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.
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 | |
Slicing | This element introduces a set of slices on Patient.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
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3. Patient.extension:ethnicCategory | |
SliceName | ethnicCategory |
Control | 0..1 |
Type | Extension(Extension-CareConnect-EthnicCategory-1) (Extension Type: CodeableConcept) |
4. Patient.extension:religiousAffiliation | |
SliceName | religiousAffiliation |
Control | 0..1 |
Type | Extension(Extension-CareConnect-ReligiousAffiliation-1) (Extension Type: CodeableConcept) |
5. Patient.extension:patient-cadavericDonor | |
SliceName | patient-cadavericDonor |
Control | 0..1 |
Type | Extension(cadavericDonor) (Extension Type: boolean) |
6. Patient.extension:residentialStatus | |
SliceName | residentialStatus |
Control | 0..1 |
Type | Extension(Extension-CareConnect-ResidentialStatus-1) (Extension Type: CodeableConcept) |
7. Patient.extension:treatmentCategory | |
SliceName | treatmentCategory |
Control | 0..1 |
Type | Extension(Extension-CareConnect-TreatmentCategory-1) (Extension Type: CodeableConcept) |
8. Patient.extension:nhsCommunication | |
SliceName | nhsCommunication |
Control | 0..* |
Type | Extension(Extension-CareConnect-NHSCommunication-1) (Complex Extension) |
9. Patient.extension:birthPlace | |
SliceName | birthPlace |
Control | 0..1 |
Type | Extension(ExtensionCareConnectbirthPlace) (Extension Type: Address) |
10. Patient.extension:nominatedPharmacy | |
SliceName | nominatedPharmacy |
Control | 0..1 |
Type | Extension(Extension-CareConnect-NominatedPharmacy-1) (Extension Type: Reference) |
11. Patient.extension:deathNotificationStatus | |
SliceName | deathNotificationStatus |
Control | 0..1 |
Type | Extension(Extension-CareConnect-DeathNotificationStatus-1) (Complex Extension) |
12. Patient.identifier | |
Note | This is a business identifier, not a resource identifier (see discussion) |
Slicing | This 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:
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13. Patient.identifier:nhsNumber | |
SliceName | nhsNumber |
Note | This is a business identifier, not a resource identifier (see discussion) |
Control | 0..1 |
14. Patient.identifier:nhsNumber.extension | |
Control | 1..? |
15. Patient.identifier:nhsNumber.extension:nhsNumberVerificationStatus | |
SliceName | nhsNumberVerificationStatus |
Control | 1..1 |
Type | Extension(Extension-CareConnect-NHSNumberVerificationStatus-1) (Extension Type: CodeableConcept) |
16. Patient.identifier:nhsNumber.system | |
Control | 1..? |
Fixed Value | https://fhir.nhs.uk/Id/nhs-number |
17. Patient.identifier:nhsNumber.value | |
Control | 1..? |
Example | General:1234567890 |
18. Patient.identifier:nhsNumber.assigner | |
Control | 0..? |
Type | Reference(CareConnect-Organization-1) |
19. Patient.name | |
Control | 10..* |
Slicing | This 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:
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20. Patient.name:official | |
SliceName | official |
Control | 1..1 |
21. Patient.name:official.use | |
Control | 1..? |
Binding | The use of a human name. |
Fixed Value | official |
22. Patient.name:official.family | |
Control | 1..? |
23. Patient.telecom | |
Control | 0..? |
24. Patient.telecom.system | |
Control | 1..? |
25. Patient.telecom.value | |
Control | 1..? |
26. Patient.gender | |
27. Patient.birthDate | |
Control | 0..? |
28. Patient.birthDate.extension | |
Control | 0..? |
Slicing | This element introduces a set of slices on Patient.birthDate.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
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29. Patient.birthDate.extension:patient-birthTime | |
SliceName | patient-birthTime |
Control | 0..1 |
Type | Extension(birthTime) (Extension Type: dateTime) |
30. Patient.address | |
Control | 0..? |
31. Patient.address.text | |
Control | 0..? |
Example | General:42 Grove Street, Overtown, West Yorkshire, LS21 1PF |
32. Patient.address.line | |
Control | 0..? |
Example | General:42 Grove Street |
33. Patient.address.city | |
Control | 0..? |
Example | General:Overtown |
34. Patient.address.district | |
Control | 0..? |
Example | General:West Yorkshire |
35. Patient.address.postalCode | |
Control | 0..? |
Example | General:LS21 1PF |
36. Patient.address.country | |
Control | 0..? |
Example | General:GBR |
37. Patient.maritalStatus | |
38. Patient.maritalStatus.coding | |
Control | 1..1 |
39. Patient.maritalStatus.coding.system | |
Control | 1..? |
Example | General:http://hl7.org/fhir/v3/MaritalStatus |
40. Patient.maritalStatus.coding.code | |
Control | 1..? |
41. Patient.maritalStatus.coding.display | |
Control | 1..? |
42. Patient.contact | |
Control | 0..? |
43. Patient.contact.name | |
Control | 10..1 |
44. Patient.contact.name.use | |
Control | 1..? |
45. Patient.contact.address | |
Control | 0..? |
46. Patient.contact.address.text | |
Control | 0..? |
Example | General:120, Grove Street, Overtown, West Yorkshire, LS21 1PT |
47. Patient.contact.address.line | |
Control | 0..? |
