExtensionCareConnectbirthPlace) (Extension Type: Address)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
11. Patient.extension:nominatedPharmacy
SliceNamenominatedPharmacy
Definition

A patient's nominated pharmacy.

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

This extension is constrained to represent a patient’s death notification (as held on Personal Demographics Service (PDS)).

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..1* This element is affected by the following invariants: ele-1
TypeExtension(Extension-CareConnect-DeathNotificationStatus-1) (Complex Extension)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
13. 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
Is Modifiertrue
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.

14. Patient.identifier
Definition

An identifier for this patient.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Summarytrue
Requirements

Patients are almost always assigned specific numerical identifiers.

SlicingThis element introduces a set of slices on Patient.identifier. The slices are unordered and Open at End, and can be differentiated using the following discriminators:
  • value @ system
15. Patient.identifier:nhsNumber
SliceNamenhsNumber
Definition

An identifier for this patient.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..1*
TypeIdentifier
Summarytrue
Requirements

Patients are almost always assigned specific numerical identifiers.

16. Patient.identifier:nhsNumber.extension
Definition

An Extension

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.

Control10..*
TypeExtension
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 on Patient.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
17. Patient.identifier:nhsNumber.extension:nhsNumberVerificationStatus
SliceNamenhsNumberVerificationStatus
Definition

The verification/tracing status of the NHS number.

Control1..1
TypeExtension(Extension-CareConnect-NHSNumberVerificationStatus-1) (Extension Type: CodeableConcept)
18. Patient.identifier:nhsNumber.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
Summarytrue
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.

19. Patient.identifier:nhsNumber.system
Definition

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

Control10..1
Typeuri
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.

Fixed Valuehttps://fhir.nhs.uk/Id/nhs-number
Example
General:http://www.acme.com/identifiers/patient
20. Patient.identifier:nhsNumber.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
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.

Example
General:123456
General:1234567890
21. Patient.identifier:nhsNumber.assigner
Definition

Organization that issued/manages the identifier.

Control0..1
TypeReference(CareConnect-Organization-1|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.

22. Patient.active
Definition

Whether this patient record is in active use.

Control0..1
Typeboolean
Is Modifiertrue
Summarytrue
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/record updates should occur on the other patient

This element is labeled as a modifier because when the patient record is marked as not active it is not expected to be used/referenced without being changed back to active.

Default Valuetrue
23. Patient.name
Definition

A name associated with the individual.

Control10..*
TypeHumanName
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.

SlicingThis element introduces a set of slices on Patient.name. The slices are unordered and Open at End, and can be differentiated using the following discriminators:
  • value @ use
24. Patient.name:official
SliceNameofficial
Definition

A name associated with the individual.

Control10..1*
TypeHumanName
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.

25. Patient.name:official.use
Definition

Identifies the purpose for this name.

Control10..1
BindingThe codes SHALL be taken from NameUse

The use of a human name.

The use of a human name

Typecode
Is Modifiertrue
Summarytrue
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.

Fixed Valueofficial
26. Patient.name:official.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.

Control10..1
Typestring
Summarytrue
Alternate Namessurname
Comments

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

27. Patient.gender
Definition

Administrative Gender - the gender that the patient 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
Summarytrue
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. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific gender aspect of interest (anatomical, chromosonal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosonal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overrideable error, not a "hard" error.

28. Patient.deceased[x]
Definition

Indicates if the individual is deceased or not.

Control0..1
TypeChoice of: boolean, dateTime
[x] NoteSee Choice of Data Types for further information about how to use [x]
Is Modifiertrue
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.

This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.

29. Patient.maritalStatus
Definition

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

Control0..1
BindingThe codes SHALL be taken from Marital Status CodesThe 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
Requirements

Most, if not all systems capture it.

30. Patient.maritalStatus.coding
Definition

A reference to a code defined by a terminology system.

Control10..1*
TypeCoding
Summarytrue
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 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.

