Interweave Implementation Guide
0.1.0 - ci-build

Interweave Implementation Guide - Local Development build (v0.1.0). See the Directory of published versions

Resource Profile: InterweavePatient

Official URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Interweave-Patient Version: 0.1.0
Active as of 2024-06-10 Computable Name: InterweavePatient

Interweave Patient resource profile.

  Status: Active: Approved (STU)

Introduction

NB: Whilst the term “Patient” is used by FHIR, the profile is equally relevant to a “citizen”, “service user” or “client” in other contexts such as Social Care.

This profile sets minimum expectations for the Patient resource to record basic demographics and other administrative information about an individual patient.

The important underlying principle is that this information identifies a patient for regional sharing. It is therefore not the aim to necessarily to record every patient immediately they present to a service, but only to populate with those who have been confidently identified and with a quality of demographic information suitable for wider sharing.

Patient coverage and references

  • A Data Provider MUST offer Patient FHIR resources to represent its own patients (those that are relevant for regional sharing).
  • This includes registering these patients with PIX, such that they become available for regional sharing.
  • When referencing a Patient then the “reference” (url of FHIR Resource) and “display” (name) MUST be populated
    • The “identifier” in the reference MAY be populated with the patient’s NHS Number

Mandatory fields

Bearing in mind the above principle, the following fields are mandatory:

  1. NHS Number (fully traced and verified)
  2. Name (“usual” name, including given and family names, and matching PDS)
  3. Date of Birth (matching PDS)

Must Support fields

In addition the following fields are “Must Support” - ie they must be populated if relevant and known:

  1. Prefix and suffix for the “usual” name
  2. Gender
  3. Active status (essential if not active. Good practice to always populate anyway)
  4. Telecom (eg phone and/or email details)
  5. Address (eg a current home address)
  6. Contacts (eg next of kin and/or emergency contact)
  7. Communication preferences - only required if a language other than English is preferred. (Note that CareConnect have defined an extension to be used in preference to the standard FHIR field)

Analytical fields

The patient resource has a number of fields which are difficult to provide definitive guidance on. In the profile they are marked as “optional” as they are not necessarily essential for the provision of direct care. Their significance in terms of both data capture and display is however likely to be scenario dependant. In some scenarios they may be extremely relevant (eg Religious Affiliation at End of Life), whereas in other scenarios they may be seen as unnecessary or even intrusive information.

These fields however assume a greater importance when considering analytics - and in particular for Public Health and Equality Monitoring. Considering, for example, the requirement for monitoring of Protect Characteristics and for reducing health inequalities based on Core20Plus5. Therefore although marked as “optional” every effort should be made to populate wherever possible and appropriate:

  1. Ethnicity
  2. Religious Affiliation (Care Connect Extension)
  3. Sexual Orientation (Interweave Extension, based on NHS Data Dictionary)
  4. Residential Status

Optional fields

Other fields are optional and may be populated if known - on the understanding that not all data consumers will necessarily make use of them. Optional fields to note include:

  • Name and Address history - these can be provided if known, optionally with periods, and importantly with a “use” that distinguishes them from the current values.

Discouraged or Removed fields

Several fields are marked as “discouraged” to indicate that they are preferably not used by new implementations. These include:

  • various administrative fields and extensions - that are either not relevant to current use-cases, or are better covered by National Systems, or have been deprecated in future versions of CareConnect.

  • the “text” summary of names and addresses. This formatting and presentation can be problematic, and the preference is to allow Data Consumers to generate their own presentation from the underlying detailed fields.

  • Photo - not relevant here, and adds size and complexity to the content

Other standard FHIR fields that have been entirely removed by CareConnect are:

  • Animal - not relevant here, and also deprecated in FHIR R4

Notes on “active” and “deceased” flags

There are several flags regarding the overall status of a patient, with further guidance on their use as follows:

  • Active - this is a “technical” flag, for example used to indicate if a record was entered in error, or has been merged. It has no bearing on the actual physical state of the patient

  • Death Notification Status - this CareConnect extension will not be used. There is a formal process for death notification which is already in place outside of this Care Record. That existing process should be used and not replicated here.

  • Deceased - this flag must NOT be populated by local Data Providers. It will however be populated in the regional Master Patient Index. This MPI is based on PDS and will reflect the deceased status of the patient, as formally recorded by PDS.

Notes on additional patient-based datasets

The PRSB defines quite a number of additional datasets which provide additional rich information about the patient. For example “About Me”, “Individual Requirements”, etc. Guidance is however that in FHIR these are generally not incorporated into the basic Patient resource, are but instead represented as separate QuestionnaireResponse resources. Additional profiles of the QuestionnaireResponse to model these datasets are therefore anticipated.