Example | General:120, Grove Street |
48. Patient.contact.address.city | |
Control | 0..? |
Example | General:Overtown |
49. Patient.contact.address.district | |
Control | 0..? |
Example | General:West Yorkshire |
50. Patient.contact.address.postalCode | |
Control | 0..? |
Example | General:LS21 1PT |
51. Patient.contact.address.country | |
Control | 0..? |
Example | General:GBR |
52. Patient.contact.gender | |
53. Patient.contact.organization | |
Type | Reference(CareConnect-Organization-1|Organization) |
54. Patient.animal | |
Control | 0..01 |
55. Patient.communication | |
Control | 0..0* |
56. Patient.managingOrganization | |
Type | Reference(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. |
Control | 0..* |
Alternate Names | SubjectOfCare Client Resident |
Invariants | Defined 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. |
Control | 0..1 |
Type | uri |
Is Modifier | true |
Summary | true |
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. |
Control | 0..* |
Type | Extension |
Alternate Names | extensions, 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. |
Slicing | This element introduces a set of slices on Patient.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
|
4. Patient.extension:ethnicCategory | |
SliceName | ethnicCategory |
Definition | The ethnicity of the subject. |
Control | 0..1 This element is affected by the following invariants: ele-1 |
Type | Extension(Extension-CareConnect-EthnicCategory-1) (Extension Type: CodeableConcept) |
Invariants | Defined 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 | |
SliceName | religiousAffiliation |
Definition | The religious affiliation of the subject. |
Control | 0..1 This element is affected by the following invariants: ele-1 |
Type | Extension(Extension-CareConnect-ReligiousAffiliation-1) (Extension Type: CodeableConcept) |
Invariants | Defined 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 | |
SliceName | patient-cadavericDonor |
Definition | Flag indicating whether the patient authorized the donation of body parts after death. |
Control | 0..1 This element is affected by the following invariants: ele-1 |
Type | Extension(cadavericDonor) (Extension Type: boolean) |
Invariants | Defined 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 | |
SliceName | residentialStatus |
Definition | The residential status of the patient. For example if this patient is a UK resident. |
Control | 0..1 This element is affected by the following invariants: ele-1 |
Type | Extension(Extension-CareConnect-ResidentialStatus-1) (Extension Type: CodeableConcept) |
Invariants | Defined 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 | |
SliceName | treatmentCategory |
Definition | The treatment category for this patient. For example if this patient is entitled to free healthcare treatment. |
Control | 0..1 This element is affected by the following invariants: ele-1 |
Type | Extension(Extension-CareConnect-TreatmentCategory-1) (Extension Type: CodeableConcept) |
Invariants | Defined 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 | |
SliceName | nhsCommunication |
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 |
Type | Extension(Extension-CareConnect-NHSCommunication-1) (Complex Extension) |
Invariants | Defined 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 | |
SliceName | birthPlace |
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. |
Control | 0..1 This element is affected by the following invariants: ele-1 |
Type | Extension(ExtensionCareConnectbirthPlace) (Extension Type: Address) |
Invariants | Defined 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 | |
SliceName | nominatedPharmacy |
Definition | A patient's nominated pharmacy. |
Control | 0..1 This element is affected by the following invariants: ele-1 |
Type | Extension(Extension-CareConnect-NominatedPharmacy-1) (Extension Type: Reference) |
Invariants | Defined 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 | |
SliceName | deathNotificationStatus |
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. |
Control | 0..1* This element is affected by the following invariants: ele-1 |
Type | Extension(Extension-CareConnect-DeathNotificationStatus-1) (Complex Extension) |
Invariants | Defined 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. |
Control | 0..* |
Type | Extension |
Is Modifier | true |
Alternate Names | extensions, 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. |
Note | This is a business identifier, not a resource identifier (see discussion) |
Control | 0..* |
Type | Identifier |
Summary | true |
Requirements | Patients are almost always assigned specific numerical identifiers. |
Slicing | This 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:
|
15. Patient.identifier:nhsNumber | |
SliceName | nhsNumber |
Definition | An identifier for this patient. |
Note | This is a business identifier, not a resource identifier (see discussion) |
Control | 0..1* |
Type | Identifier |
Summary | true |
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. |
Control | 10..* |
Type | Extension |
Alternate Names | extensions, 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. |
