MyHealth@Eu Laboratory Report
0.0.1 - qa-preview 150

This page is part of the MyHealth@Eu Laboratory Report (v0.0.1: QA Preview) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Resource Profile: PatientEuObligations - Detailed Descriptions

Page standards status: Draft Maturity Level: 0

Definitions for the Patient-obl-lab-myhealtheu resource profile.

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

0. Patient
LOINC Code
2. Patient.identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
Obligations
    ObligationsActor
    handleLabReportRepos
    handleLabReportConsumer
    sendLabReportRepos
    sendLabReportCreator
    populateLabReportCreator
    LOINC Code
    4. Patient.name
    6. Patient.name.text
    Obligations
      ObligationsActor
      handleLabReportRepos
      handleLabReportConsumer
      sendLabReportRepos
      sendLabReportCreator
      populateLabReportCreator
      LOINC Code
      8. Patient.name.family
      Obligations
        ObligationsActor
        handleLabReportRepos
        handleLabReportConsumer
        sendLabReportRepos
        sendLabReportCreator
        populateLabReportCreator
        LOINC Code
        10. Patient.name.given
        Obligations
          ObligationsActor
          handleLabReportRepos
          handleLabReportConsumer
          sendLabReportRepos
          sendLabReportCreator
          populateLabReportCreator
          LOINC Code
          12. Patient.telecom
          Obligations
            ObligationsActor
            handleLabReportRepos
            handleLabReportConsumer
            sendLabReportRepos
            sendLabReportCreator
            populateLabReportCreator
            LOINC Code
            14. Patient.gender
            Obligations
              ObligationsActor
              handleLabReportRepos
              handleLabReportConsumer
              sendLabReportRepos
              sendLabReportCreator
              populateLabReportCreator
              LOINC Code
              16. Patient.birthDate
              Obligations
                ObligationsActor
                handleLabReportRepos
                handleLabReportConsumer
                sendLabReportRepos
                sendLabReportCreator
                populateLabReportCreator
                LOINC Code
                18. Patient.address
                Obligations
                  ObligationsActor
                  handleLabReportRepos
                  handleLabReportConsumer
                  sendLabReportRepos
                  sendLabReportCreator
                  populateLabReportCreator
                  LOINC Code
                  20. Patient.generalPractitioner
                  Obligations
                    ObligationsActor
                    handleLabReportRepos
                    handleLabReportConsumer
                    sendLabReportRepos
                    sendLabReportCreator
                    populateLabReportCreator
                    LOINC Code

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

                    0. Patient
                    Definition

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

                    ShortInformation about an individual or animal receiving health care services
                    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: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
                    This element is affected by the following invariants: ele-1
                    TypeExtension(Birth Place) (Extension Type: Address)
                    Is Modifierfalse
                    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())
                    LOINC Code
                    6. 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())
                    SlicingThis element introduces a set of slices on Patient.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 8. 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
                      10. Patient.extension:birthPlace.value[x]
                      Definition

                      An address expressed using postal conventions (as opposed to GPS or other location definition formats). This data type may be used to convey addresses for use in delivering mail as well as for visiting locations which might not be valid for mail delivery. There are a variety of postal address formats defined around the world.


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

                      ShortAn address expressed using postal conventions (as opposed to GPS or other location definition formats)Value of extension
                      Comments

                      Note: address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource).

                      Control10..1
                      This element is affected by the following invariants: ele-1
                      TypeAddress(Address (EU)), 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] NoteSee Choice of Data Types for further information about how to use [x]
                      Is Modifierfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      12. Patient.extension:sex-for-clinical-use
                      Slice Namesex-for-clinical-use
                      Definition

                      A parameter that provides guidance on how a recipient should apply settings or reference ranges that are derived from observable information such as an organ inventory, recent hormone lab tests, genetic testing, menstrual status, obstetric history, etc..

                      ShortA context-specific sex parameter for clinical use
                      Control0..*
                      TypeExtension(Patient Sex Parameter For Clinical Use) (Complex Extension)
                      Is Modifierfalse
                      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())
                      LOINC Code
                      14. 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())
                      16. Patient.identifier
                      Definition

                      An identifier for this patient.

