Canadian Baseline
1.2.0 - CI Build

Canadian Baseline, published by HL7 Canada - FHIR Implementation Work Group. This guide is not an authorized publication; it is the continuous build for version 1.2.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7-Canada/ca-baseline/ and changes regularly. See the Directory of published versions

## Resource Profile: Patient Profile

Official URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-patient | Version: 1.2.0
Draft as of 2024-12-27 | Computable Name: PatientProfile

Proposed constraints and extensions on the Patient Resource as scoped to human patients

# CA Baseline Patient Profile

> This profile is seeking community and implementer feedback on whether further relaxation of the 1..1 cardinality is needed on the Patient.identifier.type & .system & .value elements.
> Due Diligence Reviews identified the above elements as 1..1 cardinality but not in the equivalent eReferral Specification profile. This variance is believed to be due to the eReferral Specification profile not necessarily expecting a Patient to always have a health card (or at minimum a health card number). General consensus from Due Diligence Review is that the cardinalities should not be relaxed in the CA Baseline. Feedback can be provided through the Simplifier issue log for this profile.
> Feedback can be provided through the Simplifier issue log for this profile.

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This Patient profile sets minimum expectations for the Patient resource to record, search and fetch demographics and other administrative information about an individual receiving care or other health-related services.

Since not all concepts are included within the base FHIR Patient resource, this profile defines localization concepts for use in an Canadian context.

## Mandatory Data Elements

All elements or attributes defined in FHIR have cardinality as part of their definition - a minimum number of required appearances and a maximum number.

Most elements in FHIR specification have a minimum cardinality of 0, which means that they may be missing from a resource when it is exchanged between systems.

In this Canadian Baseline Patient Profile all elements are optional, i.e., there is no element with a minimum cardinality of 1. However, some optional elements (e.g., identifier) have required components that MUST be present if that optional element is provided.

### Data Absent Reason

In situations where the minimum cardinality of an element or attribute is 1 and information is missing and the Responder knows the precise reason for the absence of data, Responders SHALL send the reason for the missing information using values (such as NullFlavor) from the value set where they exist or using the DataAbsentReason extension.

## Must Support Data Elements

Some elements are labeled as MustSupport meaning that implementations that produce or consume resources SHALL provide "support" for the element in some meaningful way (see Must Support definition).

Following elements are marked as Must Support in the Canadian Patient profile to aid record matching in databases with many pediatric records.

Must Support elements:

- an identifier
- a patient name
- a birth date

## Usage Note

Some of the typical use cases where the Patient profile may be used:

- Enterprise-wide information systems that manage patient registration and services ordering
- Local or cross-jurisdictional systems to query information about patients whose demographics data match data provided in the query parameters
- Synchronization of patient information between multiple ADT systems employed by healthcare enterprises

This profile includes an invariant that enforces that a family.name, given.name, or both be present. This is intended to enforce minimum constraints while allowing for cases where the patient may only have one name.

- Some jurisdictions with more rigid cardinality constraints on both family and given may be handling this today by populating the name of a patient into both fields
- Other jurisdictions may allow the population of either family or given

Usages:

- Refer to this Profile: AllergyIntolerance Profile, Condition Profile, Device Profile (Medical and Non-medical), Device Profile (Implantable)... Show 14 more, DiagnosticReport Profile for Laboratory Results Reporting, Diagnostic Report for Report and Note Exchange Profile, DocumentReference Profile for metadata about the document, Encounter Profile, Immunization Profile, ImmunizationRecommendation Profile, MedicationAdministration Profile, MedicationDispense Profile, MedicationRequest Profile, MedicationStatement Profile, Observation Profile (Laboratory Results), Observation Profile (General Use), Procedure Profile and ServiceRequest Profile for Results Reporting