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from CareConnectPatient1

NameFlagsCard.TypeDescription & Constraintsdoco
.. Patient 0..*CareConnectPatient1Information about an individual or animal receiving health care services
... id S0..1idLogical id of this artifact
... meta
.... versionId S0..1idVersion specific identifier
.... lastUpdated S0..1instantMANDATORY except in Contained Resources. When the resource version last changed.
.... profile S0..*uriProfiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
.... security 0..*CodingDISCOURAGED - may not be honoured by Data Consumers
.... Slices for tag 0..*CodingTags applied to this resource
Slice: Unordered, Open by value:system
..... tag:Source S0..1CodingMANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
...... system 1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Source
...... code S1..1codeThe Data Provider Id of the system supplying the data
...... display S1..1stringName of the system supplying the data
..... tag:Provenance S0..1CodingMANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
...... system 1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Provenance
...... code S1..1codeThe ODS Code of the organisation responsible for the data
...... display S1..1stringName of the organisation supplying the data
... implicitRules 0..1uriDISCOURAGED - may not be honoured by Data Consumers
... language 0..1codeEnglish is assumed (not currently a multi-lingual implementation)
... text 0..1NarrativeDISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
... extension:ethnicCategory 0..1Extension-CareConnect-EthnicCategory-1Ethnic Category - please provide if known. (Noting also option for 'Not Stated')
... extension:patient-cadavericDonor 0..1cadavericDonorDISCOURAGED
... extension:treatmentCategory 0..1Extension-CareConnect-TreatmentCategory-1DISCOURAGED (removed in UKCore)
... extension:nhsCommunication S0..*Extension-CareConnect-NHSCommunication-1Communication Preferences - please indicate if a preference for language other than English
.... extension:modeOfCommunication 0..*ExtensionDISCOURAGED
.... extension:communicationProficiency 0..1ExtensionDISCOURAGED
... extension:birthPlace 0..1ExtensionCareConnectbirthPlaceDISCOURAGED
... extension:nominatedPharmacy 0..1Extension-CareConnect-NominatedPharmacy-1DISCOURAGED
... extension:deathNotificationStatus 0..1Extension-CareConnect-DeathNotificationStatus-1DISCOURAGED
... sexualOrientation 0..1CodeableConceptSexual Orientation, as per NHS Data Dictionary: Person Stated Sexual Orientation Code
URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-SexualOrientation
Binding: InterweaveSexualOrientation (required)
... identifier 1..*IdentifierAn identifier for this patient
... identifier:nhsNumber S1..1IdentifierThe patient's NHS number
.... extension:nhsNumberVerificationStatus 1..1Extension-CareConnect-NHSNumberVerificationStatus-1Verification status of the NHS Number - must be traced and verified
..... value[x]:valueCodeableConcept 1..1CodeableConceptVerification status of the NHS number
Fixed Value: As shown
...... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: https://fhir.hl7.org.uk/STU3/CodeSystem/CareConnect-NHSNumberVerificationStatus-1
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: 01
....... display1..1stringRepresentation defined by the system
Fixed Value: Number present and verified
... active S0..1booleanWhether this patient's record is in active use - must be both populated and understood if 'false'. See notes on usage.
... name:official S1..1HumanNameA name associated with the patient
.... use S1..1codeusual | official | temp | nickname | anonymous | old | maiden
.... text 0..1stringDISCOURAGED: Please do not rely on this. Providers might not populate and Consumers might not use. Instead display the name based on the detailed elements.
.... family S1..1stringFamily name (often called 'Surname'). NB: First 3 letters must match PDS
.... given S1..*stringGiven names (not always 'first'). Includes middle names. NB: First letter (initial) must match PDS
.... prefix S0..*stringParts that come before the name
.... suffix S0..*stringParts that come after the name
... telecom S0..*ContactPointA contact detail for the individual
.... system S1..1codephone | fax | email | pager | url | sms | other
.... value S1..1stringThe actual contact point details
.... use S0..1codehome | work | temp | old | mobile - purpose of this contact point
... gender S0..1codemale | female | other | unknown
... birthDate S1..1dateThe date of birth for the individual. NB: Must match PDS
... deceased[x] 0..1boolean, dateTimeIndicates if the individual is deceased or not. Do not populate - populated by PDS only.
... address S0..*AddressAddresses for the individual
.... use S0..1codehome | work | temp | old - purpose of this address. Normally expect at least a 'home' address.
.... text 0..1stringDISCOURAGED: Please do not rely on this. Providers might not populate and Consumers might not use. Instead display the address based on the detailed elements.
.... line S0..*stringStreet name, number, direction & P.O. Box etc.
.... city S0..1stringName of city, town etc.
.... district S0..1stringDistrict name (aka county)
.... postalCode S0..1stringPostal code for area
... photo 0..0
... contact S0..*BackboneElementA contact party (e.g. guardian, partner, friend) for the patient
.... relationship S0..*CodeableConceptThe kind of relationship
..... coding
...... system 1..1uriIdentity of the terminology system
...... code 1..1codeSymbol in syntax defined by the system
...... display 1..1stringRepresentation defined by the system
.... name S1..1HumanNameA name associated with the contact person
..... text 0..1stringDISCOURAGED: Please do not rely on this. Providers might not populate and Consumers might not use. Instead display the name based on the detailed elements.
.... telecom S0..*ContactPointA contact detail for the person
.... address
..... text 0..1stringDISCOURAGED: Please do not rely on this. Providers might not populate and Consumers might not use. Instead display the address based on the detailed elements.
... generalPractitioner 0..*Reference(Organization | Practitioner)DISCOURAGED: PDS is the master of this information, should not normally be populated by other systems.
... managingOrganization 0..1Reference(CareConnect-Organization-1)DISCOURAGED: Already covered by the provenance tags. (If populated then must match this)
... link 0..*BackboneElementLink to another patient resource that concerns the same actual person. (For example merged record)

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Patient 0..*CareConnectPatient1Information about an individual or animal receiving health care services
... id SΣ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
.... versionId SΣ0..1idVersion specific identifier
.... lastUpdated SΣ0..1instantMANDATORY except in Contained Resources. When the resource version last changed.
.... profile SΣ0..*uriProfiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
.... security Σ0..*CodingDISCOURAGED - may not be honoured by Data Consumers
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


.... Slices for tag Σ0..*CodingTags applied to this resource
Slice: Unordered, Open by value:system
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


..... tag:Source SΣ0..1CodingMANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


...... system Σ1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Source
...... code SΣ1..1codeThe Data Provider Id of the system supplying the data
...... display SΣ1..1stringName of the system supplying the data
..... tag:Provenance SΣ0..1CodingMANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


...... system Σ1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Provenance
...... code SΣ1..1codeThe ODS Code of the organisation responsible for the data
...... display SΣ1..1stringName of the organisation supplying the data
... implicitRules ?!Σ0..1uriDISCOURAGED - may not be honoured by Data Consumers
... language 0..1codeEnglish is assumed (not currently a multi-lingual implementation)
Binding: Common Languages (extensible): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeDISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
... ethnicCategory 0..1CodeableConceptEthnic Category - please provide if known. (Noting also option for 'Not Stated')
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-EthnicCategory-1
Binding: Care Connect Ethnic Category (required): A code classifying the person's ethnicity.