31. Patient.maritalStatus.coding.system
Definition

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

Control10..1
Typeuri
Summarytrue
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.

Example
General:http://hl7.org/fhir/v3/MaritalStatus
32. Patient.maritalStatus.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).

Control10..1
Typecode
Summarytrue
Requirements

Need to refer to a particular code in the system.

33. Patient.maritalStatus.coding.display
Definition

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

Control10..1
Typestring
Summarytrue
Requirements

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

34. Patient.animal
Definition

This patient is known to be an animal.

Control0..01
TypeBackboneElement
Is Modifiertrue
Summarytrue
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 declared animal records. The absense of the animal element does not imply that the patient is a human. If a system requires such a positive assertion that the patient is human, an extension will be required. (Do not use a species of homo-sapiens in animal species, as this would incorrectly infer that the patient is an animal).

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

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

Control0..0*
TypeBackboneElement
Requirements

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

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() | (children().count() > id.count()))
36. Patient.managingOrganization
Definition

Organization that is the custodian of the patient record.

Control0..1
TypeReference(CareConnect-Organization-1|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).

37. Patient.link
Definition

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

Control0..*
TypeBackboneElement
Is Modifiertrue
Summarytrue
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.

This element is labelled as a modifier because it may not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
38. 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
Is Modifiertrue
Summarytrue
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.

39. 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.

40. 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
Summarytrue

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..*
Alternate NamesSubjectOfCare Client Resident
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 may not always be associated with version changes to the resource.

Control0..1
TypeMeta
Summarytrue
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.

Control0..1
Typeuri
Is Modifiertrue
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.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

5. Patient.language
Definition

The base language in which the resource is written.

Control0..1
BindingThe codes SHALL be taken from Common Languages; other codes may be used where these codes are not suitable A human language
Additional BindingsPurpose
AllLanguagesMax Binding
Typecode
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).

6. 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.

Control0..1 This element is affected by the following invariants: dom-1
TypeNarrative
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 in formation is added later.

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
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.

8. Patient.extension
Definition

An Extension

Control0..*
TypeExtension
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:ethnicCategory
SliceNameethnicCategory
Definition

The ethnicity of the subject.

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

The religious affiliation of the subject.

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

Flag indicating whether the patient authorized the donation of body parts after death.

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

The residential status of the patient. For example if this patient is a UK resident.

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

The treatment category for this patient. For example if this patient is entitled to free healthcare treatment.

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

Communication preferences including a list of Languages which may be used for communication

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

Birth Place: 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 This element is affected by the following invariants: ele-1
TypeExtension(ExtensionCareConnectbirthPlace) (Extension Type: Address)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
16. Patient.extension:nominatedPharmacy
SliceNamenominatedPharmacy
Definition

A patient's nominated pharmacy.

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

This extension is constrained to represent a patient’s death notification (as held on Personal Demographics Service (PDS)).

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(Extension-CareConnect-DeathNotificationStatus-1) (Complex Extension)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
18. 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
Is Modifiertrue
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.

19. Patient.identifier
Definition

An identifier for this patient.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Summarytrue
Requirements

Patients are almost always assigned specific numerical identifiers.

SlicingThis element introduces a set of slices on Patient.identifier. The slices are unordered and Open at End, and can be differentiated using the following discriminators:
  • value @ system
20. Patient.identifier:nhsNumber
SliceNamenhsNumber
Definition

An identifier for this patient.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..1
TypeIdentifier
Summarytrue
Requirements

Patients are almost always assigned specific numerical identifiers.

21. Patient.identifier:nhsNumber.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.
22. Patient.identifier:nhsNumber.extension
Definition

An Extension

Control1..*
TypeExtension
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
23. Patient.identifier:nhsNumber.extension:nhsNumberVerificationStatus
SliceNamenhsNumberVerificationStatus
Definition

The verification/tracing status of the NHS number.

