2025.2.0 - ci-build

IGTTPFHIRGatewayWorkflowbasierteSchnittstellen - Local Development build (v2025.2.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: Idat - Detailed Descriptions

Active as of 2026-02-18

Definitions for the Idat resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. Patient
Definition

Demographics and other administrative information about an individual or animal receiving care or other health-related services.

ShortPatienten-Profil zur Übermittlung von angeforderten IDATInformation about an individual or animal receiving health care services
Comments

Die per $requestTasks vorgegebenen Element-Bezeichner sind wie folgt gemappt:

given: name.given family: name.family (mit name.use!='maiden' oder nicht vorhanden) prefix: name.prefix suffix: name.suffix birthdate: birthDate gender: gender address-line: address.line address-city: address.city address-postalcode: address.postalCode birthplace: extension('http://hl7.org/fhir/StructureDefinition/patient-birthPlace').city maidenname: name.family (mit name.use='maiden') degree: name.prefix (ggf. mit gesetzter Extension http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier mit Code 'AC') language: communication.language (mit communication.preferred=true) nationality: extension(http://hl7.org/fhir/StructureDefinition/patient-nationality).valueCode.coding.code oder extension(http://hl7.org/fhir/StructureDefinition/patient-nationality).valueCode.textextension(http://hl7.org/fhir/StructureDefinition/patient-nationality).code.text maritalstatus: maritalStatus.coding.code oder maritalStatus.text

Control0..*
Is Modifierfalse
Summaryfalse
Alternate NamesSubjectOfCare Client Resident
Invariantsdom-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 or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).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())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Patient.extension
Definition

An Extension


May be used to represent additional information that is not part of the basic definition of the resource. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortExtensionAdditional content defined by implementations
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.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 6. Patient.extension:birthPlace
    Slice NamebirthPlace
    Definition

    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.

    ShortPlace of Birth for patient
    Control0..1
    TypeExtension(Patient Birth Place) (Extension Type: Address)
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    8. Patient.extension:birthPlace.extension
    Definition

    An Extension


    May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

    ShortExtensionAdditional content defined by implementations
    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.

    Control0..0*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis element introduces a set of slices on Patient.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 10. Patient.extension:birthPlace.url
      Definition

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

      Shortidentifies the meaning of the extension
      Comments

      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

      Control1..1
      Typeuri
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      Fixed Valuehttp://hl7.org/fhir/StructureDefinition/patient-birthPlace
      12. Patient.extension:birthPlace.value[x]
      Definition

      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).


      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

      ShortValue of extension
      Control10..1
      This element is affected by the following invariants: ext-1
      TypeAddress, date, Meta, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Must Supporttrue
      Standard StatusNormative (from Normative)
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      14. Patient.extension:birthPlace.value[x].use
      Definition

      The purpose of this address.

      Shorthome | work | temp | old | billing - purpose of this address
      Comments

      Applications can assume that an address is current unless it explicitly says that it is temporary or old.

      Control0..01
      BindingThe codes SHALL be taken from AddressUsehttp://hl7.org/fhir/ValueSet/address-use|4.0.1
      (required to http://hl7.org/fhir/ValueSet/address-use|4.0.1)

      The use of an address.

      Typecode
      Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Standard StatusNormative (from Normative)
      Summarytrue
      Requirements

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

      ExampleGeneral: home
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      16. Patient.extension:birthPlace.value[x].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.

      Shortpostal | physical | both
      Comments

      The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource).


      The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource).

      Control0..01
      BindingThe codes SHALL be taken from AddressTypehttp://hl7.org/fhir/ValueSet/address-type|4.0.1
      (required to http://hl7.org/fhir/ValueSet/address-type|4.0.1)

      The type of an address (physical / postal).

      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Standard StatusNormative (from Normative)
      Summarytrue
      ExampleGeneral: both
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      18. Patient.extension:birthPlace.value[x].text
      Definition

      Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts.

      ShortText representation of the address
      Comments

      Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

      Control0..01
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Standard StatusNormative (from Normative)
      Summarytrue
      Requirements

      A renderable, unencoded form.

      ExampleGeneral: 137 Nowhere Street, Erewhon 9132
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. Patient.extension:birthPlace.value[x].line
      Definition

      This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.

      ShortStreet name, number, direction & P.O. Box etc.
      Control0..0*
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Standard StatusNormative (from Normative)
      Summarytrue
      ExampleGeneral: 137 Nowhere Street
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. Patient.extension:birthPlace.value[x].city
      Definition

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

      ShortName of city, town etc.
      Control10..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Standard StatusNormative (from Normative)
      Summarytrue
      Alternate NamesMunicpality
      ExampleGeneral: Erewhon
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      24. Patient.extension:birthPlace.value[x].district
      Definition

      The name of the administrative area (county).

      ShortDistrict name (aka 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.

      Control0..01
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Standard StatusNormative (from Normative)
      Summarytrue
      Alternate NamesCounty
      ExampleGeneral: Madison
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. Patient.extension:birthPlace.value[x].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 (e.g. US 2 letter state codes).

      ShortSub-unit of country (abbreviations ok)
      Control0..01
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Standard StatusNormative (from Normative)
      Summarytrue
      Alternate NamesProvince, Territory
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      28. Patient.extension:birthPlace.value[x].postalCode
      Definition

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

      ShortPostal code for area
      Control0..01
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Standard StatusNormative (from Normative)
      Summarytrue
      Alternate NamesZip
      ExampleGeneral: 9132
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      30. Patient.extension:birthPlace.value[x].country
      Definition

      Country - a nation as commonly understood or generally accepted.

      ShortCountry (e.g. can be ISO 3166 2 or 3 letter code)
      Comments

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

      Control0..01
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Standard StatusNormative (from Normative)
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      32. Patient.extension:birthPlace.value[x].period
      Definition

      Time period when address was/is in use.

      ShortTime period when address was/is in use
      Control0..01
      TypePeriod
      Is Modifierfalse
      Summarytrue
      Requirements

      Allows addresses to be placed in historical context.

      ExampleGeneral: { "start" : "2010-03-23", "end" : "2010-07-01" }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      34. Patient.extension:nationality
      Slice Namenationality
      Definition

      The nationality of the patient.

      ShortNationality
      Control0..1
      TypeExtension(Patient Nationality) (Complex Extension)
      Is Modifierfalse
      Must Supporttrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      36. Patient.extension:nationality.extension:code
      Slice Namecode
      Definition

      An Extension

      ShortExtensionAdditional content defined by implementations
      Control0..1*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      38. Patient.extension:nationality.extension:code.extension
      Definition

      An Extension


      May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

      ShortExtensionAdditional content defined by implementations
      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.

      Control0..0*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 40. Patient.extension:nationality.extension:code.url
        Definition

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

        Shortidentifies the meaning of the extension
        Comments

        The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

        Control1..1
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        Fixed Valuecode
        42. Patient.extension:nationality.extension:code.value[x]
        Definition

        Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).


        Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

        ShortValue of extension
        Control10..1
        This element is affected by the following invariants: ext-1
        BindingThe codes SHALL be taken from For codes, see Iso3166-1-2
        (required to http://hl7.org/fhir/ValueSet/iso3166-1-2)
        TypeCodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Must Supporttrue
        Standard StatusNormative (from Normative)
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        44. Patient.extension:nationality.extension:code.value[x].coding
        Definition

        A reference to a code defined by a terminology system.

        ShortCode defined by a terminology system
        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.

        Control0..1*
        TypeCoding
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Allows for alternative encodings within a code system, and translations to other code systems.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        46. Patient.extension:nationality.extension:code.value[x].coding.system
        Definition

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

        ShortIdentity of the terminology system
        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 reference to some definition that establishes the system clearly and unambiguously.

        Control10..1
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Standard StatusNormative (from Normative)
        Summarytrue
        Requirements

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

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        48. Patient.extension:nationality.extension:code.value[x].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).

        ShortSymbol in syntax defined by the system
        Control10..1
        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Standard StatusNormative (from Normative)
        Summarytrue
        Requirements

        Need to refer to a particular code in the system.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        50. Patient.extension:nationality.extension:code.value[x].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.

        ShortPlain text representation of the concept
        Comments

        Very often the text is the same as a displayName of one of the codings.

        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Standard StatusNormative (from Normative)
        Summarytrue
        Requirements

        The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        52. Patient.extension:nationality.extension:period
        Slice Nameperiod
        Definition

        Period when nationality was effective.

        ShortNationality PeriodAdditional content defined by implementations
        Control0..1*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        54. Patient.extension:nationality.extension:period.extension
        Definition

        An Extension


        May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortExtensionAdditional content defined by implementations
        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.