... religiousAffiliation 0..1CodeableConceptReligious affiliation
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-ReligiousAffiliation-1
Binding: Care Connect Religious Affiliation (required): Religious Affiliation


... patient-cadavericDonor 0..1booleanDISCOURAGED
URL: http://hl7.org/fhir/StructureDefinition/patient-cadavericDonor
... residentialStatus 0..1CodeableConceptThe residential status of the patient
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-ResidentialStatus-1
Binding: Care Connect Residential Status (required): Residential Status


... treatmentCategory 0..1CodeableConceptDISCOURAGED (removed in UKCore)
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-TreatmentCategory-1
Binding: Care Connect Treatment Category (required): Treatment Category


... nhsCommunication S0..*(Complex)Communication Preferences - please indicate if a preference for language other than English
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-NHSCommunication-1
.... extension:language 1..1ExtensionLanguages which may be used for communication
..... url 1..1uri"language"
..... Slices for value[x] 1..1CodeableConceptValue of extension
Slice: Unordered, Closed by type:$this
...... value[x]:valueCodeableConcept 1..1CodeableConceptLanguages which may be used for communication
Binding: Care Connect Human Language (required): Human Language

.... extension:preferred 0..1ExtensionLanguage preference indicator
..... url 1..1uri"preferred"
..... Slices for value[x] 1..1booleanValue of extension
Slice: Unordered, Closed by type:$this
...... value[x]:valueBoolean 1..1booleanIndicates whether or not this language is preferred (over other languages up a certain level)
.... extension:modeOfCommunication 0..*ExtensionDISCOURAGED
..... url 1..1uri"modeOfCommunication"
..... Slices for value[x] 1..1CodeableConceptValue of extension
Slice: Unordered, Closed by type:$this
...... value[x]:valueCodeableConcept 1..1CodeableConceptA valueset to describe the mode the patient can communicate in, representing the method of expression of the language.
Binding: Care Connect Language Ability Mode (required): Language Ability Mode

.... extension:communicationProficiency 0..1ExtensionDISCOURAGED
..... url 1..1uri"communicationProficiency"
..... Slices for value[x] 1..1CodeableConceptValue of extension
Slice: Unordered, Closed by type:$this
...... value[x]:valueCodeableConcept 1..1CodeableConceptA valueset to describe the level of proficiency in communicating a language
Binding: Care Connect Language Ability Proficiency (required): Language Ability Proficiency

.... extension:interpreterRequired 0..1ExtensionInterpreter preference indicator
..... url 1..1uri"interpreterRequired"
..... Slices for value[x] 1..1booleanValue of extension
Slice: Unordered, Closed by type:$this
...... value[x]:valueBoolean 1..1booleanIndicates whether an interpreter is required for communication purposes
.... url 1..1uri"https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-NHSCommunication-1"
... birthPlace 0..1AddressDISCOURAGED
URL: http://hl7.org/fhir/StructureDefinition/birthPlace
... nominatedPharmacy 0..1Reference(CareConnect-Organization-1)DISCOURAGED
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-NominatedPharmacy-1
... deathNotificationStatus 0..1(Complex)DISCOURAGED
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-DeathNotificationStatus-1
... sexualOrientation 0..1CodeableConceptSexual Orientation, as per NHS Data Dictionary: Person Stated Sexual Orientation Code
URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-SexualOrientation
Binding: InterweaveSexualOrientation (required)
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... Slices for identifier Σ1..*IdentifierAn identifier for this patient
Slice: Unordered, Open At End by value:system
.... identifier:nhsNumber SΣ1..1IdentifierThe patient's NHS number
..... Slices for extension 1..*ExtensionExtension
Slice: Unordered, Open by value:url
..... nhsNumberVerificationStatus 1..1CodeableConceptVerification status of the NHS Number - must be traced and verified
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-NHSNumberVerificationStatus-1
Binding: Care Connect NHS Number Verification Status (required): NHS Number Verification Status


...... url 1..1uri"https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-NHSNumberVerificationStatus-1"
...... Slices for value[x] 1..1CodeableConceptValue of extension
Slice: Unordered, Closed by type:$this
....... value[x]:valueCodeableConcept 1..1CodeableConceptVerification status of the NHS number
Binding: Care Connect NHS Number Verification Status (required): NHS Number Verification Status


Fixed Value: As shown
........ id0..0stringxml:id (or equivalent in JSON)
........ extension0..0ExtensionAdditional Content defined by implementations
........ coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
......... id0..0stringxml:id (or equivalent in JSON)
......... extension0..0ExtensionAdditional Content defined by implementations
......... system1..1uriIdentity of the terminology system
Fixed Value: https://fhir.hl7.org.uk/STU3/CodeSystem/CareConnect-NHSNumberVerificationStatus-1
......... version0..0stringVersion of the system - if relevant
......... code1..1codeSymbol in syntax defined by the system
Fixed Value: 01
......... display1..1stringRepresentation defined by the system
Fixed Value: Number present and verified
......... userSelected0..0booleanIf this coding was chosen directly by the user
........ text0..0stringPlain text representation of the concept
..... use ?!Σ0..1codeusual | official | temp | secondary (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... system Σ1..1uriThe namespace for the identifier value
Fixed Value: https://fhir.nhs.uk/Id/nhs-number
..... value Σ1..1stringThe value that is unique
Example General: 123456
Example General: 1234567890
... active ?!SΣ0..1booleanWhether this patient's record is in active use - must be both populated and understood if 'false'. See notes on usage.
... Slices for name Σ1..*HumanNameA name associated with the patient
Slice: Unordered, Open At End by value:use
.... name:official SΣ1..1HumanNameA name associated with the patient
..... use ?!SΣ1..1codeusual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required): The use of a human name.