Slicing | This element introduces a set of slices on Patient.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
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17. Patient.identifier:nhsNumber.extension:nhsNumberVerificationStatus | |
SliceName | nhsNumberVerificationStatus |
Definition | The verification/tracing status of the NHS number. |
Control | 1..1 |
Type | Extension(Extension-CareConnect-NHSNumberVerificationStatus-1) (Extension Type: CodeableConcept) |
18. Patient.identifier:nhsNumber.use | |
Definition | The purpose of this identifier. |
Control | 0..1 |
Binding | The codes SHALL be taken from IdentifierUse Identifies the purpose for this identifier, if known . |
Type | code |
Is Modifier | true |
Summary | true |
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. |
Control | 10..1 |
Type | uri |
Summary | true |
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 Value | https://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. |
Control | 10..1 |
Type | string |
Summary | true |
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. |
Control | 0..1 |
Type | Reference(CareConnect-Organization-1|Organization) |
Summary | true |
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. |
Control | 0..1 |
Type | boolean |
Is Modifier | true |
Summary | true |
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 Value | true |
23. Patient.name | |
Definition | A name associated with the individual. |
Control | 10..* |
Type | HumanName |
Summary | true |
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. |
Slicing | This 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:
|
24. Patient.name:official | |
SliceName | official |
Definition | A name associated with the individual. |
Control | 10..1* |
Type | HumanName |
Summary | true |
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. |
Control | 10..1 |
Binding | The codes SHALL be taken from NameUse The use of a human name. The use of a human name |
Type | code |
Is Modifier | true |
Summary | true |
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 Value | official |
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. |
Control | 10..1 |
Type | string |
Summary | true |
Alternate Names | surname |
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. |
Control | 0..1 |
Binding | The codes SHALL be taken from AdministrativeGender The gender of a person used for administrative purposes. |
Type | code |
Summary | true |
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. |
Control | 0..1 |
Type | Choice of: boolean, dateTime |
[x] Note | See Choice of Data Types for further information about how to use [x] |
Is Modifier | true |
Summary | true |
Requirements | The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive. |
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. |
Control | 0..1 |
Binding | The 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. |
Type | CodeableConcept |
Requirements | Most, if not all systems capture it. |
30. Patient.maritalStatus.coding | |
Definition | A reference to a code defined by a terminology system. |
Control | 10..1* |
Type | Coding |
Summary | true |
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. |
Control | 10..1 |
Type | uri |
Summary | true |
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). |
Control | 10..1 |
Type | code |
Summary | true |
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. |
Control | 10..1 |
Type | string |
Summary | true |
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. |
Control | 0..01 |
Type | BackboneElement |
Is Modifier | true |
Summary | true |
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). |
Invariants | Defined 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. |
Control | 0..0* |
Type | BackboneElement |
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. |
Invariants | Defined 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. |
Control | 0..1 |
Type | Reference(CareConnect-Organization-1|Organization) |
Summary | true |
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. |
Control | 0..* |
Type | BackboneElement |
Is Modifier | true |
Summary | true |
Requirements | There are multiple usecases:
|
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'. |
Invariants | Defined 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. |
Control | 0..* |
Type | Extension |
Is Modifier | true |
Summary | true |
Alternate Names | extensions, 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. |
Control | 1..1 |
Type | Reference(Patient|RelatedPerson) |
Summary | true |
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. |
Control | 1..1 |
Binding | The codes SHALL be taken from LinkType The type of link between this patient resource and another patient resource. |
Type | code |
Summary | true |
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. | ||||
Control | 0..* | ||||
Alternate Names | SubjectOfCare 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. | ||||
Control | 0..1 | ||||
Type | id | ||||
Summary | true | ||||
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. | ||||
Control | 0..1 | ||||
Type | Meta | ||||
Summary | true | ||||