                      ShortPatient identifiersAn identifier for this patient
                      NoteThis is a business identifier, not a resource identifier (see discussion)
                      Control0..*
                      TypeIdentifier
                      Is Modifierfalse
                      Obligations
                        ObligationsActor
                        handleLabReportRepos
                        handleLabReportConsumer
                        sendLabReportRepos
                        sendLabReportCreator
                        populateLabReportCreator
                        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()))
                        18. 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..1
                        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
                        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()))
                        20. Patient.name
                        Definition

                        A human's name with the ability to identify parts and usage.


                        A name associated with the individual.

                        ShortName of a human - parts and usageA name associated with the patient
                        Comments

                        Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts might or might not be imbued with some implicit meaning; various cultures associate different importance with the name parts and the degree to which systems must care about name parts around the world varies widely.


                        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.

                        Control10..*
                        This element is affected by the following invariants: ele-1
                        TypeHumanName(HumanName (Eu))
                        Is Modifierfalse
                        Requirements

                        Need to be able to track the patient by multiple names. Examples are your official name and a partner name. The Alphabetic representation of the name SHALL be always provided


                        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()))
                        eu-pat-1: given, family, text or a data-absent-reason extension SHALL be present (family.exists() or given.exists() or text.exists() or extension('http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists())
                        22. Patient.name.extension:name-absent-reason
                        Slice Namename-absent-reason
                        Definition

                        Reason for not providing the name

                        ShortReason for not providing the name
                        Control0..*
                        TypeExtension(Why value is missing) (Extension Type: code)
                        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())
                        LOINC Code
                        24. 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
                        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()))
                        26. Patient.name.text
                        Definition

                        Text representation of the full name. Due to the cultural variance around the world a consuming system may not know how to present the name correctly; moreover not all the parts of the name go in given or family. Creators are therefore strongly encouraged to provide through this element a presented version of the name. Future versions of this guide may require this element


                        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..1
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Obligations
                          ObligationsActor
                          handleLabReportRepos
                          handleLabReportConsumer
                          sendLabReportRepos
                          sendLabReportCreator
                          populateLabReportCreator
                          Summarytrue
                          Requirements

                          A renderable, unencoded form.

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

                          Family name. When more the family is composed by more than one names, this element documents the full composed family name with the proper * name.familyrder. The parts are recorded in the fhater and mother family names extensions.


                          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 nameFamily 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
                          Obligations
                            ObligationsActor
                            handleLabReportRepos
                            handleLabReportConsumer
                            sendLabReportRepos
                            sendLabReportCreator
                            populateLabReportCreator
                            Summarytrue
                            Alternate Namessurname
                            Example<br/><b>spanish name</b>:Valero Iglesias <br/><b>spanish</b>:Valero Iglesias
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            30. Patient.name.family.extension:fathersFamily
                            Slice NamefathersFamily
                            Definition

                            The portion of the family name that is derived from the person's father.

                            ShortPortion of family name derived from father
                            Control0..*
                            This element is affected by the following invariants: ele-1
                            TypeExtension(fathers-family) (Extension Type: string)
                            Is Modifierfalse
                            Example<br/><b>spanish name</b>:Valero
                            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())
                            LOINC Code
                            32. Patient.name.family.extension:mothersFamily
                            Slice NamemothersFamily
                            Definition

                            The portion of the family name that is derived from the person's mother.

                            ShortPortion of family name derived from mother
                            Control0..*
                            This element is affected by the following invariants: ele-1
                            TypeExtension(mothers-family) (Extension Type: string)
                            Is Modifierfalse
                            Example<br/><b>spanish name</b>:Iglesias
                            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())
                            LOINC Code
                            34. Patient.name.given
                            Definition

                            Given name.

                            ShortGiven names. Includes middle namesGiven 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
                            Obligations
                              ObligationsActor
                              handleLabReportRepos
                              handleLabReportConsumer
                              sendLabReportRepos
                              sendLabReportCreator
                              populateLabReportCreator
                              Summarytrue
                              Alternate Namesfirst name, middle name
                              Example<br/><b>spanish name</b>:Borja
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              36. 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 patientA 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..*
                              TypeContactPoint
                              Is Modifierfalse
                              Obligations
                                ObligationsActor
                                handleLabReportRepos
                                handleLabReportConsumer
                                sendLabReportRepos
                                sendLabReportCreator
                                populateLabReportCreator
                                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()))
                                38. Patient.gender
                                Definition

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

                                ShortAdministrative Gendermale | 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
                                Obligations
                                  ObligationsActor
                                  handleLabReportRepos
                                  handleLabReportConsumer
                                  sendLabReportRepos
                                  sendLabReportCreator
                                  populateLabReportCreator
                                  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()))
                                  40. 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).