        Control0..0*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 56. Patient.extension:nationality.extension:period.url
          Definition

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

          Shortidentifies the meaning of the extension
          Comments

          The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

          Control1..1
          Typeuri
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          Fixed Valueperiod
          58. Patient.extension:nationality.extension:period.value[x]
          Definition

          Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).


          Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

          ShortValue of extension
          Control10..1
          This element is affected by the following invariants: ext-1
          TypePeriod, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          60. Patient.extension:nationality.url
          Definition

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

          Shortidentifies the meaning of the extension
          Comments

          The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

          Control1..1
          Typeuri
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          Fixed Valuehttp://hl7.org/fhir/StructureDefinition/patient-nationality
          62. Patient.extension:nationality.value[x]
          Definition

          Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).


          Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

          ShortValue of extension
          Control0..01
          This element is affected by the following invariants: ext-1
          TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta, Contributor
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          64. 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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored
          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.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
          Summaryfalse
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          66. Patient.identifier
          Definition

          An identifier for this patient.

          ShortAn identifier for this patient
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..0*
          TypeIdentifier
          Is Modifierfalse
          Summarytrue
          Requirements

          Patients are almost always assigned specific numerical identifiers.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          68. Patient.active
          Definition

          Whether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules.

          It is often used to filter patient lists to exclude inactive patients

          Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death.

          ShortWhether this patient's record is in active use
          Comments

          If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient.

          Control0..01
          Typeboolean
          Is Modifiertrue because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Standard StatusNormative (from Normative)
          Summarytrue
          Requirements

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

          Meaning if MissingThis resource is generally assumed to be active if no value is provided for the active element
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          70. Patient.name
          Definition

          A name associated with the individual.

          ShortA name associated with the patient
          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.

          Control0..*
          TypeHumanName
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Requirements

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

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          72. Patient.name.use
          Definition

          Identifies the purpose for this name.

          Shortusual | official | temp | nickname | anonymous | old | maiden
          Comments

          Applications can assume that a name is current unless it explicitly says that it is temporary or old.

          Control0..1
          BindingThe codes SHALL be taken from NameUsehttp://hl7.org/fhir/ValueSet/name-use|4.0.1
          (required to http://hl7.org/fhir/ValueSet/name-use|4.0.1)

          The use of a human name.

          Typecode
          Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Standard StatusNormative (from Normative)
          Summarytrue
          Requirements

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

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          74. Patient.name.text
          Definition

          Specifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts.

          ShortText representation of the full name
          Comments

          Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

          Control0..01
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Standard StatusNormative (from Normative)
          Summarytrue
          Requirements

          A renderable, unencoded form.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          76. Patient.name.family
          Definition

          The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.

          ShortFamily name (often called 'Surname')
          Comments

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

          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Standard StatusNormative (from Normative)
          Summarytrue
          Alternate Namessurname
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          78. Patient.name.given
          Definition

          Given name.

          ShortGiven names (not always 'first'). Includes middle names
          Comments

          If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first.

          Control0..*
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Standard StatusNormative (from Normative)
          Summarytrue
          Alternate Namesfirst name, middle name
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          80. Patient.name.prefix
          Definition

          Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name.

          ShortParts that come before the name
          Control0..*
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Standard StatusNormative (from Normative)
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          82. Patient.name.prefix.extension
          Definition

          An Extension


          May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortExtensionAdditional content defined by implementations
          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.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on Patient.name.prefix.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 84. Patient.name.prefix.extension:academic
            Slice Nameacademic
            Definition

            A set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type.

            ShortLS | AC | NB | PR | HON | BR | AD | SP | MID | CL | IN | VV
            Comments

            Used to indicate additional information about the name part and how it should be used.

            Control0..1
            TypeExtension(EN Qualifier) (Extension Type: code)
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            86. Patient.name.prefix.extension:academic.extension
            Definition

            An Extension


            May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortExtensionAdditional content defined by implementations
            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.

            Control0..0*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on Patient.name.prefix.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 88. Patient.name.prefix.extension:academic.url
              Definition

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

              Shortidentifies the meaning of the extension
              Comments

              The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

              Control1..1
              Typeuri
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              Fixed Valuehttp://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier
              90. Patient.name.prefix.extension:academic.value[x]
              Definition

              Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).


              Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

              ShortValue of extension
              Control10..1
              This element is affected by the following invariants: ext-1
              BindingThe codes SHALL be taken from For codes, see EntityNamePartQualifier
              (required to http://hl7.org/fhir/ValueSet/name-part-qualifier)
              Typecode, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Standard StatusNormative (from Normative)
              Summaryfalse
              Fixed ValueAC
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              92. Patient.name.suffix
              Definition

              Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name.

              ShortParts that come after the name
              Control0..*
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Standard StatusNormative (from Normative)
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              94. Patient.name.period
              Definition

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

              ShortTime period when name was/is in use
              Control0..01
              TypePeriod
              Is Modifierfalse
              Summarytrue
              Requirements

              Allows names to be placed in historical context.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              96. Patient.telecom
              Definition

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

              ShortA contact detail for the individual
              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 might 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).

              Control0..0*
              TypeContactPoint
              Is Modifierfalse
              Summarytrue
              Requirements

              People have (primary) ways to contact them in some way such as phone, email.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              98. Patient.gender
              Definition

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

              Shortmale | female | other | unknown
              Comments

              The gender might 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 male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, 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, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex.

              Control0..1
              BindingThe codes SHALL be taken from AdministrativeGenderhttp://hl7.org/fhir/ValueSet/administrative-gender|4.0.1
              (required to http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1)

              The gender of a person used for administrative purposes.

              Typecode
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Standard StatusNormative (from Normative)
              Summarytrue
              Requirements

              Needed for identification of the individual, in combination with (at least) name and birth date.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              100. Patient.birthDate
              Definition

              The date of birth for the individual.

              ShortThe date of birth for the individual
              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 maternity/infant care systems).

              Control0..1
              Typedate
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Standard StatusNormative (from Normative)
              Summarytrue
              Requirements

              Age of the individual drives many clinical processes.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              LOINC Code21112-8
              102. Patient.deceased[x]
              Definition

              Indicates if the individual is deceased or not.

              ShortIndicates if the individual is deceased or not
              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.

              Control0..01
              TypeChoice of: boolean, dateTime
              Is Modifiertrue because 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.
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Standard StatusNormative (from Normative)
              Summarytrue
              Requirements

              The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              104. Patient.address
              Definition

              An address for the individual.

              ShortAn address for the individual
              Comments

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

              Control0..*
              TypeAddress
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Requirements

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

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              106. Patient.address.use
              Definition

              The purpose of this address.

              Shorthome | work | temp | old | billing - purpose of this address
              Comments

              Applications can assume that an address is current unless it explicitly says that it is temporary or old.

              Control0..1
              BindingThe codes SHALL be taken from AddressUsehttp://hl7.org/fhir/ValueSet/address-use|4.0.1
              (required to http://hl7.org/fhir/ValueSet/address-use|4.0.1)

              The use of an address.

              Typecode
              Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

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

              ExampleGeneral: home
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              108. Patient.address.text
              Definition

              Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts.

              ShortText representation of the address
              Comments

              Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

              Control0..01
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Standard StatusNormative (from Normative)
              Summarytrue
              Requirements

              A renderable, unencoded form.

              ExampleGeneral: 137 Nowhere Street, Erewhon 9132
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              110. 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.

              ShortStreet name, number, direction & P.O. Box etc.
              Control0..*
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Standard StatusNormative (from Normative)
              Summarytrue
              ExampleGeneral: 137 Nowhere Street
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              112. Patient.address.city
              Definition

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

              ShortName of city, town etc.
              Control0..1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Standard StatusNormative (from Normative)
              Summarytrue
              Alternate NamesMunicpality
              ExampleGeneral: Erewhon
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              114. Patient.address.district
              Definition

              The name of the administrative area (county).

              ShortDistrict name (aka 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.

              Control0..01
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Standard StatusNormative (from Normative)
              Summarytrue
              Alternate NamesCounty
              ExampleGeneral: Madison
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              116. 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 (e.g. US 2 letter state codes).

              ShortSub-unit of country (abbreviations ok)
              Control0..01
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Standard StatusNormative (from Normative)
              Summarytrue
              Alternate NamesProvince, Territory
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              118. Patient.address.postalCode
              Definition

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

              ShortPostal code for area
              Control0..1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Standard StatusNormative (from Normative)
              Summarytrue
              Alternate NamesZip
              ExampleGeneral: 9132
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              120. Patient.address.country
              Definition

              Country - a nation as commonly understood or generally accepted.