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. | ||||
Control | 0..1 | ||||
Type | uri | ||||
Is Modifier | true | ||||
Summary | true | ||||
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. | ||||
Control | 0..1 | ||||
Binding | The codes SHALL be taken from Common Languages; other codes may be used where these codes are not suitable
A human language
| ||||
Type | code | ||||
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. | ||||
Control | 0..1 This element is affected by the following invariants: dom-1 | ||||
Type | Narrative | ||||
Alternate Names | narrative, 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. | ||||
Control | 0..* | ||||
Type | Resource | ||||
Alternate Names | inline 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 | ||||
Control | 0..* | ||||
Type | Extension | ||||
Slicing | This element introduces a set of slices on Patient.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
| ||||
9. Patient.extension:ethnicCategory | |||||
SliceName | ethnicCategory | ||||
Definition | The ethnicity of the subject. | ||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
Type | Extension(Extension-CareConnect-EthnicCategory-1) (Extension Type: CodeableConcept) | ||||
Invariants | Defined 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 | |||||
SliceName | religiousAffiliation | ||||
Definition | The religious affiliation of the subject. | ||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
Type | Extension(Extension-CareConnect-ReligiousAffiliation-1) (Extension Type: CodeableConcept) | ||||
Invariants | Defined 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 | |||||
SliceName | patient-cadavericDonor | ||||
Definition | Flag indicating whether the patient authorized the donation of body parts after death. | ||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
Type | Extension(cadavericDonor) (Extension Type: boolean) | ||||
Invariants | Defined 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 | |||||
SliceName | residentialStatus | ||||
Definition | The residential status of the patient. For example if this patient is a UK resident. | ||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
Type | Extension(Extension-CareConnect-ResidentialStatus-1) (Extension Type: CodeableConcept) | ||||
Invariants | Defined 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 | |||||
SliceName | treatmentCategory | ||||
Definition | The treatment category for this patient. For example if this patient is entitled to free healthcare treatment. | ||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
Type | Extension(Extension-CareConnect-TreatmentCategory-1) (Extension Type: CodeableConcept) | ||||
Invariants | Defined 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 | |||||
SliceName | nhsCommunication | ||||
Definition | Communication preferences including a list of Languages which may be used for communication | ||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||
Type | Extension(Extension-CareConnect-NHSCommunication-1) (Complex Extension) | ||||
Invariants | Defined 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 | |||||
SliceName | birthPlace | ||||
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. | ||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
Type | Extension(ExtensionCareConnectbirthPlace) (Extension Type: Address) | ||||
Invariants | Defined 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 | |||||
SliceName | nominatedPharmacy | ||||
Definition | A patient's nominated pharmacy. | ||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
Type | Extension(Extension-CareConnect-NominatedPharmacy-1) (Extension Type: Reference) | ||||
Invariants | Defined 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 | |||||
SliceName | deathNotificationStatus | ||||
Definition | This extension is constrained to represent a patient’s death notification (as held on Personal Demographics Service (PDS)). | ||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
Type | Extension(Extension-CareConnect-DeathNotificationStatus-1) (Complex Extension) | ||||
Invariants | Defined 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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | true | ||||
Alternate Names | extensions, 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. | ||||
Note | This is a business identifier, not a resource identifier (see discussion) | ||||
Control | 0..* | ||||
Type | Identifier | ||||
Summary | true | ||||
Requirements | Patients are almost always assigned specific numerical identifiers. | ||||
Slicing | This 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:
| ||||
20. Patient.identifier:nhsNumber | |||||
SliceName | nhsNumber | ||||
Definition | An identifier for this patient. | ||||
Note | This is a business identifier, not a resource identifier (see discussion) | ||||
Control | 0..1 | ||||
Type | Identifier | ||||
Summary | true | ||||
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. | ||||
Control | 0..1 | ||||
Type | string | ||||
XML Representation | In the XML format, this property is represented as an attribute. | ||||
22. Patient.identifier:nhsNumber.extension | |||||