Fixed Value: official
..... text Σ0..1stringDISCOURAGED: Please do not rely on this. Providers might not populate and Consumers might not use. Instead display the name based on the detailed elements.
..... family SΣ1..1stringFamily name (often called 'Surname'). NB: First 3 letters must match PDS
..... given SΣ1..*stringGiven names (not always 'first'). Includes middle names. NB: First letter (initial) must match PDS
This repeating element order: Given Names appear in the correct order for presenting the name
..... prefix SΣ0..*stringParts that come before the name
This repeating element order: Prefixes appear in the correct order for presenting the name
..... suffix SΣ0..*stringParts that come after the name
This repeating element order: Suffixes appear in the correct order for presenting the name
... telecom SΣ0..*ContactPointA contact detail for the individual
.... system SΣC1..1codephone | fax | email | pager | url | sms | other
Binding: ContactPointSystem (required): Telecommunications form for contact point

.... value SΣ1..1stringThe actual contact point details
.... use ?!SΣ0..1codehome | work | temp | old | mobile - purpose of this contact point
Binding: ContactPointUse (required): Use of contact point

... gender SΣ0..1codemale | female | other | unknown
Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.

... birthDate SΣ1..1dateThe date of birth for the individual. NB: Must match PDS
.... patient-birthTime 0..1dateTimeTime of day of birth
URL: http://hl7.org/fhir/StructureDefinition/patient-birthTime
... deceased[x] ?!Σ0..1Indicates if the individual is deceased or not. Do not populate - populated by PDS only.
.... deceasedBooleanboolean
.... deceasedDateTimedateTime
... address SΣ0..*AddressAddresses for the individual
.... use ?!SΣ0..1codehome | work | temp | old - purpose of this address. Normally expect at least a 'home' address.
Binding: AddressUse (required): The use of an address


Example General: home
.... text Σ0..1stringDISCOURAGED: Please do not rely on this. Providers might not populate and Consumers might not use. Instead display the address based on the detailed elements.
Example General: 137 Nowhere Street, Erewhon 9132
Example General: 42 Grove Street, Overtown, West Yorkshire, LS21 1PF
.... line SΣ0..*stringStreet name, number, direction & P.O. Box etc.
This repeating element order: The order in which lines should appear in an address label
Example General: 137 Nowhere Street
Example General: 42 Grove Street
.... city SΣ0..1stringName of city, town etc.
Example General: Erewhon
Example General: Overtown
.... district SΣ0..1stringDistrict name (aka county)
Example General: Madison
Example General: West Yorkshire
.... postalCode SΣ0..1stringPostal code for area
Example General: 9132
Example General: LS21 1PF
... contact SC0..*BackboneElementA contact party (e.g. guardian, partner, friend) for the patient
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... relationship S0..*CodeableConceptThe kind of relationship
Binding: v2 Contact Role (extensible): The nature of the relationship between a patient and a contact person for that patient.


.... name S1..1HumanNameA name associated with the contact person
..... use ?!Σ1..1codeusual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required): The use of a human name

..... text Σ0..1stringDISCOURAGED: Please do not rely on this. Providers might not populate and Consumers might not use. Instead display the name based on the detailed elements.
.... telecom S0..*ContactPointA contact detail for the person
... generalPractitioner 0..*Reference(Organization | Practitioner)DISCOURAGED: PDS is the master of this information, should not normally be populated by other systems.
... managingOrganization Σ0..1Reference(CareConnect-Organization-1)DISCOURAGED: Already covered by the provenance tags. (If populated then must match this)
... link ?!Σ0..*BackboneElementLink to another patient resource that concerns the same actual person. (For example merged record)
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... other Σ1..1Reference(Patient | RelatedPerson)The other patient or related person resource that the link refers to
.... type Σ1..1codereplaced-by | replaces | refer | seealso - type of link
Binding: LinkType (required): The type of link between this patient resource and another patient resource.


doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Patient.meta.securityextensibleAll Security Labels
Patient.meta.tagexampleCommon Tags
Patient.meta.tag:SourceexampleCommon Tags
Patient.meta.tag:ProvenanceexampleCommon Tags
Patient.languageextensibleCommon Languages
Additional Bindings Purpose
AllLanguages Max Binding
Patient.extension:nhsCommunication.extension:language.value[x]:valueCodeableConceptrequiredCare Connect Human Language
Patient.extension:nhsCommunication.extension:modeOfCommunication.value[x]:valueCodeableConceptrequiredCare Connect Language Ability Mode
Patient.extension:nhsCommunication.extension:communicationProficiency.value[x]:valueCodeableConceptrequiredCare Connect Language Ability Proficiency
Patient.identifier:nhsNumber.extension:nhsNumberVerificationStatus.value[x]:valueCodeableConceptrequiredFixed Value: 01("Number present and verified")
Patient.identifier:nhsNumber.userequiredIdentifierUse
Patient.name:official.userequiredFixed Value: official
Patient.telecom.systemrequiredContactPointSystem
Patient.telecom.userequiredContactPointUse
Patient.genderrequiredAdministrativeGender
Patient.address.userequiredAddressUse
Patient.contact.relationshipextensiblev2 Contact Role
Patient.contact.name.userequiredNameUse
Patient.animal.speciesexampleAnimalSpecies
Patient.communication.languageextensibleCommon Languages
Additional Bindings Purpose
AllLanguages Max Binding
Patient.link.typerequiredLinkType

Constraints

IdGradePath(s)DetailsRequirements
dom-1errorPatientIf the resource is contained in another resource, it SHALL NOT contain any narrative
: contained.text.empty()
dom-2errorPatientIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorPatientIf 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-4errorPatientIf 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()
ele-1errorPatient.extension:ethnicCategory, Patient.extension:religiousAffiliation, Patient.extension:patient-cadavericDonor, Patient.extension:residentialStatus, Patient.extension:treatmentCategory, Patient.extension:nhsCommunication, Patient.extension:birthPlace, Patient.extension:nominatedPharmacy, Patient.extension:deathNotificationStatus, Patient.birthDate.extension:patient-birthTime, Patient.contact, Patient.linkAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
ext-1errorPatient.extension:ethnicCategory, Patient.extension:religiousAffiliation, Patient.extension:patient-cadavericDonor, Patient.extension:residentialStatus, Patient.extension:treatmentCategory, Patient.extension:nhsCommunication, Patient.extension:birthPlace, Patient.extension:nominatedPharmacy, Patient.extension:deathNotificationStatus, Patient.birthDate.extension:patient-birthTimeMust have either extensions or value[x], not both
: extension.exists() != value.exists()
pat-1errorPatient.contactSHALL at least contain a contact's details or a reference to an organization
: name.exists() or telecom.exists() or address.exists() or organization.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. Patient 0..*CareConnectPatient1Information about an individual or animal receiving health care services
... id SΣ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... versionId SΣ0..1idVersion specific identifier
.... lastUpdated SΣ0..1instantMANDATORY except in Contained Resources. When the resource version last changed.
.... profile SΣ0..*uriProfiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
.... security Σ0..*CodingDISCOURAGED - may not be honoured by Data Consumers
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