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

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

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Patient |  | 0..* | Patient | Patient Profile
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:aboriginalidentitygroup |  | 0..1 | Coding | Extension: Aboriginal Identity Group URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-aboriginalidentitygroup Binding: Aboriginal Identity Group (preferred): One of aboriginal identity codes
extension:aboriginalidentityindicator |  | 0..1 | Coding | Extension: Aboriginal Identity Indicator URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-aboriginalidentityindicator Binding: Aboriginal Identity Indicator (preferred): One of self-reported codes identity as an aboriginal person
extension:birthsex |  | 0..1 | Coding | Extension: Sex at Birth URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-patientbirthsex Binding: Birth Sex (example): Code for sex assigned at birth
extension:ethnicity |  | 0..1 | Coding | Extension: ethnicity extension URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-ethnicity Binding: EthnicityCode (preferred): One of self-reported ethnic group codes representing the ethnicity concept and should not be confused with citizenship or nationality.
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for identifier | Σ | 0..* | IdentifierCABaseline | An identifier for this patient Slice: Unordered, Open by pattern:type
identifier:All Slices |  |  |  | Content/Rules for all slices
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system | Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | Σ | 1..1 | string | The value that is unique within the system. Example General: 123456
identifier:JHN | Σ | 0..* | Identifier | Jurisdictional Health Number
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:versionCode |  | 0..1 | string | Health Number Version Code URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-identifierversion
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 1..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: JHN
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
system | Σ | 1..1 | uri | A Health Number Naming System from the Canadian URI Registry Example General: http://www.acme.com/identifiers/patient
value | Σ | 1..1 | string | The value that is unique within the system. Example General: 123456
active | ?!Σ | 0..1 | boolean | Whether this patient's record is in active use
name | S Σ C | 0..* | HumanName | A name associated with the patient Constraints: ipa-pat-2
use | ?!Σ | 0..1 | code | usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
family | Σ | 0..1 | string | Family name (often called 'Surname')
given | Σ | 0..* | string | Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name
telecom | Σ | 0..* | ContactPoint | A contact detail for the individual
system | Σ C | 1..1 | code | phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value | Σ | 1..1 | string | The actual contact point details
use | ?!Σ | 0..1 | code | home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.
birthDate | S Σ | 0..1 | date | The date of birth for the individual
deceased[x] | ?!Σ | 0..1 |  | Indicates if the individual is deceased or not
deceasedBoolean |  |  | boolean |
deceasedDateTime |  |  | dateTime |
address | Σ | 0..* | Address | An address for the individual
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:preferred |  | 0..1 | boolean | HL7 Preferred Address Flag extension URL: http://hl7.org/fhir/StructureDefinition/iso21090-preferred
extension:noFixedAddress |  | 0..1 | boolean | No Fixed Address indicator URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-nofixedaddress
use | ?!Σ | 0..1 | code | home | work | temp | old | billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
link | ?!Σ | 0..* | BackboneElement | Link to another patient resource that concerns the same actual person
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
other | Σ | 1..1 | Reference(Patient | RelatedPerson) | The other patient or related person resource that the link refers to
type | Σ | 1..1 | code | replaced-by | replaces | refer | seealso Binding: LinkType (required): The type of link between this patient resource and another patient resource.
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Patient.identifier.use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
Patient.identifier.type | Base | extensible | IdentifierType | 📍4.0.1 | FHIR Std.
Patient.identifier:JHN.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
Patient.identifier:JHN.​type | Base | extensible | IdentifierType | 📍4.0.1 | FHIR Std.
Patient.name.use | Base | required | NameUse | 📍4.0.1 | FHIR Std.
Patient.telecom.system | Base | required | ContactPointSystem | 📍4.0.1 | FHIR Std.
Patient.telecom.use | Base | required | ContactPointUse | 📍4.0.1 | FHIR Std.
Patient.address.use | Base | required | AddressUse | 📍4.0.1 | FHIR Std.
Patient.link.type | Base | required | LinkType | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Patient | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Patient | 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 | error | Patient | 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 | error | Patient | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Patient | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
ipa-pat-2 | error | Patient.name | Either Patient.name.given and/or Patient.name.family and/or Patient.name.text SHALL be present or a Data Absent Reason Extension SHALL be present. | `(family.exists() or given.exists() or text.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()`