Control1..1
TypeExtension(Extension-CareConnect-NHSNumberVerificationStatus-1) (Extension Type: CodeableConcept)
24. Patient.identifier:nhsNumber.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
Summarytrue
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.

25. Patient.identifier:nhsNumber.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.

26. Patient.identifier:nhsNumber.system
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttps://fhir.nhs.uk/Id/nhs-number
Example
General:http://www.acme.com/identifiers/patient
27. Patient.identifier:nhsNumber.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
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.

Example
General:123456
General:1234567890
28. Patient.identifier:nhsNumber.period
Definition

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

Control0..1
TypePeriod
Summarytrue
29. Patient.identifier:nhsNumber.assigner
Definition

Organization that issued/manages the identifier.

Control0..1
TypeReference(CareConnect-Organization-1)
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.

30. Patient.active
Definition

Whether this patient record is in active use.

Control0..1
Typeboolean
Is Modifiertrue
Summarytrue
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/record updates should occur on the other patient

This element is labeled as a modifier because when the patient record is marked as not active it is not expected to be used/referenced without being changed back to active.

Default Valuetrue
31. Patient.name
Definition

A name associated with the individual.

Control1..*
TypeHumanName
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.

SlicingThis element introduces a set of slices on Patient.name. The slices are unordered and Open at End, and can be differentiated using the following discriminators:
  • value @ use
32. Patient.name:official
SliceNameofficial
Definition

A name associated with the individual.

Control1..1
TypeHumanName
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.

33. Patient.name:official.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.
34. Patient.name:official.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
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 on Patient.name.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
35. Patient.name:official.use
Definition

Identifies the purpose for this name.

Control1..1
BindingThe codes SHALL be taken from NameUse The use of a human name
Typecode
Is Modifiertrue
Summarytrue
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.

Fixed Valueofficial
36. Patient.name:official.text
Definition

A full text representation of the name.

Control0..1
Typestring
Summarytrue
Requirements

A renderable, unencoded form.

Comments

Can provide both a text representation and structured parts.

37. Patient.name:official.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
Summarytrue
Alternate Namessurname
Comments

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

38. Patient.name:official.given
Definition

Given name.

Control0..*
Typestring
Summarytrue
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.

39. Patient.name:official.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
Summarytrue
40. Patient.name:official.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
Summarytrue
41. Patient.name:official.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.

42. Patient.telecom
Definition

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

Control0..*
TypeContactPoint
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 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).

43. 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.
44. 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
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 on Patient.telecom.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
45. 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 poin
Typecode
Summarytrue
46. 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
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.

47. Patient.telecom.use
Definition

Identifies the purpose for the contact point.

Control0..1
BindingThe codes SHALL be taken from ContactPointUse Use of contact poin
Typecode
Is Modifiertrue
Summarytrue
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.

48. Patient.telecom.rank
Definition

Specifies a preferred order in which to use a set of contacts. Contacts are ranked with lower values coming before higher values.

Control0..1
TypepositiveInt
Summarytrue
Comments

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

49. Patient.telecom.period
Definition

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

Control0..1
TypePeriod
Summarytrue
50. Patient.gender
Definition

Administrative Gender - the gender that the patient 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
Summarytrue
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. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific gender aspect of interest (anatomical, chromosonal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosonal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overrideable error, not a "hard" error.

51. Patient.birthDate
Definition

The date of birth for the individual.

Control0..1
Typedate
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 maternaty/infant care systems).

LOINC Code21112-8
52. 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.
53. Patient.birthDate.extension
Definition

An Extension

Control0..*
TypeExtension
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
54. Patient.birthDate.extension:patient-birthTime
SliceNamepatient-birthTime
Definition

The time of day that the Patient was born. This includes the date to ensure that the timezone information can be communicated effectively.

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

The actual value

Control0..1
Typedate
XML RepresentationIn the XML format, this property is represented as an attribute.
56. Patient.deceased[x]
Definition

Indicates if the individual is deceased or not.