.... Slices for tag Σ0..*CodingTags applied to this resource
Slice: Unordered, Open by value:system
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


..... tag:Source SΣ0..1CodingMANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


...... id 0..1stringxml:id (or equivalent in JSON)
...... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Source
...... version Σ0..1stringVersion of the system - if relevant
...... code SΣ1..1codeThe Data Provider Id of the system supplying the data
...... display SΣ1..1stringName of the system supplying the data
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... tag:Provenance SΣ0..1CodingMANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


...... id 0..1stringxml:id (or equivalent in JSON)
...... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Provenance
...... version Σ0..1stringVersion of the system - if relevant
...... code SΣ1..1codeThe ODS Code of the organisation responsible for the data
...... display SΣ1..1stringName of the organisation supplying the data
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
... implicitRules ?!Σ0..1uriDISCOURAGED - may not be honoured by Data Consumers
... language 0..1codeEnglish is assumed (not currently a multi-lingual implementation)
Binding: Common Languages (extensible): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeDISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
... contained 0..*ResourceContained, inline Resources
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... ethnicCategory 0..1CodeableConceptEthnic Category - please provide if known. (Noting also option for 'Not Stated')
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-EthnicCategory-1
Binding: Care Connect Ethnic Category (required): A code classifying the person's ethnicity.


... religiousAffiliation 0..1CodeableConceptReligious affiliation
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-ReligiousAffiliation-1
Binding: Care Connect Religious Affiliation (required): Religious Affiliation


... patient-cadavericDonor 0..1booleanDISCOURAGED
URL: http://hl7.org/fhir/StructureDefinition/patient-cadavericDonor
... residentialStatus 0..1CodeableConceptThe residential status of the patient
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-ResidentialStatus-1
Binding: Care Connect Residential Status (required): Residential Status


... treatmentCategory 0..1CodeableConceptDISCOURAGED (removed in UKCore)
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-TreatmentCategory-1
Binding: Care Connect Treatment Category (required): Treatment Category


... nhsCommunication S0..*(Complex)Communication Preferences - please indicate if a preference for language other than English
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-NHSCommunication-1
.... id 0..1stringxml:id (or equivalent in JSON)
.... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
.... extension:language 1..1ExtensionLanguages which may be used for communication
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1uri"language"
..... Slices for value[x] 1..1CodeableConceptValue of extension
Slice: Unordered, Closed by type:$this
...... value[x]:valueCodeableConcept 1..1CodeableConceptLanguages which may be used for communication
Binding: Care Connect Human Language (required): Human Language

.... extension:preferred 0..1ExtensionLanguage preference indicator
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1uri"preferred"
..... Slices for value[x] 1..1booleanValue of extension
Slice: Unordered, Closed by type:$this
...... value[x]:valueBoolean 1..1booleanIndicates whether or not this language is preferred (over other languages up a certain level)
.... extension:modeOfCommunication 0..*ExtensionDISCOURAGED
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1uri"modeOfCommunication"
..... Slices for value[x] 1..1CodeableConceptValue of extension
Slice: Unordered, Closed by type:$this
...... value[x]:valueCodeableConcept 1..1CodeableConceptA valueset to describe the mode the patient can communicate in, representing the method of expression of the language.
Binding: Care Connect Language Ability Mode (required): Language Ability Mode

.... extension:communicationProficiency 0..1ExtensionDISCOURAGED
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1uri"communicationProficiency"
..... Slices for value[x] 1..1CodeableConceptValue of extension
Slice: Unordered, Closed by type:$this
...... value[x]:valueCodeableConcept 1..1CodeableConceptA valueset to describe the level of proficiency in communicating a language
Binding: Care Connect Language Ability Proficiency (required): Language Ability Proficiency

.... extension:interpreterRequired 0..1ExtensionInterpreter preference indicator
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
..... url 1..1uri"interpreterRequired"
..... Slices for value[x] 1..1booleanValue of extension
Slice: Unordered, Closed by type:$this
...... value[x]:valueBoolean 1..1booleanIndicates whether an interpreter is required for communication purposes
.... url 1..1uri"https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-NHSCommunication-1"
... birthPlace 0..1AddressDISCOURAGED
URL: http://hl7.org/fhir/StructureDefinition/birthPlace
... nominatedPharmacy 0..1Reference(CareConnect-Organization-1)DISCOURAGED
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-NominatedPharmacy-1
... deathNotificationStatus 0..1(Complex)DISCOURAGED
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-DeathNotificationStatus-1
... sexualOrientation 0..1CodeableConceptSexual Orientation, as per NHS Data Dictionary: Person Stated Sexual Orientation Code
URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-SexualOrientation
Binding: InterweaveSexualOrientation (required)
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... Slices for identifier Σ1..*IdentifierAn identifier for this patient
Slice: Unordered, Open At End by value:system
.... identifier:nhsNumber SΣ1..1IdentifierThe patient's NHS number
..... id 0..1stringxml:id (or equivalent in JSON)
..... Slices for extension 1..*ExtensionExtension
Slice: Unordered, Open by value:url
..... nhsNumberVerificationStatus 1..1CodeableConceptVerification status of the NHS Number - must be traced and verified
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-NHSNumberVerificationStatus-1
Binding: Care Connect NHS Number Verification Status (required): NHS Number Verification Status