              ShortCountry (e.g. can be ISO 3166 2 or 3 letter code)
              Comments

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

              Control0..01
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Standard StatusNormative (from Normative)
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              122. Patient.address.period
              Definition

              Time period when address was/is in use.

              ShortTime period when address was/is in use
              Control0..01
              TypePeriod
              Is Modifierfalse
              Summarytrue
              Requirements

              Allows addresses to be placed in historical context.

              ExampleGeneral: { "start" : "2010-03-23", "end" : "2010-07-01" }
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              124. Patient.maritalStatus
              Definition

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

              ShortMarital (civil) status of a patient
              Control0..1
              BindingThe codes SHALL be taken from Unless not suitable, these codes SHALL be taken from Marital Status Codeshttp://hl7.org/fhir/ValueSet/marital-status|4.0.1
              (required to http://hl7.org/fhir/ValueSet/marital-status)

              The domestic partnership status of a person.

              TypeCodeableConcept
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Requirements

              Most, if not all systems capture it.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              126. Patient.maritalStatus.coding
              Definition

              A reference to a code defined by a terminology system.

              ShortCode defined by a terminology system
              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.

              Control0..1*
              TypeCoding
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Requirements

              Allows for alternative encodings within a code system, and translations to other code systems.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              128. Patient.maritalStatus.coding.system
              Definition

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

              ShortIdentity of the terminology system
              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 reference to some definition that establishes the system clearly and unambiguously.

              Control10..1
              Typeuri
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Standard StatusNormative (from Normative)
              Summarytrue
              Requirements

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

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              130. 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).

              ShortSymbol in syntax defined by the system
              Control10..1
              Typecode
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Standard StatusNormative (from Normative)
              Summarytrue
              Requirements

              Need to refer to a particular code in the system.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              132. 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.

              ShortPlain text representation of the concept
              Comments

              Very often the text is the same as a displayName of one of the codings.

              Control10..1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Standard StatusNormative (from Normative)
              Summarytrue
              Requirements

              The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              134. Patient.multipleBirth[x]
              Definition

              Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer).

              ShortWhether patient is part of a multiple birth
              Comments

              Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in triplets would be valueInteger=2 and the third born would have valueInteger=3 If a boolean value was provided for this triplets example, then all 3 patient records would have valueBoolean=true (the ordering is not indicated).

              Control0..01
              TypeChoice of: boolean, integer
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Standard StatusNormative (from Normative)
              Summaryfalse
              Requirements

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

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              136. Patient.photo
              Definition

              Image of the patient.

              ShortImage of the patient
              Comments

              Guidelines:

              • Use id photos, not clinical photos.
              • Limit dimensions to thumbnail.
              • Keep byte count low to ease resource updates.
              Control0..0*
              TypeAttachment
              Is Modifierfalse
              Summaryfalse
              Requirements

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

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              138. Patient.contact
              Definition

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

              ShortA contact party (e.g. guardian, partner, friend) for 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.

              Control0..0*
              TypeBackboneElement
              Is Modifierfalse
              Summaryfalse
              Requirements

              Need to track people you can contact about the patient.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (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())
              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())
              141. Patient.communication
              Definition

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

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

              Control0..*
              TypeBackboneElement
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Requirements

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

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              143. Patient.communication.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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

              ShortExtensions that cannot be ignored even if unrecognized
              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.

              Control0..*
              TypeExtension
              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
              Summarytrue
              Requirements

              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

              Alternate Namesextensions, user content, modifiers
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              145. Patient.communication.language
              Definition

              The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English.

              ShortThe language which can be used to communicate with the patient about his or her health
              Comments

              The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.

              Control1..1
              BindingThe codes SHALL be taken from The codes SHOULD be taken from CommonLanguageshttp://hl7.org/fhir/ValueSet/languages|4.0.1
              (required to http://hl7.org/fhir/ValueSet/languages)

              A human language.

              Additional BindingsPurpose
              AllLanguagesMax Binding
              TypeCodeableConcept
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Requirements

              Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              147. Patient.communication.language.coding
              Definition

              A reference to a code defined by a terminology system.

              ShortCode defined by a terminology system
              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.

              Control0..1*
              TypeCoding
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Requirements

              Allows for alternative encodings within a code system, and translations to other code systems.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              149. Patient.communication.language.coding.system
              Definition

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

              ShortIdentity of the terminology system
              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 reference to some definition that establishes the system clearly and unambiguously.

              Control10..1
              Typeuri
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Standard StatusNormative (from Normative)
              Summarytrue
              Requirements

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

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              151. Patient.communication.language.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).

              ShortSymbol in syntax defined by the system
              Control10..1
              Typecode
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Standard StatusNormative (from Normative)
              Summarytrue
              Requirements

              Need to refer to a particular code in the system.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              153. Patient.communication.language.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.

              ShortPlain text representation of the concept
              Comments

              Very often the text is the same as a displayName of one of the codings.

              Control0..1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Standard StatusNormative (from Normative)
              Summarytrue
              Requirements

              The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              155. Patient.communication.preferred
              Definition

              Indicates whether or not the patient prefers this language (over other languages he masters up a certain level).

              ShortLanguage preference indicator
              Comments

              This language is specifically identified for communicating healthcare information.

              Control10..1
              Typeboolean
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Standard StatusNormative (from Normative)
              Summaryfalse
              Requirements

              People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method.

              Fixed Valuetrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              157. Patient.generalPractitioner
              Definition

              Patient's nominated care provider.

              ShortPatient's nominated primary care provider
              Comments

              This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability 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. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues.

              Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type.

              Control0..0*
              TypeReference(Organization, Practitioner, PractitionerRole)
              Is Modifierfalse
              Summaryfalse
              Alternate NamescareProvider
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              159. Patient.managingOrganization
              Definition

              Organization that is the custodian of the patient record.

              ShortOrganization that is the custodian of the patient record
              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).

              Control0..01
              TypeReference(Organization)
              Is Modifierfalse
              Summarytrue
              Requirements

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

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              161. Patient.link
              Definition

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

              ShortLink to another patient resource that concerns the same actual person
              Comments

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

              Control0..0*
              TypeBackboneElement
              Is Modifiertrue because This element is labeled as a modifier because it might 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'
              Summarytrue
              Requirements

              There are multiple use cases:

              • Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and
              • Distribution of patient information across multiple servers.
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

              Guidance on how to interpret the contents of this table can be foundhere

              0. Patient
              ShortPatienten-Profil zur Übermittlung von angeforderten IDAT
              Comments

              Die per $requestTasks vorgegebenen Element-Bezeichner sind wie folgt gemappt:

              given: name.given family: name.family (mit name.use!='maiden' oder nicht vorhanden) prefix: name.prefix suffix: name.suffix birthdate: birthDate gender: gender address-line: address.line address-city: address.city address-postalcode: address.postalCode birthplace: extension('http://hl7.org/fhir/StructureDefinition/patient-birthPlace').city maidenname: name.family (mit name.use='maiden') degree: name.prefix (ggf. mit gesetzter Extension http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier mit Code 'AC') language: communication.language (mit communication.preferred=true) nationality: extension(http://hl7.org/fhir/StructureDefinition/patient-nationality).valueCode.coding.code oder extension(http://hl7.org/fhir/StructureDefinition/patient-nationality).valueCode.textextension(http://hl7.org/fhir/StructureDefinition/patient-nationality).code.text maritalstatus: maritalStatus.coding.code oder maritalStatus.text