This structure is derived from Patient

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Patient |  | 0..* | Patient | Patient Profile
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:aboriginalidentitygroup |  | 0..1 | Coding | Extension: Aboriginal Identity Group URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-aboriginalidentitygroup Binding: Aboriginal Identity Group (preferred): One of aboriginal identity codes
extension:aboriginalidentityindicator |  | 0..1 | Coding | Extension: Aboriginal Identity Indicator URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-aboriginalidentityindicator Binding: Aboriginal Identity Indicator (preferred): One of self-reported codes identity as an aboriginal person
extension:birthsex |  | 0..1 | Coding | Extension: Sex at Birth URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-patientbirthsex Binding: Birth Sex (example): Code for sex assigned at birth
extension:ethnicity |  | 0..1 | Coding | Extension: ethnicity extension URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-ethnicity Binding: EthnicityCode (preferred): One of self-reported ethnic group codes representing the ethnicity concept and should not be confused with citizenship or nationality.
Slices for identifier |  | 0..* | IdentifierCABaseline | An identifier for this patient Slice: Unordered, Open by pattern:type
identifier:All Slices |  |  |  | Content/Rules for all slices
type |  | 0..1 | CodeableConcept | Description of identifier
system |  | 1..1 | uri | The namespace for the identifier value
value |  | 1..1 | string | The value that is unique within the system.
identifier:JHN |  | 0..* | Identifier | Jurisdictional Health Number
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:versionCode |  | 0..1 | string | Health Number Version Code URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-identifierversion
type |  | 1..1 | CodeableConcept | Description of identifier Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: JHN
system |  | 1..1 | uri | A Health Number Naming System from the Canadian URI Registry
value |  | 1..1 | string | The value that is unique within the system.
name | S C | 0..* | HumanName | A name associated with the patient Constraints: ipa-pat-2
family |  | 0..1 | string | Family name (often called 'Surname')
given |  | 0..* | string | Given names (not always 'first'). Includes middle names
telecom |  | 0..* | ContactPoint | A contact detail for the individual
system |  | 1..1 | code | phone | fax | email | pager | url | sms | other
value |  | 1..1 | string | The actual contact point details
birthDate | S | 0..1 | date | The date of birth for the individual
address |  | 0..* | Address | An address for the individual
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:preferred |  | 0..1 | boolean | HL7 Preferred Address Flag extension URL: http://hl7.org/fhir/StructureDefinition/iso21090-preferred
extension:noFixedAddress |  | 0..1 | boolean | No Fixed Address indicator URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-nofixedaddress
Documentation for this format