                                  Control10..1
                                  Typedate
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Obligations
                                    ObligationsActor
                                    handleLabReportRepos
                                    handleLabReportConsumer
                                    sendLabReportRepos
                                    sendLabReportCreator
                                    populateLabReportCreator
                                    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
                                    42. 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..1
                                    TypeChoice of: boolean, dateTime
                                    [x] NoteSee Choice of Data Types for further information about how to use [x]
                                    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
                                    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()))
                                    44. Patient.address
                                    Definition

                                    An address expressed using postal conventions (as opposed to GPS or other location definition formats). This data type may be used to convey addresses for use in delivering mail as well as for visiting locations which might not be valid for mail delivery. There are a variety of postal address formats defined around the world.


                                    An address for the individual.

                                    ShortAn address expressed using postal conventions (as opposed to GPS or other location definition formats)An address for the individual
                                    Comments

                                    Note: address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource).


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

                                    Control0..*
                                    This element is affected by the following invariants: ele-1
                                    TypeAddress(Address (EU))
                                    Is Modifierfalse
                                    Obligations
                                      ObligationsActor
                                      handleLabReportRepos
                                      handleLabReportConsumer
                                      sendLabReportRepos
                                      sendLabReportCreator
                                      populateLabReportCreator
                                      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()))
                                      pat-cnt-2or3-char: The content of the country element (if present) SHALL be selected EITHER from ValueSet ISO Country Alpha-2 http://hl7.org/fhir/ValueSet/iso3166-1-2 OR MAY be selected from ISO Country Alpha-3 Value Set http://hl7.org/fhir/ValueSet/iso3166-1-3, IF the country is not specified in value Set ISO Country Alpha-2 http://hl7.org/fhir/ValueSet/iso3166-1-2. (country.empty() or (country.memberOf('http://hl7.org/fhir/ValueSet/iso3166-1-2') or country.memberOf('http://hl7.org/fhir/ValueSet/iso3166-1-3')))
                                      46. Patient.generalPractitioner
                                      Definition

                                      Patient's nominated care provider.

                                      ShortPatient's nominated care providerPatient'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..*
                                      TypeReference(Organization, Practitioner, PractitionerRole)
                                      Is Modifierfalse
                                      Obligations
                                        ObligationsActor
                                        handleLabReportRepos
                                        handleLabReportConsumer
                                        sendLabReportRepos
                                        sendLabReportCreator
                                        populateLabReportCreator
                                        Summaryfalse
                                        Alternate NamescareProvider
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        48. 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..*
                                        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()))
                                        50. Patient.link.modifierExtension
                                        Definition

                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element 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())
                                        52. Patient.link.other
                                        Definition

                                        The other patient resource that the link refers to.

                                        ShortThe other patient or related person resource that the link refers to
                                        Comments

                                        Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.

                                        Control1..1
                                        TypeReference(Patient, RelatedPerson)
                                        Is Modifierfalse
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        54. Patient.link.type
                                        Definition

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

                                        Shortreplaced-by | replaces | refer | seealso
                                        Control1..1
                                        BindingThe codes SHALL be taken from LinkTypehttp://hl7.org/fhir/ValueSet/link-type|4.0.1
                                        (required to http://hl7.org/fhir/ValueSet/link-type|4.0.1)

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

                                        Typecode
                                        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()))

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

                                        0. Patient
                                        Definition

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

                                        ShortInformation about an individual or animal receiving health care services
                                        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)

                                        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 are unordered 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
                                          This element is affected by the following invariants: ele-1
                                          TypeExtension(Birth Place) (Extension Type: Address)
                                          Is Modifierfalse
                                          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
                                          Typestring
                                          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 are unordered 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

                                            An address expressed using postal conventions (as opposed to GPS or other location definition formats). This data type may be used to convey addresses for use in delivering mail as well as for visiting locations which might not be valid for mail delivery. There are a variety of postal address formats defined around the world.

                                            ShortAn address expressed using postal conventions (as opposed to GPS or other location definition formats)
                                            Comments

                                            Note: address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource).

                                            Control1..1
                                            This element is affected by the following invariants: ele-1
                                            TypeAddress(Address (EU))
                                            [x] NoteSee Choice of Data Types for further information about how to use [x]
                                            Is Modifierfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            26. Patient.extension:sex-for-clinical-use
                                            Slice Namesex-for-clinical-use
                                            Definition

                                            A parameter that provides guidance on how a recipient should apply settings or reference ranges that are derived from observable information such as an organ inventory, recent hormone lab tests, genetic testing, menstrual status, obstetric history, etc..