Control0..1
TypeChoice of: boolean, dateTime
[x] NoteSee Choice of Data Types for further information about how to use [x]
Is Modifiertrue
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.

This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.

57. Patient.address
Definition

Addresses for the individual.

Control0..*
TypeAddress
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.

58. 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.
59. Patient.address.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
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 on Patient.address.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
60. Patient.address.use
Definition

The purpose of this address.

Control0..1
BindingThe codes SHALL be taken from AddressUse The use of an addres
Typecode
Is Modifiertrue
Summarytrue
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.

Example
General:home
61. 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
Summarytrue
Example
General:both
62. Patient.address.text
Definition

A full text representation of the address.

Control0..1
Typestring
Summarytrue
Requirements

A renderable, unencoded form.

Comments

Can provide both a text representation and parts.

Example
General:137 Nowhere Street, Erewhon 9132
General:42 Grove Street, Overtown, West Yorkshire, LS21 1PF
63. 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
Summarytrue
Requirements

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

Example
General:137 Nowhere Street
General:42 Grove Street
64. Patient.address.city
Definition

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

Control0..1
Typestring
Summarytrue
Alternate NamesMunicpality
Example
General:Erewhon
General:Overtown
65. Patient.address.district
Definition

The name of the administrative area (county).

Control0..1
Typestring
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
General:West Yorkshire
66. 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
Typestring
Summarytrue
Alternate NamesProvince, Territory
67. Patient.address.postalCode
Definition

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

Control0..1
Typestring
Summarytrue
Alternate NamesZip
Example
General:9132
General:LS21 1PF
68. Patient.address.country
Definition

Country - a nation as commonly understood or generally accepted.

Control0..1
Typestring
Summarytrue
Comments

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

Example
General:GBR
69. Patient.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>
70. 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 The domestic partnership status of a person
TypeCodeableConcept
Requirements

Most, if not all systems capture it.

71. Patient.maritalStatus.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.
72. Patient.maritalStatus.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
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 on Patient.maritalStatus.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
73. Patient.maritalStatus.coding
Definition

A reference to a code defined by a terminology system.

Control1..1
TypeCoding
Summarytrue
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 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.

74. Patient.maritalStatus.coding.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.
75. Patient.maritalStatus.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
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 on Patient.maritalStatus.coding.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
76. Patient.maritalStatus.coding.system
Definition

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

Control1..1
Typeuri
Summarytrue
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.

Example
General:http://hl7.org/fhir/v3/MaritalStatus
77. Patient.maritalStatus.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.

NoteThis is a business versionId, not a resource version id (see discussion)
Control0..1
Typestring
Summarytrue
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.

78. Patient.maritalStatus.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
Summarytrue
Requirements

Need to refer to a particular code in the system.

79. Patient.maritalStatus.coding.display
Definition

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

Control1..1
Typestring
Summarytrue
Requirements

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

80. Patient.maritalStatus.coding.userSelected
Definition

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

Control0..1
Typeboolean
Summarytrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair 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. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

81. Patient.maritalStatus.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
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.

82. Patient.multipleBirth[x]
Definition

Indicates whether the patient is part of a multiple (bool) 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]
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 tripplets would be valueInteger=2 and the third born would have valueInteger=3 If a bool value was provided for this tripplets examle, then all 3 patient records would have valueBool=true (the ordering is not indicated).

83. Patient.photo
Definition

Image of the patient.

Control0..*
TypeAttachment
Requirements

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

84. Patient.contact
Definition

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

Control0..*
TypeBackboneElement
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() | (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())
85. 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.
86. 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
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.

87. 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
Is Modifiertrue
Summarytrue
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.

88. Patient.contact.relationship
Definition

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

Control0..*
BindingThe codes SHALL be taken from v2 Contact Role; 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
Requirements

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

89. Patient.contact.name
Definition

A name associated with the contact person.