#### Constraints

Id | Grade | Path(s) | Description | Expression
ipa-pat-2 | error | Patient.name | Either Patient.name.given and/or Patient.name.family and/or Patient.name.text SHALL be present or a Data Absent Reason Extension SHALL be present. | `(family.exists() or given.exists() or text.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Patient |  | 0..* | Patient | Patient Profile
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:aboriginalidentitygroup |  | 0..1 | Coding | Extension: Aboriginal Identity Group URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-aboriginalidentitygroup Binding: Aboriginal Identity Group (preferred): One of aboriginal identity codes
extension:aboriginalidentityindicator |  | 0..1 | Coding | Extension: Aboriginal Identity Indicator URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-aboriginalidentityindicator Binding: Aboriginal Identity Indicator (preferred): One of self-reported codes identity as an aboriginal person
extension:birthsex |  | 0..1 | Coding | Extension: Sex at Birth URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-patientbirthsex Binding: Birth Sex (example): Code for sex assigned at birth
extension:ethnicity |  | 0..1 | Coding | Extension: ethnicity extension URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-ethnicity Binding: EthnicityCode (preferred): One of self-reported ethnic group codes representing the ethnicity concept and should not be confused with citizenship or nationality.
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for identifier | Σ | 0..* | IdentifierCABaseline | An identifier for this patient Slice: Unordered, Open by pattern:type
identifier:All Slices |  |  |  | Content/Rules for all slices
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system | Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | Σ | 1..1 | string | The value that is unique within the system. Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
identifier:JHN | Σ | 0..* | Identifier | Jurisdictional Health Number
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:versionCode |  | 0..1 | string | Health Number Version Code URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-identifierversion
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 1..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: JHN
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
system | Σ | 1..1 | uri | A Health Number Naming System from the Canadian URI Registry Example General: http://www.acme.com/identifiers/patient
value | Σ | 1..1 | string | The value that is unique within the system. Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
active | ?!Σ | 0..1 | boolean | Whether this patient's record is in active use
name | S Σ C | 0..* | HumanName | A name associated with the patient Constraints: ipa-pat-2
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
text | Σ | 0..1 | string | Text representation of the full name
family | Σ | 0..1 | string | Family name (often called 'Surname')
given | Σ | 0..* | string | Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name
prefix | Σ | 0..* | string | Parts that come before the name This repeating element order: Prefixes appear in the correct order for presenting the name
suffix | Σ | 0..* | string | Parts that come after the name This repeating element order: Suffixes appear in the correct order for presenting the name
period | Σ | 0..1 | Period | Time period when name was/is in use
telecom | Σ | 0..* | ContactPoint | A contact detail for the individual
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ C | 1..1 | code | phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value | Σ | 1..1 | string | The actual contact point details
use | ?!Σ | 0..1 | code | home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.
rank | Σ | 0..1 | positiveInt | Specify preferred order of use (1 = highest)
period | Σ | 0..1 | Period | Time period when the contact point was/is in use
gender | Σ | 0..1 | code | male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
birthDate | S Σ | 0..1 | date | The date of birth for the individual
deceased[x] | ?!Σ | 0..1 |  | Indicates if the individual is deceased or not
deceasedBoolean |  |  | boolean |
deceasedDateTime |  |  | dateTime |
address | Σ | 0..* | Address | An address for the individual
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:preferred |  | 0..1 | boolean | HL7 Preferred Address Flag extension URL: http://hl7.org/fhir/StructureDefinition/iso21090-preferred
extension:noFixedAddress |  | 0..1 | boolean | No Fixed Address indicator URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-nofixedaddress
use | ?!Σ | 0..1 | code | home | work | temp | old | billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
type | Σ | 0..1 | code | postal | physical | both Binding: AddressType (required): The type of an address (physical / postal). Example General: both
text | Σ | 0..1 | string | Text representation of the address Example General: 137 Nowhere Street, Erewhon 9132
line | Σ | 0..* | string | Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label Example General: 137 Nowhere Street
city | Σ | 0..1 | string | Name of city, town etc. Example General: Erewhon
district | Σ | 0..1 | string | District name (aka county) Example General: Madison
state | Σ | 0..1 | string | Sub-unit of country (abbreviations ok)
postalCode | Σ | 0..1 | string | Postal code for area Example General: 9132
country | Σ | 0..1 | string | Country (e.g. can be ISO 3166 2 or 3 letter code)
period | Σ | 0..1 | Period | Time period when address was/is in use Example General: {"start":"2010-03-23","end":"2010-07-01"}
maritalStatus |  | 0..1 | CodeableConcept | Marital (civil) status of a patient Binding: Marital Status Codes (extensible): The domestic partnership status of a person.
multipleBirth[x] |  | 0..1 |  | Whether patient is part of a multiple birth
multipleBirthBoolean |  |  | boolean |
multipleBirthInteger |  |  | integer |
photo |  | 0..* | Attachment | Image of the patient
contact | C | 0..* | BackboneElement | A contact party (e.g. guardian, partner, friend) for the patient Constraints: pat-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
relationship |  | 0..* | CodeableConcept | The kind of relationship Binding: PatientContactRelationship (extensible): The nature of the relationship between a patient and a contact person for that patient.
name |  | 0..1 | HumanName | A name associated with the contact person
telecom |  | 0..* | ContactPoint | A contact detail for the person
address |  | 0..1 | Address | Address for the contact person
gender |  | 0..1 | code | male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
organization | C | 0..1 | Reference(Organization) | Organization that is associated with the contact
period |  | 0..1 | Period | The period during which this contact person or organization is valid to be contacted relating to this patient
communication |  | 0..* | BackboneElement | A language which may be used to communicate with the patient about his or her health
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
language |  | 1..1 | CodeableConcept | The language which can be used to communicate with the patient about his or her health Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
preferred |  | 0..1 | boolean | Language preference indicator
generalPractitioner |  | 0..* | Reference(Organization | Practitioner | PractitionerRole) | Patient's nominated primary care provider
managingOrganization | Σ | 0..1 | Reference(Organization) | Organization that is the custodian of the patient record
link | ?!Σ | 0..* | BackboneElement | Link to another patient resource that concerns the same actual person
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
other | Σ | 1..1 | Reference(Patient | RelatedPerson) | The other patient or related person resource that the link refers to
type | Σ | 1..1 | code | replaced-by | replaces | refer | seealso Binding: LinkType (required): The type of link between this patient resource and another patient resource.
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Patient.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Patient.identifier.use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
Patient.identifier.type | Base | extensible | IdentifierType | 📍4.0.1 | FHIR Std.
Patient.identifier:JHN.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
Patient.identifier:JHN.​type | Base | extensible | IdentifierType | 📍4.0.1 | FHIR Std.
Patient.name.use | Base | required | NameUse | 📍4.0.1 | FHIR Std.
Patient.telecom.system | Base | required | ContactPointSystem | 📍4.0.1 | FHIR Std.
Patient.telecom.use | Base | required | ContactPointUse | 📍4.0.1 | FHIR Std.
Patient.gender | Base | required | AdministrativeGender | 📍4.0.1 | FHIR Std.
Patient.address.use | Base | required | AddressUse | 📍4.0.1 | FHIR Std.
Patient.address.type | Base | required | AddressType | 📍4.0.1 | FHIR Std.
Patient.maritalStatus | Base | extensible | MaritalStatus | 📍4.0.1 | FHIR Std.
Patient.contact.relationship | Base | extensible | Patient Contact Relationship | 📍4.0.1 | FHIR Std.
Patient.contact.gender | Base | required | AdministrativeGender | 📍4.0.1 | FHIR Std.
Patient.communication.​language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Patient.link.type | Base | required | LinkType | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Patient | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Patient | 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 | error | Patient | 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 | error | Patient | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Patient | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
ipa-pat-2 | error | Patient.name | Either Patient.name.given and/or Patient.name.family and/or Patient.name.text SHALL be present or a Data Absent Reason Extension SHALL be present. | `(family.exists() or given.exists() or text.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()`
pat-1 | error | Patient.contact | 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()`