                                            ShortA context-specific sex parameter for clinical use
                                            Control0..*
                                            TypeExtension(Patient Sex Parameter For Clinical Use) (Complex Extension)
                                            Is Modifierfalse
                                            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())
                                            28. 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())
                                            30. Patient.identifier
                                            Definition

                                            An identifier for this patient.

                                            ShortPatient identifiers
                                            NoteThis is a business identifier, not a resource identifier (see discussion)
                                            Control0..*
                                            TypeIdentifier
                                            Is Modifierfalse
                                            Obligations
                                              ObligationsActor
                                              handleLabReportRepos
                                              handleLabReportConsumer
                                              sendLabReportRepos
                                              sendLabReportCreator
                                              populateLabReportCreator
                                              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()))
                                              32. 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..1
                                              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
                                              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()))
                                              34. Patient.name
                                              Definition

                                              A human's name with the ability to identify parts and usage.

                                              ShortName of a human - parts and usage
                                              Comments

                                              Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts might or might not be imbued with some implicit meaning; various cultures associate different importance with the name parts and the degree to which systems must care about name parts around the world varies widely.

                                              Control1..*
                                              This element is affected by the following invariants: ele-1
                                              TypeHumanName(HumanName (Eu))
                                              Is Modifierfalse
                                              Requirements

                                              Need to be able to track the patient by multiple names. Examples are your official name and a partner name. The Alphabetic representation of the name SHALL be always provided

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              eu-pat-1: given, family, text or a data-absent-reason extension SHALL be present (family.exists() or given.exists() or text.exists() or extension('http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists())
                                              36. 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
                                              38. 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 are unordered and Open, and can be differentiated using the following discriminators:
                                              • value @ url
                                              • 40. Patient.name.extension:name-absent-reason
                                                Slice Namename-absent-reason
                                                Definition

                                                Reason for not providing the name

                                                ShortReason for not providing the name
                                                Control0..*
                                                TypeExtension(Why value is missing) (Extension Type: code)
                                                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())
                                                42. 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
                                                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()))
                                                44. Patient.name.text
                                                Definition

                                                Text representation of the full name. Due to the cultural variance around the world a consuming system may not know how to present the name correctly; moreover not all the parts of the name go in given or family. Creators are therefore strongly encouraged to provide through this element a presented version of the name. Future versions of this guide may require this element

                                                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..1
                                                Typestring
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Obligations
                                                  ObligationsActor
                                                  handleLabReportRepos
                                                  handleLabReportConsumer
                                                  sendLabReportRepos
                                                  sendLabReportCreator
                                                  populateLabReportCreator
                                                  Summarytrue
                                                  Requirements

                                                  A renderable, unencoded form.

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

                                                  Family name. When more the family is composed by more than one names, this element documents the full composed family name with the proper * name.familyrder. The parts are recorded in the fhater and mother family names extensions.

                                                  ShortFamily name
                                                  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
                                                  Obligations
                                                    ObligationsActor
                                                    handleLabReportRepos
                                                    handleLabReportConsumer
                                                    sendLabReportRepos
                                                    sendLabReportCreator
                                                    populateLabReportCreator
                                                    Summarytrue
                                                    Alternate Namessurname
                                                    Example<br/><b>spanish name</b>:Valero Iglesias <br/><b>spanish</b>:Valero Iglesias
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    48. Patient.name.family.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
                                                    50. Patient.name.family.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.family.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                    • value @ url
                                                    • 52. Patient.name.family.extension:fathersFamily
                                                      Slice NamefathersFamily
                                                      Definition

                                                      The portion of the family name that is derived from the person's father.

                                                      ShortPortion of family name derived from father
                                                      Control0..*
                                                      This element is affected by the following invariants: ele-1
                                                      TypeExtension(fathers-family) (Extension Type: string)
                                                      Is Modifierfalse
                                                      Example<br/><b>spanish name</b>:Valero
                                                      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())
                                                      54. Patient.name.family.extension:mothersFamily
                                                      Slice NamemothersFamily
                                                      Definition

                                                      The portion of the family name that is derived from the person's mother.