...... id 0..1stringxml:id (or equivalent in JSON)
...... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
...... url 1..1uri"https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-NHSNumberVerificationStatus-1"
...... Slices for value[x] 1..1CodeableConceptValue of extension
Slice: Unordered, Closed by type:$this
....... value[x]:valueCodeableConcept 1..1CodeableConceptVerification status of the NHS number
Binding: Care Connect NHS Number Verification Status (required): NHS Number Verification Status


Fixed Value: As shown
........ id0..0stringxml:id (or equivalent in JSON)
........ extension0..0ExtensionAdditional Content defined by implementations
........ coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
......... id0..0stringxml:id (or equivalent in JSON)
......... extension0..0ExtensionAdditional Content defined by implementations
......... system1..1uriIdentity of the terminology system
Fixed Value: https://fhir.hl7.org.uk/STU3/CodeSystem/CareConnect-NHSNumberVerificationStatus-1
......... version0..0stringVersion of the system - if relevant
......... code1..1codeSymbol in syntax defined by the system
Fixed Value: 01
......... display1..1stringRepresentation defined by the system
Fixed Value: Number present and verified
......... userSelected0..0booleanIf this coding was chosen directly by the user
........ text0..0stringPlain text representation of the concept
..... use ?!Σ0..1codeusual | official | temp | secondary (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... type Σ0..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

..... system Σ1..1uriThe namespace for the identifier value
Fixed Value: https://fhir.nhs.uk/Id/nhs-number
..... value Σ1..1stringThe value that is unique
Example General: 123456
Example General: 1234567890
..... period Σ0..1PeriodTime period when id is/was valid for use
..... assigner Σ0..1Reference(CareConnect-Organization-1)Organization that issued id (may be just text)
... active ?!SΣ0..1booleanWhether this patient's record is in active use - must be both populated and understood if 'false'. See notes on usage.
... Slices for name Σ1..*HumanNameA name associated with the patient
Slice: Unordered, Open At End by value:use
.... name:official SΣ1..1HumanNameA name associated with the patient
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!SΣ1..1codeusual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required): The use of a human name.


Fixed Value: official
..... text Σ0..1stringDISCOURAGED: Please do not rely on this. Providers might not populate and Consumers might not use. Instead display the name based on the detailed elements.
..... family SΣ1..1stringFamily name (often called 'Surname'). NB: First 3 letters must match PDS
..... given SΣ1..*stringGiven names (not always 'first'). Includes middle names. NB: First letter (initial) must match PDS
This repeating element order: Given Names appear in the correct order for presenting the name
..... prefix SΣ0..*stringParts that come before the name
This repeating element order: Prefixes appear in the correct order for presenting the name
..... suffix SΣ0..*stringParts that come after the name
This repeating element order: Suffixes appear in the correct order for presenting the name
..... period Σ0..1PeriodTime period when name was/is in use
... telecom SΣ0..*ContactPointA contact detail for the individual
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... system SΣC1..1codephone | fax | email | pager | url | sms | other
Binding: ContactPointSystem (required): Telecommunications form for contact point

.... value SΣ1..1stringThe actual contact point details
.... use ?!SΣ0..1codehome | work | temp | old | mobile - purpose of this contact point
Binding: ContactPointUse (required): Use of contact point

.... rank Σ0..1positiveIntSpecify preferred order of use (1 = highest)
.... period Σ0..1PeriodTime period when the contact point was/is in use
... gender SΣ0..1codemale | female | other | unknown
Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.

... birthDate SΣ1..1dateThe date of birth for the individual. NB: Must match PDS
.... id 0..1stringxml:id (or equivalent in JSON)
.... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
.... patient-birthTime 0..1dateTimeTime of day of birth
URL: http://hl7.org/fhir/StructureDefinition/patient-birthTime
.... value 0..1datePrimitive value for date
... deceased[x] ?!Σ0..1Indicates if the individual is deceased or not. Do not populate - populated by PDS only.
.... deceasedBooleanboolean
.... deceasedDateTimedateTime
... address SΣ0..*AddressAddresses for the individual
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!SΣ0..1codehome | work | temp | old - purpose of this address. Normally expect at least a 'home' address.
Binding: AddressUse (required): The use of an address


Example General: home
.... type Σ0..1codepostal | physical | both
Binding: AddressType (required): The type of an address (physical / postal)


Example General: both
.... text Σ0..1stringDISCOURAGED: Please do not rely on this. Providers might not populate and Consumers might not use. Instead display the address based on the detailed elements.
Example General: 137 Nowhere Street, Erewhon 9132
Example General: 42 Grove Street, Overtown, West Yorkshire, LS21 1PF
.... line SΣ0..*stringStreet name, number, direction & P.O. Box etc.
This repeating element order: The order in which lines should appear in an address label
Example General: 137 Nowhere Street
Example General: 42 Grove Street
.... city SΣ0..1stringName of city, town etc.
Example General: Erewhon
Example General: Overtown
.... district SΣ0..1stringDistrict name (aka county)
Example General: Madison
Example General: West Yorkshire
.... state Σ0..1stringSub-unit of country (abbreviations ok)
.... postalCode SΣ0..1stringPostal code for area
Example General: 9132
Example General: LS21 1PF
.... country Σ0..1stringCountry (e.g. can be ISO 3166 2 or 3 letter code)
Example General: GBR
.... period Σ0..1PeriodTime period when address was/is in use
Example General: {"start":"2010-03-23","end":"2010-07-01"}
... maritalStatus 0..1CodeableConceptMarital (civil) status of a patient
Binding: Marital Status Codes (required): The domestic partnership status of a person.

.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... coding Σ1..1CodingCode defined by a terminology system
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
..... system Σ1..1uriIdentity of the terminology system
Example General: http://hl7.org/fhir/v3/MaritalStatus
..... version Σ0..1stringVersion of the system - if relevant
..... code Σ1..1codeSymbol in syntax defined by the system
..... display Σ1..1stringRepresentation defined by the system
..... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... multipleBirth[x] 0..1Whether patient is part of a multiple birth
.... multipleBirthBooleanboolean
.... multipleBirthIntegerinteger
... contact SC0..*BackboneElementA contact party (e.g. guardian, partner, friend) for the patient
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... relationship S0..*CodeableConceptThe kind of relationship
Binding: v2 Contact Role (extensible): The nature of the relationship between a patient and a contact person for that patient.