              2. Patient.extension
              SlicingThis element introduces a set of slices on Patient.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 4. Patient.extension:birthPlace
                Slice NamebirthPlace
                Control0..1
                TypeExtension(Patient Birth Place) (Extension Type: Address)
                Must Supporttrue
                6. Patient.extension:birthPlace.value[x]
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Must Supporttrue
                Standard StatusNormative (from Normative)
                8. Patient.extension:birthPlace.value[x].use
                Control0..0
                Standard StatusNormative (from Normative)
                10. Patient.extension:birthPlace.value[x].type
                Control0..0
                Standard StatusNormative (from Normative)
                12. Patient.extension:birthPlace.value[x].text
                Control0..0
                Standard StatusNormative (from Normative)
                14. Patient.extension:birthPlace.value[x].line
                Control0..0
                Standard StatusNormative (from Normative)
                16. Patient.extension:birthPlace.value[x].city
                Control1..?
                Must Supporttrue
                Standard StatusNormative (from Normative)
                18. Patient.extension:birthPlace.value[x].district
                Control0..0
                Standard StatusNormative (from Normative)
                20. Patient.extension:birthPlace.value[x].state
                Control0..0
                Standard StatusNormative (from Normative)
                22. Patient.extension:birthPlace.value[x].postalCode
                Control0..0
                Standard StatusNormative (from Normative)
                24. Patient.extension:birthPlace.value[x].country
                Control0..0
                Standard StatusNormative (from Normative)
                26. Patient.extension:birthPlace.value[x].period
                Control0..0
                28. Patient.extension:nationality
                Slice Namenationality
                Control0..1
                TypeExtension(Patient Nationality) (Complex Extension)
                Must Supporttrue
                30. Patient.extension:nationality.extension:code
                Slice Namecode
                32. Patient.extension:nationality.extension:code.value[x]
                BindingThe codes SHALL be taken from Iso3166-1-2
                (required to http://hl7.org/fhir/ValueSet/iso3166-1-2)
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Must Supporttrue
                Standard StatusNormative (from Normative)
                34. Patient.extension:nationality.extension:code.value[x].coding
                Control0..1
                Must Supporttrue
                36. Patient.extension:nationality.extension:code.value[x].coding.system
                Control1..?
                Must Supporttrue
                Standard StatusNormative (from Normative)
                38. Patient.extension:nationality.extension:code.value[x].coding.code
                Control1..?
                Must Supporttrue
                Standard StatusNormative (from Normative)
                40. Patient.extension:nationality.extension:code.value[x].text
                Must Supporttrue
                Standard StatusNormative (from Normative)
                42. Patient.identifier
                NoteThis is a business identifier, not a resource identifier (see discussion)
                Control0..0
                44. Patient.active
                Control0..0
                Standard StatusNormative (from Normative)
                46. Patient.name
                Must Supporttrue
                48. Patient.name.use
                Must Supporttrue
                Standard StatusNormative (from Normative)
                50. Patient.name.text
                Control0..0
                Standard StatusNormative (from Normative)
                52. Patient.name.family
                Must Supporttrue
                Standard StatusNormative (from Normative)
                54. Patient.name.given
                Must Supporttrue
                Standard StatusNormative (from Normative)
                56. Patient.name.prefix
                Must Supporttrue
                Standard StatusNormative (from Normative)
                58. Patient.name.prefix.extension
                SlicingThis element introduces a set of slices on Patient.name.prefix.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 60. Patient.name.prefix.extension:academic
                  Slice Nameacademic
                  Control0..1
                  TypeExtension(EN Qualifier) (Extension Type: code)
                  Must Supporttrue
                  62. Patient.name.prefix.extension:academic.value[x]
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Must Supporttrue
                  Standard StatusNormative (from Normative)
                  Fixed ValueAC
                  64. Patient.name.suffix
                  Must Supporttrue
                  Standard StatusNormative (from Normative)
                  66. Patient.name.period
                  Control0..0
                  68. Patient.telecom
                  Control0..0
                  70. Patient.gender
                  Must Supporttrue
                  Standard StatusNormative (from Normative)
                  72. Patient.birthDate
                  Must Supporttrue
                  Standard StatusNormative (from Normative)
                  LOINC Code
                  74. Patient.deceased[x]
                  Control0..0
                  Standard StatusNormative (from Normative)
                  76. Patient.address
                  Must Supporttrue
                  78. Patient.address.text
                  Control0..0
                  Standard StatusNormative (from Normative)
                  80. Patient.address.line
                  Must Supporttrue
                  Standard StatusNormative (from Normative)
                  82. Patient.address.city
                  Must Supporttrue
                  Standard StatusNormative (from Normative)
                  84. Patient.address.district
                  Control0..0
                  Standard StatusNormative (from Normative)
                  86. Patient.address.state
                  Control0..0
                  Standard StatusNormative (from Normative)
                  88. Patient.address.postalCode
                  Must Supporttrue
                  Standard StatusNormative (from Normative)
                  90. Patient.address.country
                  Control0..0
                  Standard StatusNormative (from Normative)
                  92. Patient.address.period
                  Control0..0
                  94. Patient.maritalStatus
                  BindingThe codes SHALL be taken from Marital Status Codes
                  (required to http://hl7.org/fhir/ValueSet/marital-status)

                  The domestic partnership status of a person.

                  Must Supporttrue
                  96. Patient.maritalStatus.coding
                  Control0..1
                  Must Supporttrue
                  98. Patient.maritalStatus.coding.system
                  Control1..?
                  Must Supporttrue
                  Standard StatusNormative (from Normative)
                  100. Patient.maritalStatus.coding.code
                  Control1..?
                  Must Supporttrue
                  Standard StatusNormative (from Normative)
                  102. Patient.maritalStatus.text
                  Control1..?
                  Must Supporttrue
                  Standard StatusNormative (from Normative)
                  104. Patient.multipleBirth[x]
                  Control0..0
                  Standard StatusNormative (from Normative)
                  106. Patient.photo
                  Control0..0
                  108. Patient.contact
                  Control0..0
                  110. Patient.communication
                  Must Supporttrue
                  112. Patient.communication.language
                  BindingThe codes SHALL be taken from CommonLanguages
                  (required to http://hl7.org/fhir/ValueSet/languages)

                  A human language.

                  Additional BindingsPurpose
                  AllLanguagesMax Binding
                  Must Supporttrue
                  114. Patient.communication.language.coding
                  Control0..1
                  Must Supporttrue
                  116. Patient.communication.language.coding.system
                  Control1..?
                  Must Supporttrue
                  Standard StatusNormative (from Normative)
                  118. Patient.communication.language.coding.code
                  Control1..?
                  Must Supporttrue
                  Standard StatusNormative (from Normative)
                  120. Patient.communication.language.text
                  Must Supporttrue
                  Standard StatusNormative (from Normative)
                  122. Patient.communication.preferred
                  Control1..?
                  Must Supporttrue
                  Standard StatusNormative (from Normative)
                  Fixed Valuetrue
                  124. Patient.generalPractitioner
                  Control0..0
                  126. Patient.managingOrganization
                  Control0..0
                  128. Patient.link
                  Control0..0

                  Guidance on how to interpret the contents of this table can be foundhere

                  0. Patient
                  Definition

                  Demographics and other administrative information about an individual or animal receiving care or other health-related services.

                  ShortPatienten-Profil zur Übermittlung von angeforderten IDAT
                  Comments

                  Die per $requestTasks vorgegebenen Element-Bezeichner sind wie folgt gemappt:

                  given: name.given family: name.family (mit name.use!='maiden' oder nicht vorhanden) prefix: name.prefix suffix: name.suffix birthdate: birthDate gender: gender address-line: address.line address-city: address.city address-postalcode: address.postalCode birthplace: extension('http://hl7.org/fhir/StructureDefinition/patient-birthPlace').city maidenname: name.family (mit name.use='maiden') degree: name.prefix (ggf. mit gesetzter Extension http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier mit Code 'AC') language: communication.language (mit communication.preferred=true) nationality: extension(http://hl7.org/fhir/StructureDefinition/patient-nationality).valueCode.coding.code oder extension(http://hl7.org/fhir/StructureDefinition/patient-nationality).valueCode.textextension(http://hl7.org/fhir/StructureDefinition/patient-nationality).code.text maritalstatus: maritalStatus.coding.code oder maritalStatus.text

                  Control0..*
                  Is Modifierfalse
                  Summaryfalse
                  Alternate NamesSubjectOfCare Client Resident
                  Invariantsdom-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 or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).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())
                  dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                  dom-6: A resource should have narrative for robust management (text.`div`.exists())
                  2. Patient.id
                  Definition

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

                  ShortLogical id of this artifact
                  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.

                  Control0..1
                  Typeid
                  Is Modifierfalse
                  Summarytrue
                  4. Patient.meta
                  Definition

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

                  ShortMetadata about the resource
                  Control0..1
                  TypeMeta
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  6. 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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                  ShortA set of rules under which this content was created
                  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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

                  Control0..1
                  Typeuri
                  Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  8. Patient.language
                  Definition

                  The base language in which the resource is written.

                  ShortLanguage of the resource content
                  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).

                  Control0..1
                  BindingThe codes SHOULD be taken from CommonLanguages
                  (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

                  A human language.

                  Additional BindingsPurpose
                  AllLanguagesMax Binding
                  Typecode
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  10. Patient.text
                  Definition

                  A human-readable narrative that contains a summary of the resource and can 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.

                  ShortText summary of the resource, for human interpretation
                  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 information is added later.

                  Control0..1
                  TypeNarrative
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesnarrative, html, xhtml, display
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  12. 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.

                  ShortContained, inline 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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

                  Control0..*
                  TypeResource
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesinline resources, anonymous resources, contained resources
                  14. Patient.extension
                  Definition

                  An Extension

                  ShortExtension
                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  SlicingThis element introduces a set of slices on Patient.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 16. Patient.extension:birthPlace
                    Slice NamebirthPlace
                    Definition

                    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.