Definition | An Extension | ||||
Control | 1..* | ||||
Type | Extension | ||||
Slicing | This element introduces a set of slices on Patient.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
| ||||
23. Patient.identifier:nhsNumber.extension:nhsNumberVerificationStatus | |||||
SliceName | nhsNumberVerificationStatus | ||||
Definition | The verification/tracing status of the NHS number. | ||||
Control | 1..1 | ||||
Type | Extension(Extension-CareConnect-NHSNumberVerificationStatus-1) (Extension Type: CodeableConcept) | ||||
24. Patient.identifier:nhsNumber.use | |||||
Definition | The purpose of this identifier. | ||||
Control | 0..1 | ||||
Binding | The codes SHALL be taken from IdentifierUse Identifies the purpose for this identifier, if known | ||||
Type | code | ||||
Is Modifier | true | ||||
Summary | true | ||||
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. | ||||
Control | 0..1 | ||||
Binding | The 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 | ||||
Type | CodeableConcept | ||||
Summary | true | ||||
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. | ||||
Control | 1..1 | ||||
Type | uri | ||||
Summary | true | ||||
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 Value | https://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. | ||||
Control | 1..1 | ||||
Type | string | ||||
Summary | true | ||||
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. | ||||
Control | 0..1 | ||||
Type | Period | ||||
Summary | true | ||||
29. Patient.identifier:nhsNumber.assigner | |||||
Definition | Organization that issued/manages the identifier. | ||||
Control | 0..1 | ||||
Type | Reference(CareConnect-Organization-1) | ||||
Summary | true | ||||
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. | ||||
Control | 0..1 | ||||
Type | boolean | ||||
Is Modifier | true | ||||
Summary | true | ||||
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 Value | true | ||||
31. Patient.name | |||||
Definition | A name associated with the individual. | ||||
Control | 1..* | ||||
Type | HumanName | ||||
Summary | true | ||||
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. | ||||
Slicing | This 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:
| ||||
32. Patient.name:official | |||||
SliceName | official | ||||
Definition | A name associated with the individual. | ||||
Control | 1..1 | ||||
Type | HumanName | ||||
Summary | true | ||||
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. | ||||
Control | 0..1 | ||||
Type | string | ||||
XML Representation | In 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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Alternate Names | extensions, 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. | ||||
Slicing | This element introduces a set of slices on Patient.name.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
| ||||
35. Patient.name:official.use | |||||
Definition | Identifies the purpose for this name. | ||||
Control | 1..1 | ||||
Binding | The codes SHALL be taken from NameUse The use of a human name | ||||
Type | code | ||||
Is Modifier | true | ||||
Summary | true | ||||
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 Value | official | ||||
36. Patient.name:official.text | |||||
Definition | A full text representation of the name. | ||||
Control | 0..1 | ||||
Type | string | ||||
Summary | true | ||||
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. | ||||
Control | 1..1 | ||||
Type | string | ||||
Summary | true | ||||
Alternate Names | surname | ||||
Comments | Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures). | ||||
38. Patient.name:official.given | |||||
Definition | Given name. | ||||
Control | 0..* | ||||
Type | string | ||||
Summary | true | ||||
Alternate Names | first 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. | ||||
Control | 0..* | ||||
Type | string | ||||
Summary | true | ||||
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. | ||||
Control | 0..* | ||||
Type | string | ||||
Summary | true | ||||
41. Patient.name:official.period | |||||
Definition | Indicates the period of time when this name was valid for the named person. | ||||
Control | 0..1 | ||||
Type | Period | ||||
Summary | true | ||||
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. | ||||
Control | 0..* | ||||
Type | ContactPoint | ||||
Summary | true | ||||
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. | ||||
Control | 0..1 | ||||
Type | string | ||||
XML Representation | In 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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Alternate Names | extensions, 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. | ||||
Slicing | This element introduces a set of slices on Patient.telecom.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
| ||||
45. Patient.telecom.system | |||||
Definition | Telecommunications form for contact point - what communications system is required to make use of the contact. | ||||
Control | 1..1 This element is affected by the following invariants: cpt-2 | ||||
Binding | The codes SHALL be taken from ContactPointSystem Telecommunications form for contact poin | ||||