..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
..... coding Σ0..*CodingCode defined by a terminology system
...... id 0..1stringxml:id (or equivalent in JSON)
...... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ1..1codeSymbol in syntax defined by the system
...... display Σ1..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringPlain text representation of the concept
.... name S1..1HumanNameA name associated with the contact person
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ1..1codeusual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required): The use of a human name

..... text Σ0..1stringDISCOURAGED: Please do not rely on this. Providers might not populate and Consumers might not use. Instead display the name based on the detailed elements.
..... family Σ0..1stringFamily name (often called 'Surname')
..... given Σ0..*stringGiven names (not always 'first'). Includes middle names
This repeating element order: Given Names appear in the correct order for presenting the name
..... prefix Σ0..*stringParts that come before the name
This repeating element order: Prefixes appear in the correct order for presenting the name
..... suffix Σ0..*stringParts that come after the name
This repeating element order: Suffixes appear in the correct order for presenting the name
..... period Σ0..1PeriodTime period when name was/is in use
.... telecom S0..*ContactPointA contact detail for the person
.... address 0..1AddressAddress for the contact person
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ0..1codehome | work | temp | old - purpose of this address
Binding: AddressUse (required): The use of an address


Example General: home
..... type Σ0..1codepostal | physical | both
Binding: AddressType (required): The type of an address (physical / postal)


Example General: both
..... text Σ0..1stringDISCOURAGED: Please do not rely on this. Providers might not populate and Consumers might not use. Instead display the address based on the detailed elements.
Example General: 137 Nowhere Street, Erewhon 9132
Example General: 120, Grove Street, Overtown, West Yorkshire, LS21 1PT
..... line Σ0..*stringStreet name, number, direction & P.O. Box etc.
This repeating element order: The order in which lines should appear in an address label
Example General: 137 Nowhere Street
Example General: 120, Grove Street
..... city Σ0..1stringName of city, town etc.
Example General: Erewhon
Example General: Overtown
..... district Σ0..1stringDistrict name (aka county)
Example General: Madison
Example General: West Yorkshire
..... state Σ0..1stringSub-unit of country (abbreviations ok)
..... postalCode Σ0..1stringPostal code for area
Example General: 9132
Example General: LS21 1PT
..... country Σ0..1stringCountry (e.g. can be ISO 3166 2 or 3 letter code)
Example General: GBR
..... period Σ0..1PeriodTime period when address was/is in use
Example General: {"start":"2010-03-23","end":"2010-07-01"}
.... gender 0..1codemale | female | other | unknown
Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.

.... organization C0..1Reference(CareConnect-Organization-1)Organization that is associated with the contact
.... period 0..1PeriodThe period during which this contact person or organization is valid to be contacted relating to this patient
... generalPractitioner 0..*Reference(Organization | Practitioner)DISCOURAGED: PDS is the master of this information, should not normally be populated by other systems.
... managingOrganization Σ0..1Reference(CareConnect-Organization-1)DISCOURAGED: Already covered by the provenance tags. (If populated then must match this)
... link ?!Σ0..*BackboneElementLink to another patient resource that concerns the same actual person. (For example merged record)
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... other Σ1..1Reference(Patient | RelatedPerson)The other patient or related person resource that the link refers to
.... type Σ1..1codereplaced-by | replaces | refer | seealso - type of link
Binding: LinkType (required): The type of link between this patient resource and another patient resource.


doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Patient.meta.securityextensibleAll Security Labels
Patient.meta.tagexampleCommon Tags
Patient.meta.tag:SourceexampleCommon Tags
Patient.meta.tag:ProvenanceexampleCommon Tags
Patient.languageextensibleCommon Languages
Additional Bindings Purpose
AllLanguages Max Binding
Patient.extension:nhsCommunication.extension:language.value[x]:valueCodeableConceptrequiredCare Connect Human Language
Patient.extension:nhsCommunication.extension:modeOfCommunication.value[x]:valueCodeableConceptrequiredCare Connect Language Ability Mode
Patient.extension:nhsCommunication.extension:communicationProficiency.value[x]:valueCodeableConceptrequiredCare Connect Language Ability Proficiency
Patient.identifier:nhsNumber.extension:nhsNumberVerificationStatus.value[x]:valueCodeableConceptrequiredFixed Value: 01("Number present and verified")
Patient.identifier:nhsNumber.userequiredIdentifierUse
Patient.identifier:nhsNumber.typeextensibleIdentifier Type Codes
Patient.name:official.userequiredFixed Value: official
Patient.telecom.systemrequiredContactPointSystem
Patient.telecom.userequiredContactPointUse
Patient.genderrequiredAdministrativeGender
Patient.address.userequiredAddressUse
Patient.address.typerequiredAddressType
Patient.maritalStatusrequiredMarital Status Codes
Patient.contact.relationshipextensiblev2 Contact Role
Patient.contact.name.userequiredNameUse
Patient.contact.address.userequiredAddressUse
Patient.contact.address.typerequiredAddressType
Patient.contact.genderrequiredAdministrativeGender
Patient.animal.speciesexampleAnimalSpecies
Patient.animal.breedexampleAnimalBreeds
Patient.animal.genderStatusexampleGenderStatus
Patient.communication.languageextensibleCommon Languages
Additional Bindings Purpose
AllLanguages Max Binding
Patient.link.typerequiredLinkType