                    ShortPlace of Birth for patient
                    Control0..1
                    TypeExtension(Patient Birth Place) (Extension Type: Address)
                    Is Modifierfalse
                    Must Supporttrue
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    18. Patient.extension:birthPlace.id
                    Definition

                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                    ShortUnique id for inter-element referencing
                    Control0..1
                    This element is affected by the following invariants: ele-1
                    Typeid
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    20. Patient.extension:birthPlace.extension
                    Definition

                    An Extension

                    ShortExtension
                    Control0..0
                    TypeExtension
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    SlicingThis element introduces a set of slices on Patient.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 22. Patient.extension:birthPlace.url
                      Definition

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

                      Shortidentifies the meaning of the extension
                      Comments

                      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                      Control1..1
                      Typeuri
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      Fixed Valuehttp://hl7.org/fhir/StructureDefinition/patient-birthPlace
                      24. Patient.extension:birthPlace.value[x]
                      Definition

                      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                      ShortValue of extension
                      Control1..1
                      This element is affected by the following invariants: ext-1
                      TypeAddress
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Is Modifierfalse
                      Must Supporttrue
                      Standard StatusNormative (from Normative)
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      26. Patient.extension:birthPlace.value[x].id
                      Definition

                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                      ShortUnique id for inter-element referencing
                      Control0..1
                      Typestring
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      28. Patient.extension:birthPlace.value[x].extension
                      Definition

                      May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                      ShortAdditional content defined by implementations
                      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.

                      Control0..*
                      TypeExtension
                      Is Modifierfalse
                      Summaryfalse
                      Alternate Namesextensions, user content
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      SlicingThis element introduces a set of slices on Patient.extension.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 30. Patient.extension:birthPlace.value[x].use
                        Definition

                        The purpose of this address.

                        Shorthome | work | temp | old | billing - purpose of this address
                        Comments

                        Applications can assume that an address is current unless it explicitly says that it is temporary or old.

                        Control0..0
                        BindingThe codes SHALL be taken from AddressUse
                        (required to http://hl7.org/fhir/ValueSet/address-use|4.0.1)

                        The use of an address.

                        Typecode
                        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Standard StatusNormative (from Normative)
                        Summarytrue
                        Requirements

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

                        ExampleGeneral: home
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        32. Patient.extension:birthPlace.value[x].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.

                        Shortpostal | physical | both
                        Comments

                        The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource).

                        Control0..0
                        BindingThe codes SHALL be taken from AddressType
                        (required to http://hl7.org/fhir/ValueSet/address-type|4.0.1)

                        The type of an address (physical / postal).

                        Typecode
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Standard StatusNormative (from Normative)
                        Summarytrue
                        ExampleGeneral: both
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        34. Patient.extension:birthPlace.value[x].text
                        Definition

                        Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts.

                        ShortText representation of the address
                        Comments

                        Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

                        Control0..0
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Standard StatusNormative (from Normative)
                        Summarytrue
                        Requirements

                        A renderable, unencoded form.

                        ExampleGeneral: 137 Nowhere Street, Erewhon 9132
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        36. Patient.extension:birthPlace.value[x].line
                        Definition

                        This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.

                        ShortStreet name, number, direction & P.O. Box etc.
                        Control0..0
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Standard StatusNormative (from Normative)
                        Summarytrue
                        ExampleGeneral: 137 Nowhere Street
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        38. Patient.extension:birthPlace.value[x].city
                        Definition

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

                        ShortName of city, town etc.
                        Control1..1
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Standard StatusNormative (from Normative)
                        Summarytrue
                        Alternate NamesMunicpality
                        ExampleGeneral: Erewhon
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        40. Patient.extension:birthPlace.value[x].district
                        Definition

                        The name of the administrative area (county).

                        ShortDistrict name (aka 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.

                        Control0..0
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Standard StatusNormative (from Normative)
                        Summarytrue
                        Alternate NamesCounty
                        ExampleGeneral: Madison
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        42. Patient.extension:birthPlace.value[x].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 (e.g. US 2 letter state codes).

                        ShortSub-unit of country (abbreviations ok)
                        Control0..0
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Standard StatusNormative (from Normative)
                        Summarytrue
                        Alternate NamesProvince, Territory
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        44. Patient.extension:birthPlace.value[x].postalCode
                        Definition

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

                        ShortPostal code for area
                        Control0..0
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Standard StatusNormative (from Normative)
                        Summarytrue
                        Alternate NamesZip
                        ExampleGeneral: 9132
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        46. Patient.extension:birthPlace.value[x].country
                        Definition

                        Country - a nation as commonly understood or generally accepted.

                        ShortCountry (e.g. can be ISO 3166 2 or 3 letter code)
                        Comments

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

                        Control0..0
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Standard StatusNormative (from Normative)
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        48. Patient.extension:birthPlace.value[x].period
                        Definition

                        Time period when address was/is in use.

                        ShortTime period when address was/is in use
                        Control0..0
                        TypePeriod
                        Is Modifierfalse
                        Summarytrue
                        Requirements

                        Allows addresses to be placed in historical context.

                        ExampleGeneral: { "start" : "2010-03-23", "end" : "2010-07-01" }
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        50. Patient.extension:nationality
                        Slice Namenationality
                        Definition

                        The nationality of the patient.

                        ShortNationality
                        Control0..1
                        TypeExtension(Patient Nationality) (Complex Extension)
                        Is Modifierfalse
                        Must Supporttrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        52. Patient.extension:nationality.id
                        Definition

                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                        ShortUnique id for inter-element referencing
                        Control0..1
                        This element is affected by the following invariants: ele-1
                        Typeid
                        Is Modifierfalse
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Summaryfalse
                        54. Patient.extension:nationality.extension
                        Definition

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

                        ShortAdditional content defined by implementations
                        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.

                        Control0..*
                        TypeExtension
                        Is Modifierfalse
                        Summaryfalse
                        Alternate Namesextensions, user content
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        SlicingThis element introduces a set of slices on Patient.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 56. Patient.extension:nationality.extension:code
                          Slice Namecode
                          Definition

                          An Extension

                          ShortExtension
                          Control0..1
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          58. Patient.extension:nationality.extension:code.id
                          Definition

                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                          ShortUnique id for inter-element referencing
                          Control0..1
                          This element is affected by the following invariants: ele-1
                          Typeid
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          60. Patient.extension:nationality.extension:code.extension
                          Definition

                          An Extension

                          ShortExtension
                          Control0..0
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          SlicingThis element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 62. Patient.extension:nationality.extension:code.url
                            Definition

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

                            Shortidentifies the meaning of the extension
                            Comments

                            The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                            Control1..1
                            Typeuri
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            Fixed Valuecode
                            64. Patient.extension:nationality.extension:code.value[x]
                            Definition

                            Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                            ShortValue of extension
                            Control1..1
                            This element is affected by the following invariants: ext-1
                            BindingThe codes SHALL be taken from Iso3166-1-2
                            (required to http://hl7.org/fhir/ValueSet/iso3166-1-2)
                            TypeCodeableConcept
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            Is Modifierfalse
                            Must Supporttrue
                            Standard StatusNormative (from Normative)
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            66. Patient.extension:nationality.extension:code.value[x].id
                            Definition

                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                            ShortUnique id for inter-element referencing
                            Control0..1
                            Typestring
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            68. Patient.extension:nationality.extension:code.value[x].extension
                            Definition

                            May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                            ShortAdditional content defined by implementations
                            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.

                            Control0..*
                            TypeExtension
                            Is Modifierfalse
                            Summaryfalse
                            Alternate Namesextensions, user content
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            SlicingThis element introduces a set of slices on Patient.extension.extension.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 70. Patient.extension:nationality.extension:code.value[x].coding
                              Definition

                              A reference to a code defined by a terminology system.

                              ShortCode defined by a terminology system
                              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.

                              Control0..1
                              TypeCoding
                              Is Modifierfalse
                              Must Supporttrue
                              Summarytrue
                              Requirements

                              Allows for alternative encodings within a code system, and translations to other code systems.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              72. Patient.extension:nationality.extension:code.value[x].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.

                              ShortUnique id for inter-element referencing
                              Control0..1
                              Typestring
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              74. Patient.extension:nationality.extension:code.value[x].coding.extension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortAdditional content defined by implementations
                              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.

                              Control0..*
                              TypeExtension
                              Is Modifierfalse
                              Summaryfalse
                              Alternate Namesextensions, user content
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              SlicingThis element introduces a set of slices on Patient.extension.extension.value[x].coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 76. Patient.extension:nationality.extension:code.value[x].coding.system
                                Definition

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

                                ShortIdentity of the terminology system
                                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 reference to some definition that establishes the system clearly and unambiguously.