Type | code | ||||
Summary | true | ||||
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). | ||||
Control | 1..1 | ||||
Type | string | ||||
Summary | true | ||||
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. | ||||
Control | 0..1 | ||||
Binding | The codes SHALL be taken from ContactPointUse Use of contact poin | ||||
Type | code | ||||
Is Modifier | true | ||||
Summary | true | ||||
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. | ||||
Control | 0..1 | ||||
Type | positiveInt | ||||
Summary | true | ||||
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. | ||||
Control | 0..1 | ||||
Type | Period | ||||
Summary | true | ||||
50. Patient.gender | |||||
Definition | Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes. | ||||
Control | 0..1 | ||||
Binding | The codes SHALL be taken from AdministrativeGender The gender of a person used for administrative purposes | ||||
Type | code | ||||
Summary | true | ||||
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. | ||||
Control | 0..1 | ||||
Type | date | ||||
Summary | true | ||||
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 Code | 21112-8 | ||||
52. Patient.birthDate.id | |||||
Definition | unique id for the element within a resource (for internal references) | ||||
Control | 0..1 | ||||
Type | string | ||||
XML Representation | In the XML format, this property is represented as an attribute. | ||||
53. Patient.birthDate.extension | |||||
Definition | An Extension | ||||
Control | 0..* | ||||
Type | Extension | ||||
Slicing | This element introduces a set of slices on Patient.birthDate.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
| ||||
54. Patient.birthDate.extension:patient-birthTime | |||||
SliceName | patient-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. | ||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
Type | Extension(birthTime) (Extension Type: dateTime) | ||||
Invariants | Defined 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 | ||||
Control | 0..1 | ||||
Type | date | ||||
XML Representation | In the XML format, this property is represented as an attribute. | ||||
56. Patient.deceased[x] | |||||
Definition | Indicates if the individual is deceased or not. | ||||
Control | 0..1 | ||||
Type | Choice of: boolean, dateTime | ||||
[x] Note | See Choice of Data Types for further information about how to use [x] | ||||
Is Modifier | true | ||||
Summary | true | ||||
Requirements | The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive. | ||||
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. | ||||
Control | 0..* | ||||
Type | Address | ||||
Summary | true | ||||
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. | ||||
Control | 0..1 | ||||
Type | string | ||||
XML Representation | In 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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Alternate Names | extensions, 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. | ||||
Slicing | This element introduces a set of slices on Patient.address.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
| ||||
60. Patient.address.use | |||||
Definition | The purpose of this address. | ||||
Control | 0..1 | ||||
Binding | The codes SHALL be taken from AddressUse The use of an addres | ||||
Type | code | ||||
Is Modifier | true | ||||
Summary | true | ||||
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. | ||||
Control | 0..1 | ||||
Binding | The codes SHALL be taken from AddressType The type of an address (physical / postal | ||||
Type | code | ||||
Summary | true | ||||
Example | General:both | ||||
62. Patient.address.text | |||||
Definition | A full text representation of the address. | ||||
Control | 0..1 | ||||
Type | string | ||||
Summary | true | ||||
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. | ||||
Control | 0..* | ||||
Type | string | ||||
Summary | true | ||||
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. | ||||
Control | 0..1 | ||||
Type | string | ||||
Summary | true | ||||
Alternate Names | Municpality | ||||
Example | General:Erewhon General:Overtown | ||||
65. Patient.address.district | |||||
Definition | The name of the administrative area (county). | ||||
Control | 0..1 | ||||
Type | string | ||||
Summary | true | ||||
Alternate Names | County | ||||
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). | ||||
Control | 0..1 | ||||
Type | string | ||||
Summary | true | ||||
Alternate Names | Province, Territory | ||||
67. Patient.address.postalCode | |||||
Definition | A postal code designating a region defined by the postal service. | ||||
Control | 0..1 | ||||
Type | string | ||||
Summary | true | ||||
Alternate Names | Zip | ||||
Example | General:9132 General:LS21 1PF | ||||
68. Patient.address.country | |||||
Definition | Country - a nation as commonly understood or generally accepted. | ||||
Control | 0..1 | ||||
Type | string | ||||
Summary | true | ||||
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. | ||||
Control | 0..1 | ||||
Type | Period | ||||
Summary | true | ||||
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. | ||||
Control | 0..1 | ||||