                                                      ShortPortion of family name derived from mother
                                                      Control0..*
                                                      This element is affected by the following invariants: ele-1
                                                      TypeExtension(mothers-family) (Extension Type: string)
                                                      Is Modifierfalse
                                                      Example<br/><b>spanish name</b>:Iglesias
                                                      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())
                                                      56. Patient.name.family.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 Length1048576
                                                      58. Patient.name.given
                                                      Definition

                                                      Given name.

                                                      ShortGiven names. 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
                                                      Obligations
                                                        ObligationsActor
                                                        handleLabReportRepos
                                                        handleLabReportConsumer
                                                        sendLabReportRepos
                                                        sendLabReportCreator
                                                        populateLabReportCreator
                                                        Summarytrue
                                                        Alternate Namesfirst name, middle name
                                                        Example<br/><b>spanish name</b>:Borja
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        60. 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
                                                        Summarytrue
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        62. 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
                                                        Summarytrue
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        64. 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..1
                                                        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()))
                                                        66. 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 patient
                                                        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..*
                                                        TypeContactPoint
                                                        Is Modifierfalse
                                                        Obligations
                                                          ObligationsActor
                                                          handleLabReportRepos
                                                          handleLabReportConsumer
                                                          sendLabReportRepos
                                                          sendLabReportCreator
                                                          populateLabReportCreator
                                                          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()))
                                                          68. Patient.gender
                                                          Definition

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

                                                          ShortAdministrative Gender
                                                          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
                                                          Obligations
                                                            ObligationsActor
                                                            handleLabReportRepos
                                                            handleLabReportConsumer
                                                            sendLabReportRepos
                                                            sendLabReportCreator
                                                            populateLabReportCreator
                                                            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()))
                                                            70. 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).

                                                            Control1..1
                                                            Typedate
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Obligations
                                                              ObligationsActor
                                                              handleLabReportRepos
                                                              handleLabReportConsumer
                                                              sendLabReportRepos
                                                              sendLabReportCreator
                                                              populateLabReportCreator
                                                              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
                                                              72. 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..1
                                                              TypeChoice of: boolean, dateTime
                                                              [x] NoteSee Choice of Data Types for further information about how to use [x]
                                                              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
                                                              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()))
                                                              74. Patient.address
                                                              Definition

                                                              An address expressed using postal conventions (as opposed to GPS or other location definition formats). This data type may be used to convey addresses for use in delivering mail as well as for visiting locations which might not be valid for mail delivery. There are a variety of postal address formats defined around the world.

                                                              ShortAn address expressed using postal conventions (as opposed to GPS or other location definition formats)
                                                              Comments

                                                              Note: address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource).

                                                              Control0..*
                                                              This element is affected by the following invariants: ele-1
                                                              TypeAddress(Address (EU))
                                                              Is Modifierfalse
                                                              Obligations
                                                                ObligationsActor
                                                                handleLabReportRepos
                                                                handleLabReportConsumer
                                                                sendLabReportRepos
                                                                sendLabReportCreator
                                                                populateLabReportCreator
                                                                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()))
                                                                pat-cnt-2or3-char: The content of the country element (if present) SHALL be selected EITHER from ValueSet ISO Country Alpha-2 http://hl7.org/fhir/ValueSet/iso3166-1-2 OR MAY be selected from ISO Country Alpha-3 Value Set http://hl7.org/fhir/ValueSet/iso3166-1-3, IF the country is not specified in value Set ISO Country Alpha-2 http://hl7.org/fhir/ValueSet/iso3166-1-2. (country.empty() or (country.memberOf('http://hl7.org/fhir/ValueSet/iso3166-1-2') or country.memberOf('http://hl7.org/fhir/ValueSet/iso3166-1-3')))
                                                                76. Patient.maritalStatus
                                                                Definition

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

                                                                ShortMarital (civil) status of a patient
                                                                Control0..1
                                                                BindingUnless not suitable, these codes SHALL be taken from Marital Status Codes
                                                                (extensible to http://hl7.org/fhir/ValueSet/marital-status)

                                                                The domestic partnership status of a person.