                                Control1..1
                                Typeuri
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supporttrue
                                Standard StatusNormative (from Normative)
                                Summarytrue
                                Requirements

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

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                78. Patient.extension:nationality.extension:code.value[x].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.

                                ShortVersion of the system - if relevant
                                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.

                                NoteThis is a business version Id, not a resource version Id (see discussion)
                                Control0..1
                                Typestring
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                80. Patient.extension:nationality.extension:code.value[x].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).

                                ShortSymbol in syntax defined by the system
                                Control1..1
                                Typecode
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supporttrue
                                Standard StatusNormative (from Normative)
                                Summarytrue
                                Requirements

                                Need to refer to a particular code in the system.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                82. Patient.extension:nationality.extension:code.value[x].coding.display
                                Definition

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

                                ShortRepresentation defined by the system
                                Control0..1
                                Typestring
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Requirements

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

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                84. Patient.extension:nationality.extension:code.value[x].coding.userSelected
                                Definition

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

                                ShortIf this coding was chosen directly by the user
                                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.

                                Control0..1
                                Typeboolean
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Requirements

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

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                86. Patient.extension:nationality.extension:code.value[x].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.

                                ShortPlain text representation of the concept
                                Comments

                                Very often the text is the same as a displayName of one of the codings.

                                Control0..1
                                Typestring
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supporttrue
                                Standard StatusNormative (from Normative)
                                Summarytrue
                                Requirements

                                The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                88. Patient.extension:nationality.extension:period
                                Slice Nameperiod
                                Definition

                                Period when nationality was effective.

                                ShortNationality Period
                                Control0..1
                                TypeExtension
                                Is Modifierfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                90. Patient.extension:nationality.extension:period.id
                                Definition

                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                ShortUnique id for inter-element referencing
                                Control0..1
                                This element is affected by the following invariants: ele-1
                                Typeid
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                92. Patient.extension:nationality.extension:period.extension
                                Definition

                                An Extension

                                ShortExtension
                                Control0..0
                                TypeExtension
                                Is Modifierfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                SlicingThis element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 94. Patient.extension:nationality.extension:period.url
                                  Definition

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

                                  Shortidentifies the meaning of the extension
                                  Comments

                                  The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                  Control1..1
                                  Typeuri
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  Fixed Valueperiod
                                  96. Patient.extension:nationality.extension:period.value[x]
                                  Definition

                                  Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                  ShortValue of extension
                                  Control1..1
                                  This element is affected by the following invariants: ext-1
                                  TypePeriod
                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                  Is Modifierfalse
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  98. Patient.extension:nationality.url
                                  Definition

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

                                  Shortidentifies the meaning of the extension
                                  Comments

                                  The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                  Control1..1
                                  Typeuri
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  Fixed Valuehttp://hl7.org/fhir/StructureDefinition/patient-nationality
                                  100. Patient.extension:nationality.value[x]
                                  Definition

                                  Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                  ShortValue of extension
                                  Control0..0
                                  This element is affected by the following invariants: ext-1
                                  TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  102. 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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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.

                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                  ShortExtensions that cannot be ignored
                                  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.

                                  Control0..*
                                  TypeExtension
                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                                  Summaryfalse
                                  Requirements

                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                  Alternate Namesextensions, user content
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  104. Patient.identifier
                                  Definition

                                  An identifier for this patient.

                                  ShortAn identifier for this patient
                                  NoteThis is a business identifier, not a resource identifier (see discussion)
                                  Control0..0
                                  TypeIdentifier
                                  Is Modifierfalse
                                  Summarytrue
                                  Requirements

                                  Patients are almost always assigned specific numerical identifiers.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  106. Patient.active
                                  Definition

                                  Whether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules.

                                  It is often used to filter patient lists to exclude inactive patients

                                  Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death.

                                  ShortWhether this patient's record is in active use
                                  Comments

                                  If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient.

                                  Control0..0
                                  Typeboolean
                                  Is Modifiertrue because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Standard StatusNormative (from Normative)
                                  Summarytrue
                                  Requirements

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

                                  Meaning if MissingThis resource is generally assumed to be active if no value is provided for the active element
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  108. Patient.name
                                  Definition

                                  A name associated with the individual.

                                  ShortA name associated with the patient
                                  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.

                                  Control0..*
                                  TypeHumanName
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summarytrue
                                  Requirements

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

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  110. Patient.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.

                                  ShortUnique id for inter-element referencing
                                  Control0..1
                                  Typestring
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  112. Patient.name.extension
                                  Definition

                                  May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                  ShortAdditional content defined by implementations
                                  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.

                                  Control0..*
                                  TypeExtension
                                  Is Modifierfalse
                                  Summaryfalse
                                  Alternate Namesextensions, user content
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  SlicingThis element introduces a set of slices on Patient.name.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 114. Patient.name.use
                                    Definition

                                    Identifies the purpose for this name.

                                    Shortusual | official | temp | nickname | anonymous | old | maiden
                                    Comments

                                    Applications can assume that a name is current unless it explicitly says that it is temporary or old.

                                    Control0..1
                                    BindingThe codes SHALL be taken from NameUse
                                    (required to http://hl7.org/fhir/ValueSet/name-use|4.0.1)

                                    The use of a human name.

                                    Typecode
                                    Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Must Supporttrue
                                    Standard StatusNormative (from Normative)
                                    Summarytrue
                                    Requirements

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

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    116. Patient.name.text
                                    Definition

                                    Specifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts.

                                    ShortText representation of the full name
                                    Comments

                                    Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

                                    Control0..0
                                    Typestring
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Standard StatusNormative (from Normative)
                                    Summarytrue
                                    Requirements

                                    A renderable, unencoded form.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    118. Patient.name.family
                                    Definition

                                    The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.

                                    ShortFamily name (often called 'Surname')
                                    Comments

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

                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Must Supporttrue
                                    Standard StatusNormative (from Normative)
                                    Summarytrue
                                    Alternate Namessurname
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    120. Patient.name.given
                                    Definition

                                    Given name.

                                    ShortGiven names (not always 'first'). Includes middle names
                                    Comments

                                    If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first.

                                    Control0..*
                                    Typestring
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Must Supporttrue
                                    Standard StatusNormative (from Normative)
                                    Summarytrue
                                    Alternate Namesfirst name, middle name
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    122. Patient.name.prefix
                                    Definition

                                    Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name.

                                    ShortParts that come before the name
                                    Control0..*
                                    Typestring
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Must Supporttrue
                                    Standard StatusNormative (from Normative)
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    124. Patient.name.prefix.id
                                    Definition

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

                                    Shortxml:id (or equivalent in JSON)
                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    Summaryfalse
                                    126. Patient.name.prefix.extension
                                    Definition

                                    An Extension

                                    ShortExtension
                                    Control0..*
                                    TypeExtension
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    SlicingThis element introduces a set of slices on Patient.name.prefix.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 128. Patient.name.prefix.extension:academic
                                      Slice Nameacademic
                                      Definition

                                      A set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type.

                                      ShortLS | AC | NB | PR | HON | BR | AD | SP | MID | CL | IN | VV
                                      Comments

                                      Used to indicate additional information about the name part and how it should be used.

                                      Control0..1
                                      TypeExtension(EN Qualifier) (Extension Type: code)
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      130. Patient.name.prefix.extension:academic.id
                                      Definition

                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                      ShortUnique id for inter-element referencing
                                      Control0..1
                                      This element is affected by the following invariants: ele-1
                                      Typeid
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      132. Patient.name.prefix.extension:academic.extension
                                      Definition

                                      An Extension

                                      ShortExtension
                                      Control0..0
                                      TypeExtension
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      SlicingThis element introduces a set of slices on Patient.name.prefix.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 134. Patient.name.prefix.extension:academic.url
                                        Definition

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

                                        Shortidentifies the meaning of the extension
                                        Comments

                                        The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                        Control1..1
                                        Typeuri
                                        Is Modifierfalse
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        Summaryfalse
                                        Fixed Valuehttp://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier
                                        136. Patient.name.prefix.extension:academic.value[x]
                                        Definition

                                        Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                        ShortValue of extension
                                        Control1..1
                                        This element is affected by the following invariants: ext-1
                                        BindingThe codes SHALL be taken from EntityNamePartQualifier
                                        (required to http://hl7.org/fhir/ValueSet/name-part-qualifier)
                                        Typecode
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supporttrue
                                        Standard StatusNormative (from Normative)
                                        Summaryfalse
                                        Fixed ValueAC
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        138. Patient.name.prefix.value
                                        Definition

                                        The actual value

                                        ShortPrimitive value for string
                                        Control0..1
                                        Typestring
                                        Is Modifierfalse
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        Summaryfalse
                                        Max Length:1048576
                                        140. Patient.name.suffix
                                        Definition

                                        Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name.