Binding | The codes SHALL be taken from Marital Status Codes The domestic partnership status of a person | ||||
Type | CodeableConcept | ||||
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. | ||||
Control | 0..1 | ||||
Type | string | ||||
XML Representation | In 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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Alternate Names | extensions, 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. | ||||
Slicing | This element introduces a set of slices on Patient.maritalStatus.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
| ||||
73. Patient.maritalStatus.coding | |||||
Definition | A reference to a code defined by a terminology system. | ||||
Control | 1..1 | ||||
Type | Coding | ||||
Summary | true | ||||
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. | ||||
Control | 0..1 | ||||
Type | string | ||||
XML Representation | In 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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Alternate Names | extensions, 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. | ||||
Slicing | This 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:
| ||||
76. Patient.maritalStatus.coding.system | |||||
Definition | The identification of the code system that defines the meaning of the symbol in the code. | ||||
Control | 1..1 | ||||
Type | uri | ||||
Summary | true | ||||
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. | ||||
Note | This is a business versionId, not a resource version id (see discussion) | ||||
Control | 0..1 | ||||
Type | string | ||||
Summary | true | ||||
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). | ||||
Control | 1..1 | ||||
Type | code | ||||
Summary | true | ||||
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. | ||||
Control | 1..1 | ||||
Type | string | ||||
Summary | true | ||||
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). | ||||
Control | 0..1 | ||||
Type | boolean | ||||
Summary | true | ||||
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. | ||||
Control | 0..1 | ||||
Type | string | ||||
Summary | true | ||||
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). | ||||
Control | 0..1 | ||||
Type | Choice of: boolean, integer | ||||
[x] Note | See 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. | ||||
Control | 0..* | ||||
Type | Attachment | ||||
Requirements | Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too. | ||||
84. Patient.contact | |||||
Definition | A contact party (e.g. guardian, partner, friend) for the patient. | ||||
Control | 0..* | ||||
Type | BackboneElement | ||||
Requirements | Need to track people you can contact about the patient. | ||||
Comments | Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact. | ||||
Invariants | Defined on this element 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. | ||||
Control | 0..1 | ||||
Type | string | ||||
XML Representation | In 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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Alternate Names | extensions, 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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | true | ||||
Summary | true | ||||
Alternate Names | extensions, 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. | ||||
Control | 0..* | ||||
Binding | The 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 | ||||
Type | CodeableConcept | ||||
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. | ||||
Control | 1..1 | ||||
Type | HumanName | ||||
Requirements | Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that 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. | ||||
Control | 0..1 | ||||
Type | string | ||||
XML Representation | In 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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Alternate Names | extensions, 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. | ||||
Slicing | This 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:
| ||||
92. Patient.contact.name.use | |||||
Definition | Identifies the purpose for this name. | ||||
Control | 1..1 | ||||
Binding | The codes SHALL be taken from NameUse The use of a human nam | ||||
Type | code | ||||
Is Modifier | true | ||||
Summary | true | ||||
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. | ||||
Control | 0..1 | ||||
Type | string | ||||
Summary | true | ||||
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. | ||||
Control | 0..1 | ||||
Type | string | ||||
Summary | true | ||||
Alternate Names | surname | ||||
Comments | Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures). | ||||
95. Patient.contact.name.given | |||||
Definition | Given name. | ||||
Control | 0..* | ||||
Type | string | ||||
Summary | true | ||||
Alternate Names | first 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. | ||||
Control | 0..* | ||||
Type | string | ||||
Summary | true | ||||
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. | ||||
Control | 0..* | ||||
Type | string | ||||
Summary | true | ||||
98. Patient.contact.name.period | |||||
Definition | Indicates the period of time when this name was valid for the named person. | ||||