Constraints

IdGradePath(s)DetailsRequirements
ele-1errorPatient.extension:ethnicCategory, Patient.extension:religiousAffiliation, Patient.extension:patient-cadavericDonor, Patient.extension:residentialStatus, Patient.extension:treatmentCategory, Patient.extension:nhsCommunication, Patient.extension:birthPlace, Patient.extension:nominatedPharmacy, Patient.extension:deathNotificationStatus, Patient.birthDate.extension:patient-birthTime, Patient.contact, Patient.linkAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
ext-1errorPatient.extension:ethnicCategory, Patient.extension:religiousAffiliation, Patient.extension:patient-cadavericDonor, Patient.extension:residentialStatus, Patient.extension:treatmentCategory, Patient.extension:nhsCommunication, Patient.extension:birthPlace, Patient.extension:nominatedPharmacy, Patient.extension:deathNotificationStatus, Patient.birthDate.extension:patient-birthTimeMust have either extensions or value[x], not both
: extension.exists() != value.exists()
pat-1errorPatient.contactSHALL at least contain a contact's details or a reference to an organization
: name.exists() or telecom.exists() or address.exists() or organization.exists()

This structure is derived from CareConnectPatient1

Summary

Mandatory: 4 elements (9 nested mandatory elements)
Must-Support: 35 elements
Fixed Value: 3 elements
Prohibited: 1 element

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element Patient.meta.tag is sliced based on the value of value:system

Differential View

This structure is derived from CareConnectPatient1

NameFlagsCard.TypeDescription & Constraintsdoco
.. Patient 0..*CareConnectPatient1Information about an individual or animal receiving health care services
... id S0..1idLogical id of this artifact
... meta
.... versionId S0..1idVersion specific identifier
.... lastUpdated S0..1instantMANDATORY except in Contained Resources. When the resource version last changed.
.... profile S0..*uriProfiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
.... security 0..*CodingDISCOURAGED - may not be honoured by Data Consumers
.... Slices for tag 0..*CodingTags applied to this resource
Slice: Unordered, Open by value:system
..... tag:Source S0..1CodingMANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
...... system 1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Source
...... code S1..1codeThe Data Provider Id of the system supplying the data
...... display S1..1stringName of the system supplying the data
..... tag:Provenance S0..1CodingMANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
...... system 1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Provenance
...... code S1..1codeThe ODS Code of the organisation responsible for the data
...... display S1..1stringName of the organisation supplying the data
... implicitRules 0..1uriDISCOURAGED - may not be honoured by Data Consumers
... language 0..1codeEnglish is assumed (not currently a multi-lingual implementation)
... text 0..1NarrativeDISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
... extension:ethnicCategory 0..1Extension-CareConnect-EthnicCategory-1Ethnic Category - please provide if known. (Noting also option for 'Not Stated')
... extension:patient-cadavericDonor 0..1cadavericDonorDISCOURAGED
... extension:treatmentCategory 0..1Extension-CareConnect-TreatmentCategory-1DISCOURAGED (removed in UKCore)
... extension:nhsCommunication S0..*Extension-CareConnect-NHSCommunication-1Communication Preferences - please indicate if a preference for language other than English
.... extension:modeOfCommunication 0..*ExtensionDISCOURAGED
.... extension:communicationProficiency 0..1ExtensionDISCOURAGED
... extension:birthPlace 0..1ExtensionCareConnectbirthPlaceDISCOURAGED
... extension:nominatedPharmacy 0..1Extension-CareConnect-NominatedPharmacy-1DISCOURAGED
... extension:deathNotificationStatus 0..1Extension-CareConnect-DeathNotificationStatus-1DISCOURAGED
... sexualOrientation 0..1CodeableConceptSexual Orientation, as per NHS Data Dictionary: Person Stated Sexual Orientation Code
URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-SexualOrientation
Binding: InterweaveSexualOrientation (required)
... identifier 1..*IdentifierAn identifier for this patient
... identifier:nhsNumber S1..1IdentifierThe patient's NHS number
.... extension:nhsNumberVerificationStatus 1..1Extension-CareConnect-NHSNumberVerificationStatus-1Verification status of the NHS Number - must be traced and verified
..... value[x]:valueCodeableConcept 1..1CodeableConceptVerification status of the NHS number
Fixed Value: As shown
...... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: https://fhir.hl7.org.uk/STU3/CodeSystem/CareConnect-NHSNumberVerificationStatus-1
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: 01
....... display1..1stringRepresentation defined by the system
Fixed Value: Number present and verified
... active S0..1booleanWhether this patient's record is in active use - must be both populated and understood if 'false'. See notes on usage.
... name:official S1..1HumanNameA name associated with the patient
.... use S1..1codeusual | official | temp | nickname | anonymous | old | maiden
.... text 0..1stringDISCOURAGED: Please do not rely on this. Providers might not populate and Consumers might not use. Instead display the name based on the detailed elements.
.... family S1..1stringFamily name (often called 'Surname'). NB: First 3 letters must match PDS
.... given S1..*stringGiven names (not always 'first'). Includes middle names. NB: First letter (initial) must match PDS
.... prefix S0..*stringParts that come before the name
.... suffix S0..*stringParts that come after the name
... telecom S0..*ContactPointA contact detail for the individual
.... system S1..1codephone | fax | email | pager | url | sms | other
.... value S1..1stringThe actual contact point details
.... use S0..1codehome | work | temp | old | mobile - purpose of this contact point
... gender S0..1codemale | female | other | unknown
... birthDate S1..1dateThe date of birth for the individual. NB: Must match PDS
... deceased[x] 0..1boolean, dateTimeIndicates if the individual is deceased or not. Do not populate - populated by PDS only.
... address S0..*AddressAddresses for the individual
.... use S0..1codehome | work | temp | old - purpose of this address. Normally expect at least a 'home' address.
.... text 0..1stringDISCOURAGED: Please do not rely on this. Providers might not populate and Consumers might not use. Instead display the address based on the detailed elements.
.... line S0..*stringStreet name, number, direction & P.O. Box etc.
.... city S0..1stringName of city, town etc.
.... district S0..1stringDistrict name (aka county)
.... postalCode S0..1stringPostal code for area
... photo 0..0
... contact S0..*BackboneElementA contact party (e.g. guardian, partner, friend) for the patient
.... relationship S0..*CodeableConceptThe kind of relationship
..... coding
...... system 1..1uriIdentity of the terminology system
...... code 1..1codeSymbol in syntax defined by the system