                                        ShortParts that come after the name
                                        Control0..*
                                        Typestring
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supporttrue
                                        Standard StatusNormative (from Normative)
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        142. Patient.name.period
                                        Definition

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

                                        ShortTime period when name was/is in use
                                        Control0..0
                                        TypePeriod
                                        Is Modifierfalse
                                        Summarytrue
                                        Requirements

                                        Allows names to be placed in historical context.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        144. Patient.telecom
                                        Definition

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

                                        ShortA contact detail for the individual
                                        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 might 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).

                                        Control0..0
                                        TypeContactPoint
                                        Is Modifierfalse
                                        Summarytrue
                                        Requirements

                                        People have (primary) ways to contact them in some way such as phone, email.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        146. Patient.gender
                                        Definition

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

                                        Shortmale | female | other | unknown
                                        Comments

                                        The gender might 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 male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, 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, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex.

                                        Control0..1
                                        BindingThe codes SHALL be taken from AdministrativeGender
                                        (required to http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1)

                                        The gender of a person used for administrative purposes.

                                        Typecode
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supporttrue
                                        Standard StatusNormative (from Normative)
                                        Summarytrue
                                        Requirements

                                        Needed for identification of the individual, in combination with (at least) name and birth date.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        148. Patient.birthDate
                                        Definition

                                        The date of birth for the individual.

                                        ShortThe date of birth for the individual
                                        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 maternity/infant care systems).

                                        Control0..1
                                        Typedate
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supporttrue
                                        Standard StatusNormative (from Normative)
                                        Summarytrue
                                        Requirements

                                        Age of the individual drives many clinical processes.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        LOINC Code21112-8
                                        150. Patient.deceased[x]
                                        Definition

                                        Indicates if the individual is deceased or not.

                                        ShortIndicates if the individual is deceased or not
                                        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.

                                        Control0..0
                                        TypeChoice of: boolean, dateTime
                                        Is Modifiertrue because 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.
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Standard StatusNormative (from Normative)
                                        Summarytrue
                                        Requirements

                                        The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        152. Patient.address
                                        Definition

                                        An address for the individual.

                                        ShortAn address for the individual
                                        Comments

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

                                        Control0..*
                                        TypeAddress
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Summarytrue
                                        Requirements

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

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        154. 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.

                                        ShortUnique id for inter-element referencing
                                        Control0..1
                                        Typestring
                                        Is Modifierfalse
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        Summaryfalse
                                        156. Patient.address.extension
                                        Definition

                                        May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                        ShortAdditional content defined by implementations
                                        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.

                                        Control0..*
                                        TypeExtension
                                        Is Modifierfalse
                                        Summaryfalse
                                        Alternate Namesextensions, user content
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        SlicingThis element introduces a set of slices on Patient.address.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • value @ url
                                        • 158. Patient.address.use
                                          Definition

                                          The purpose of this address.

                                          Shorthome | work | temp | old | billing - purpose of this address
                                          Comments

                                          Applications can assume that an address is current unless it explicitly says that it is temporary or old.

                                          Control0..1
                                          BindingThe codes SHALL be taken from AddressUse
                                          (required to http://hl7.org/fhir/ValueSet/address-use|4.0.1)

                                          The use of an address.

                                          Typecode
                                          Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summarytrue
                                          Requirements

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

                                          ExampleGeneral: home
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          160. 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.

                                          Shortpostal | physical | both
                                          Comments

                                          The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource).

                                          Control0..1
                                          BindingThe codes SHALL be taken from AddressType
                                          (required to http://hl7.org/fhir/ValueSet/address-type|4.0.1)

                                          The type of an address (physical / postal).

                                          Typecode
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summarytrue
                                          ExampleGeneral: both
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          162. Patient.address.text
                                          Definition

                                          Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts.

                                          ShortText representation of the address
                                          Comments

                                          Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

                                          Control0..0
                                          Typestring
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Standard StatusNormative (from Normative)
                                          Summarytrue
                                          Requirements

                                          A renderable, unencoded form.

                                          ExampleGeneral: 137 Nowhere Street, Erewhon 9132
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          164. 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.

                                          ShortStreet name, number, direction & P.O. Box etc.
                                          Control0..*
                                          Typestring
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supporttrue
                                          Standard StatusNormative (from Normative)
                                          Summarytrue
                                          ExampleGeneral: 137 Nowhere Street
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          166. Patient.address.city
                                          Definition

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

                                          ShortName of city, town etc.
                                          Control0..1
                                          Typestring
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supporttrue
                                          Standard StatusNormative (from Normative)
                                          Summarytrue
                                          Alternate NamesMunicpality
                                          ExampleGeneral: Erewhon
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          168. Patient.address.district
                                          Definition

                                          The name of the administrative area (county).

                                          ShortDistrict name (aka 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.

                                          Control0..0
                                          Typestring
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Standard StatusNormative (from Normative)
                                          Summarytrue
                                          Alternate NamesCounty
                                          ExampleGeneral: Madison
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          170. 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 (e.g. US 2 letter state codes).

                                          ShortSub-unit of country (abbreviations ok)
                                          Control0..0
                                          Typestring
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Standard StatusNormative (from Normative)
                                          Summarytrue
                                          Alternate NamesProvince, Territory
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          172. Patient.address.postalCode
                                          Definition

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

                                          ShortPostal code for area
                                          Control0..1
                                          Typestring
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supporttrue
                                          Standard StatusNormative (from Normative)
                                          Summarytrue
                                          Alternate NamesZip
                                          ExampleGeneral: 9132
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          174. Patient.address.country
                                          Definition

                                          Country - a nation as commonly understood or generally accepted.

                                          ShortCountry (e.g. can be ISO 3166 2 or 3 letter code)
                                          Comments

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

                                          Control0..0
                                          Typestring
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Standard StatusNormative (from Normative)
                                          Summarytrue
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          176. Patient.address.period
                                          Definition

                                          Time period when address was/is in use.

                                          ShortTime period when address was/is in use
                                          Control0..0
                                          TypePeriod
                                          Is Modifierfalse
                                          Summarytrue
                                          Requirements

                                          Allows addresses to be placed in historical context.

                                          ExampleGeneral: { "start" : "2010-03-23", "end" : "2010-07-01" }
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          178. Patient.maritalStatus
                                          Definition

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

                                          ShortMarital (civil) status of a patient
                                          Control0..1
                                          BindingThe codes SHALL be taken from Marital Status Codes
                                          (required to http://hl7.org/fhir/ValueSet/marital-status)

                                          The domestic partnership status of a person.

                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Summaryfalse
                                          Requirements

                                          Most, if not all systems capture it.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          180. 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.

                                          ShortUnique id for inter-element referencing
                                          Control0..1
                                          Typestring
                                          Is Modifierfalse
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          Summaryfalse
                                          182. Patient.maritalStatus.extension
                                          Definition

                                          May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                          ShortAdditional content defined by implementations
                                          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.

                                          Control0..*
                                          TypeExtension
                                          Is Modifierfalse
                                          Summaryfalse
                                          Alternate Namesextensions, user content
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          SlicingThis element introduces a set of slices on Patient.maritalStatus.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                          • value @ url
                                          • 184. Patient.maritalStatus.coding
                                            Definition

                                            A reference to a code defined by a terminology system.

                                            ShortCode defined by a terminology system
                                            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.

                                            Control0..1
                                            TypeCoding
                                            Is Modifierfalse
                                            Must Supporttrue
                                            Summarytrue
                                            Requirements

                                            Allows for alternative encodings within a code system, and translations to other code systems.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            186. 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.

                                            ShortUnique id for inter-element referencing
                                            Control0..1
                                            Typestring
                                            Is Modifierfalse
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            Summaryfalse
                                            188. Patient.maritalStatus.coding.extension
                                            Definition

                                            May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                            ShortAdditional content defined by implementations
                                            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.

                                            Control0..*
                                            TypeExtension
                                            Is Modifierfalse
                                            Summaryfalse
                                            Alternate Namesextensions, user content
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            SlicingThis element introduces a set of slices on Patient.maritalStatus.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • value @ url
                                            • 190. Patient.maritalStatus.coding.system
                                              Definition

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

                                              ShortIdentity of the terminology system
                                              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 reference to some definition that establishes the system clearly and unambiguously.