Control1..1
TypeHumanName
Requirements

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

90. 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.
91. 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
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 on Patient.contact.name.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
92. Patient.contact.name.use
Definition

Identifies the purpose for this name.

Control1..1
BindingThe codes SHALL be taken from NameUse The use of a human nam
Typecode
Is Modifiertrue
Summarytrue
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.

93. Patient.contact.name.text
Definition

A full text representation of the name.

Control0..1
Typestring
Summarytrue
Requirements

A renderable, unencoded form.

Comments

Can provide both a text representation and structured parts.

94. 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
Summarytrue
Alternate Namessurname
Comments

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

95. Patient.contact.name.given
Definition

Given name.

Control0..*
Typestring
Summarytrue
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.

96. 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
Summarytrue
97. 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
Summarytrue
98. 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.

99. Patient.contact.telecom
Definition

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

Control0..*
TypeContactPoint
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.

100. Patient.contact.address
Definition

Address for the contact person.

Control0..1
TypeAddress
Requirements

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

101. 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.
102. Patient.contact.address.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
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 on Patient.contact.address.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
103. Patient.contact.address.use
Definition

The purpose of this address.

Control0..1
BindingThe codes SHALL be taken from AddressUse The use of an addres
Typecode
Is Modifiertrue
Summarytrue
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.

Example
General:home
104. 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
Summarytrue
Example
General:both
105. Patient.contact.address.text
Definition

A full text representation of the address.

Control0..1
Typestring
Summarytrue
Requirements

A renderable, unencoded form.

Comments

Can provide both a text representation and parts.

Example
General:137 Nowhere Street, Erewhon 9132
General:120, Grove Street, Overtown, West Yorkshire, LS21 1PT
106. 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
Summarytrue
Requirements

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

Example
General:137 Nowhere Street
General:120, Grove Street
107. Patient.contact.address.city
Definition

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

Control0..1
Typestring
Summarytrue
Alternate NamesMunicpality
Example
General:Erewhon
General:Overtown
108. Patient.contact.address.district
Definition

The name of the administrative area (county).

Control0..1
Typestring
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
General:West Yorkshire
109. 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
Typestring
Summarytrue
Alternate NamesProvince, Territory
110. Patient.contact.address.postalCode
Definition

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

Control0..1
Typestring
Summarytrue
Alternate NamesZip
Example
General:9132
General:LS21 1PT
111. Patient.contact.address.country
Definition

Country - a nation as commonly understood or generally accepted.

Control0..1
Typestring
Summarytrue
Comments

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

Example
General:GBR
112. 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>
113. 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
Requirements

Needed to address the person correctly.

114. 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(CareConnect-Organization-1)
Requirements

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

115. 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
116. Patient.animal
Definition

This patient is known to be an animal.

Control0..0
TypeBackboneElement
Is Modifiertrue
Summarytrue
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 declared animal records. The absense of the animal element does not imply that the patient is a human. If a system requires such a positive assertion that the patient is human, an extension will be required. (Do not use a species of homo-sapiens in animal species, as this would incorrectly infer that the patient is an animal).

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

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

Control0..0
TypeBackboneElement
Requirements

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

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() | (children().count() > id.count()))
118. Patient.generalPractitioner
Definition

Patient's nominated care provider.

Control0..*
TypeReference(Organization|Practitioner)
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/disablity setting, or even organization that will provide people to perform the care provider roles.

It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources.

119. Patient.managingOrganization
Definition

Organization that is the custodian of the patient record.

Control0..1
TypeReference(CareConnect-Organization-1)
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).

120. Patient.link
Definition

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

Control0..*
TypeBackboneElement
Is Modifiertrue
Summarytrue
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.

This element is labelled as a modifier because it may not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
121. 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.
122. 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
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.

123. 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
Is Modifiertrue
Summarytrue
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.

124. 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.

125. 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
Summarytrue