Control | 0..1 | ||||
Type | Period | ||||
Summary | true | ||||
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. | ||||
Control | 0..* | ||||
Type | ContactPoint | ||||
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. | ||||
Control | 0..1 | ||||
Type | Address | ||||
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. | ||||
Control | 0..1 | ||||
Type | string | ||||
XML Representation | In 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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Alternate Names | extensions, 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. | ||||
Slicing | This 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:
| ||||
103. Patient.contact.address.use | |||||
Definition | The purpose of this address. | ||||
Control | 0..1 | ||||
Binding | The codes SHALL be taken from AddressUse The use of an addres | ||||
Type | code | ||||
Is Modifier | true | ||||
Summary | true | ||||
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. | ||||
Control | 0..1 | ||||
Binding | The codes SHALL be taken from AddressType The type of an address (physical / postal | ||||
Type | code | ||||
Summary | true | ||||
Example | General:both | ||||
105. Patient.contact.address.text | |||||
Definition | A full text representation of the address. | ||||
Control | 0..1 | ||||
Type | string | ||||
Summary | true | ||||
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. | ||||
Control | 0..* | ||||
Type | string | ||||
Summary | true | ||||
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. | ||||
Control | 0..1 | ||||
Type | string | ||||
Summary | true | ||||
Alternate Names | Municpality | ||||
Example | General:Erewhon General:Overtown | ||||
108. Patient.contact.address.district | |||||
Definition | The name of the administrative area (county). | ||||
Control | 0..1 | ||||
Type | string | ||||
Summary | true | ||||
Alternate Names | County | ||||
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). | ||||
Control | 0..1 | ||||
Type | string | ||||
Summary | true | ||||
Alternate Names | Province, Territory | ||||
110. Patient.contact.address.postalCode | |||||
Definition | A postal code designating a region defined by the postal service. | ||||
Control | 0..1 | ||||
Type | string | ||||
Summary | true | ||||
Alternate Names | Zip | ||||
Example | General:9132 General:LS21 1PT | ||||
111. Patient.contact.address.country | |||||
Definition | Country - a nation as commonly understood or generally accepted. | ||||
Control | 0..1 | ||||
Type | string | ||||
Summary | true | ||||
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. | ||||
Control | 0..1 | ||||
Type | Period | ||||
Summary | true | ||||
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. | ||||
Control | 0..1 | ||||
Binding | The codes SHALL be taken from AdministrativeGender The gender of a person used for administrative purposes | ||||
Type | code | ||||
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. | ||||
Control | 0..1 This element is affected by the following invariants: pat-1 | ||||
Type | Reference(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. | ||||
Control | 0..1 | ||||
Type | Period | ||||
116. Patient.animal | |||||
Definition | This patient is known to be an animal. | ||||
Control | 0..0 | ||||
Type | BackboneElement | ||||
Is Modifier | true | ||||
Summary | true | ||||
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). | ||||
Invariants | Defined 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. | ||||
Control | 0..0 | ||||
Type | BackboneElement | ||||
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. | ||||
Invariants | Defined 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. | ||||
Control | 0..* | ||||
Type | Reference(Organization|Practitioner) | ||||
Alternate Names | careProvider | ||||
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. | ||||
Control | 0..1 | ||||
Type | Reference(CareConnect-Organization-1) | ||||
Summary | true | ||||
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. | ||||
Control | 0..* | ||||
Type | BackboneElement | ||||
Is Modifier | true | ||||
Summary | true | ||||
Requirements | There are multiple usecases:
| ||||
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'. | ||||
Invariants | Defined 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. | ||||
Control | 0..1 | ||||
Type | string | ||||
XML Representation | In 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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Alternate Names | extensions, 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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | true | ||||
Summary | true | ||||
Alternate Names | extensions, 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. | ||||
Control | 1..1 | ||||
Type | Reference(Patient|RelatedPerson) | ||||
Summary | true | ||||
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. | ||||
Control | 1..1 | ||||
Binding | The codes SHALL be taken from LinkType The type of link between this patient resource and another patient resource | ||||
Type | code | ||||
Summary | true |