                                              Control1..1
                                              Typeuri
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supporttrue
                                              Standard StatusNormative (from Normative)
                                              Summarytrue
                                              Requirements

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

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              192. 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.

                                              ShortVersion of the system - if relevant
                                              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.

                                              NoteThis is a business version Id, not a resource version Id (see discussion)
                                              Control0..1
                                              Typestring
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              194. 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).

                                              ShortSymbol in syntax defined by the system
                                              Control1..1
                                              Typecode
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supporttrue
                                              Standard StatusNormative (from Normative)
                                              Summarytrue
                                              Requirements

                                              Need to refer to a particular code in the system.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              196. Patient.maritalStatus.coding.display
                                              Definition

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

                                              ShortRepresentation defined by the system
                                              Control0..1
                                              Typestring
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summarytrue
                                              Requirements

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

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              198. Patient.maritalStatus.coding.userSelected
                                              Definition

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

                                              ShortIf this coding was chosen directly by the user
                                              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.

                                              Control0..1
                                              Typeboolean
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summarytrue
                                              Requirements

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

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              200. 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.

                                              ShortPlain text representation of the concept
                                              Comments

                                              Very often the text is the same as a displayName of one of the codings.

                                              Control1..1
                                              Typestring
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supporttrue
                                              Standard StatusNormative (from Normative)
                                              Summarytrue
                                              Requirements

                                              The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              202. Patient.multipleBirth[x]
                                              Definition

                                              Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer).

                                              ShortWhether patient is part of a multiple birth
                                              Comments

                                              Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in triplets would be valueInteger=2 and the third born would have valueInteger=3 If a boolean value was provided for this triplets example, then all 3 patient records would have valueBoolean=true (the ordering is not indicated).

                                              Control0..0
                                              TypeChoice of: boolean, integer
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Standard StatusNormative (from Normative)
                                              Summaryfalse
                                              Requirements

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

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              204. Patient.photo
                                              Definition

                                              Image of the patient.

                                              ShortImage of the patient
                                              Comments

                                              Guidelines:

                                              • Use id photos, not clinical photos.
                                              • Limit dimensions to thumbnail.
                                              • Keep byte count low to ease resource updates.
                                              Control0..0
                                              TypeAttachment
                                              Is Modifierfalse
                                              Summaryfalse
                                              Requirements

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

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              206. Patient.contact
                                              Definition

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

                                              ShortA contact party (e.g. guardian, partner, friend) for 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.

                                              Control0..0
                                              TypeBackboneElement
                                              Is Modifierfalse
                                              Summaryfalse
                                              Requirements

                                              Need to track people you can contact about the patient.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (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())
                                              218. Patient.communication
                                              Definition

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

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

                                              Control0..*
                                              TypeBackboneElement
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summaryfalse
                                              Requirements

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

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              220. Patient.communication.id
                                              Definition

                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                              ShortUnique id for inter-element referencing
                                              Control0..1
                                              Typestring
                                              Is Modifierfalse
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              Summaryfalse
                                              222. Patient.communication.extension
                                              Definition

                                              May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                              ShortAdditional content defined by implementations
                                              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.

                                              Control0..*
                                              TypeExtension
                                              Is Modifierfalse
                                              Summaryfalse
                                              Alternate Namesextensions, user content
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              224. Patient.communication.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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                              ShortExtensions that cannot be ignored even if unrecognized
                                              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.

                                              Control0..*
                                              TypeExtension
                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                              Summarytrue
                                              Requirements

                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                              Alternate Namesextensions, user content, modifiers
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              226. Patient.communication.language
                                              Definition

                                              The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English.

                                              ShortThe language which can be used to communicate with the patient about his or her health
                                              Comments

                                              The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.

                                              Control1..1
                                              BindingThe codes SHALL be taken from CommonLanguages
                                              (required to http://hl7.org/fhir/ValueSet/languages)

                                              A human language.

                                              Additional BindingsPurpose
                                              AllLanguagesMax Binding
                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summaryfalse
                                              Requirements

                                              Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              228. Patient.communication.language.id
                                              Definition

                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                              ShortUnique id for inter-element referencing
                                              Control0..1
                                              Typestring
                                              Is Modifierfalse
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              Summaryfalse
                                              230. Patient.communication.language.extension
                                              Definition

                                              May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                              ShortAdditional content defined by implementations
                                              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.

                                              Control0..*
                                              TypeExtension
                                              Is Modifierfalse
                                              Summaryfalse
                                              Alternate Namesextensions, user content
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              SlicingThis element introduces a set of slices on Patient.communication.language.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • value @ url
                                              • 232. Patient.communication.language.coding
                                                Definition

                                                A reference to a code defined by a terminology system.

                                                ShortCode defined by a terminology system
                                                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.

                                                Control0..1
                                                TypeCoding
                                                Is Modifierfalse
                                                Must Supporttrue
                                                Summarytrue
                                                Requirements

                                                Allows for alternative encodings within a code system, and translations to other code systems.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                234. Patient.communication.language.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.

                                                ShortUnique id for inter-element referencing
                                                Control0..1
                                                Typestring
                                                Is Modifierfalse
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                Summaryfalse
                                                236. Patient.communication.language.coding.extension
                                                Definition

                                                May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                ShortAdditional content defined by implementations
                                                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.

                                                Control0..*
                                                TypeExtension
                                                Is Modifierfalse
                                                Summaryfalse
                                                Alternate Namesextensions, user content
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                SlicingThis element introduces a set of slices on Patient.communication.language.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                • value @ url
                                                • 238. Patient.communication.language.coding.system
                                                  Definition

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

                                                  ShortIdentity of the terminology system
                                                  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 reference to some definition that establishes the system clearly and unambiguously.

                                                  Control1..1
                                                  Typeuri
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supporttrue
                                                  Standard StatusNormative (from Normative)
                                                  Summarytrue
                                                  Requirements

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

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  240. Patient.communication.language.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.

                                                  ShortVersion of the system - if relevant
                                                  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.

                                                  NoteThis is a business version Id, not a resource version Id (see discussion)
                                                  Control0..1
                                                  Typestring
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  242. Patient.communication.language.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).

                                                  ShortSymbol in syntax defined by the system
                                                  Control1..1
                                                  Typecode
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supporttrue
                                                  Standard StatusNormative (from Normative)
                                                  Summarytrue
                                                  Requirements

                                                  Need to refer to a particular code in the system.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  244. Patient.communication.language.coding.display
                                                  Definition

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

                                                  ShortRepresentation defined by the system
                                                  Control0..1
                                                  Typestring
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  Requirements

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

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  246. Patient.communication.language.coding.userSelected
                                                  Definition

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

                                                  ShortIf this coding was chosen directly by the user
                                                  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.

                                                  Control0..1
                                                  Typeboolean
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  Requirements

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

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  248. Patient.communication.language.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.

                                                  ShortPlain text representation of the concept
                                                  Comments

                                                  Very often the text is the same as a displayName of one of the codings.

                                                  Control0..1
                                                  Typestring
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supporttrue
                                                  Standard StatusNormative (from Normative)
                                                  Summarytrue
                                                  Requirements

                                                  The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  250. Patient.communication.preferred
                                                  Definition

                                                  Indicates whether or not the patient prefers this language (over other languages he masters up a certain level).

                                                  ShortLanguage preference indicator
                                                  Comments

                                                  This language is specifically identified for communicating healthcare information.

                                                  Control1..1
                                                  Typeboolean
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supporttrue
                                                  Standard StatusNormative (from Normative)
                                                  Summaryfalse
                                                  Requirements

                                                  People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method.

                                                  Fixed Valuetrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  252. Patient.generalPractitioner
                                                  Definition

                                                  Patient's nominated care provider.

                                                  ShortPatient's nominated primary care provider
                                                  Comments

                                                  This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability 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. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues.

                                                  Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type.

                                                  Control0..0
                                                  TypeReference(Organization, Practitioner, PractitionerRole)
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Alternate NamescareProvider
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  254. Patient.managingOrganization
                                                  Definition

                                                  Organization that is the custodian of the patient record.

                                                  ShortOrganization that is the custodian of the patient record
                                                  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).

                                                  Control0..0
                                                  TypeReference(Organization)
                                                  Is Modifierfalse
                                                  Summarytrue
                                                  Requirements

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

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  256. Patient.link
                                                  Definition

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

                                                  ShortLink to another patient resource that concerns the same actual person
                                                  Comments

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

                                                  Control0..0
                                                  TypeBackboneElement
                                                  Is Modifiertrue because This element is labeled as a modifier because it might 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'
                                                  Summarytrue
                                                  Requirements

                                                  There are multiple use cases:

                                                  • Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and
                                                  • Distribution of patient information across multiple servers.
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))