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                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()))
                                                                78. 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..1
                                                                TypeChoice of: boolean, integer
                                                                [x] NoteSee Choice of Data Types for further information about how to use [x]
                                                                Is Modifierfalse
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                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()))
                                                                80. 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..*
                                                                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()))
                                                                82. 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..*
                                                                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())
                                                                84. Patient.contact.id
                                                                Definition

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

                                                                ShortUnique id for inter-element referencing
                                                                Control0..1
                                                                Typestring
                                                                Is Modifierfalse
                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                Summaryfalse
                                                                86. Patient.contact.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())
                                                                88. Patient.contact.modifierExtension
                                                                Definition

                                                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element 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())
                                                                90. Patient.contact.relationship
                                                                Definition

                                                                A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

                                                                ShortRelationship between a patient and a contact person for that patient
                                                                Comments

                                                                Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                                                                Control0..*
                                                                This element is affected by the following invariants: ele-1
                                                                BindingUnless not suitable, these codes SHALL be taken from PatientContactRelationship
                                                                (extensible to http://hl7.org/fhir/ValueSet/patient-contactrelationship)

                                                                The nature of the relationship between a patient and a contact person for that patient.

                                                                TypeCodeableConcept(Codeable Concept (IPS))
                                                                Is Modifierfalse
                                                                Requirements

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

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

                                                                A name associated with the contact person.

                                                                ShortA name associated with the contact person
                                                                Control0..1
                                                                TypeHumanName
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

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

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

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

                                                                ShortA contact detail for the person
                                                                Comments

                                                                Contact may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification.

                                                                Control0..*
                                                                TypeContactPoint
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                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()))
                                                                96. Patient.contact.address
                                                                Definition

                                                                An address expressed using postal conventions (as opposed to GPS or other location definition formats). This data type may be used to convey addresses for use in delivering mail as well as for visiting locations which might not be valid for mail delivery. There are a variety of postal address formats defined around the world.

                                                                ShortAn address expressed using postal conventions (as opposed to GPS or other location definition formats)
                                                                Comments

                                                                Note: address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource).

                                                                Control0..1
                                                                This element is affected by the following invariants: ele-1
                                                                TypeAddress(Address (EU))
                                                                Is Modifierfalse
                                                                Requirements

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

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

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

                                                                Shortmale | female | other | unknown
                                                                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
                                                                Summaryfalse
                                                                Requirements

                                                                Needed to address the person correctly.

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

                                                                Organization on behalf of which the contact is acting or for which the contact is working.

                                                                ShortOrganization that is associated with the contact
                                                                Control0..1
                                                                This element is affected by the following invariants: pat-1
                                                                TypeReference(Organization)
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

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

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

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

                                                                ShortThe period during which this contact person or organization is valid to be contacted relating to this patient
                                                                Control0..1
                                                                TypePeriod
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                104. 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
                                                                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()))
                                                                106. 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
                                                                108. 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())
                                                                110. 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())
                                                                112. 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 SHOULD be taken from CommonLanguages
                                                                (preferred to http://hl7.org/fhir/ValueSet/languages)

                                                                A human language.

                                                                Additional BindingsPurpose
                                                                AllLanguagesMax Binding
                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                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()))
                                                                114. 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.

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

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

                                                                Patient's nominated care provider.

                                                                ShortPatient's nominated 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..*
                                                                TypeReference(Organization, Practitioner, PractitionerRole)
                                                                Is Modifierfalse
                                                                Obligations
                                                                  ObligationsActor
                                                                  handleLabReportRepos
                                                                  handleLabReportConsumer
                                                                  sendLabReportRepos
                                                                  sendLabReportCreator
                                                                  populateLabReportCreator
                                                                  Summaryfalse
                                                                  Alternate NamescareProvider
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  118. 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..1
                                                                  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()))
                                                                  120. 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..*
                                                                  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()))
                                                                  122. Patient.link.id
                                                                  Definition

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

                                                                  ShortUnique id for inter-element referencing
                                                                  Control0..1
                                                                  Typestring
                                                                  Is Modifierfalse
                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                  Summaryfalse
                                                                  124. Patient.link.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())
                                                                  126. Patient.link.modifierExtension
                                                                  Definition

                                                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element 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())
                                                                  128. Patient.link.other
                                                                  Definition

                                                                  The other patient resource that the link refers to.

                                                                  ShortThe other patient or related person resource that the link refers to
                                                                  Comments

                                                                  Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.

                                                                  Control1..1
                                                                  TypeReference(Patient, RelatedPerson)
                                                                  Is Modifierfalse
                                                                  Summarytrue
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  130. Patient.link.type
                                                                  Definition

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

                                                                  Shortreplaced-by | replaces | refer | seealso
                                                                  Control1..1
                                                                  BindingThe codes SHALL be taken from LinkType
                                                                  (required to http://hl7.org/fhir/ValueSet/link-type|4.0.1)

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

                                                                  Typecode
                                                                  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()))