This structure is derived from Patient

Summary

Mandatory: 0 element(7 nested mandatory elements)
Must-Support: 2 elements

Structures

This structure refers to these other structures:

- Identifier DataType Profile (CA Baseline) (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-identifier)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-aboriginalidentitygroup
- http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-aboriginalidentityindicator
- http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-patientbirthsex
- http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-ethnicity
- http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-identifierversion
- http://hl7.org/fhir/StructureDefinition/iso21090-preferred
- http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-nofixedaddress

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Patient.identifier

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Patient |  | 0..* | Patient | Patient Profile
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:aboriginalidentitygroup |  | 0..1 | Coding | Extension: Aboriginal Identity Group URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-aboriginalidentitygroup Binding: Aboriginal Identity Group (preferred): One of aboriginal identity codes
extension:aboriginalidentityindicator |  | 0..1 | Coding | Extension: Aboriginal Identity Indicator URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-aboriginalidentityindicator Binding: Aboriginal Identity Indicator (preferred): One of self-reported codes identity as an aboriginal person
extension:birthsex |  | 0..1 | Coding | Extension: Sex at Birth URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-patientbirthsex Binding: Birth Sex (example): Code for sex assigned at birth
extension:ethnicity |  | 0..1 | Coding | Extension: ethnicity extension URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-ethnicity Binding: EthnicityCode (preferred): One of self-reported ethnic group codes representing the ethnicity concept and should not be confused with citizenship or nationality.
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for identifier | Σ | 0..* | IdentifierCABaseline | An identifier for this patient Slice: Unordered, Open by pattern:type
identifier:All Slices |  |  |  | Content/Rules for all slices
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system | Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | Σ | 1..1 | string | The value that is unique within the system. Example General: 123456
identifier:JHN | Σ | 0..* | Identifier | Jurisdictional Health Number
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:versionCode |  | 0..1 | string | Health Number Version Code URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-identifierversion
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 1..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: JHN
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
system | Σ | 1..1 | uri | A Health Number Naming System from the Canadian URI Registry Example General: http://www.acme.com/identifiers/patient
value | Σ | 1..1 | string | The value that is unique within the system. Example General: 123456
active | ?!Σ | 0..1 | boolean | Whether this patient's record is in active use
name | S Σ C | 0..* | HumanName | A name associated with the patient Constraints: ipa-pat-2
use | ?!Σ | 0..1 | code | usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
family | Σ | 0..1 | string | Family name (often called 'Surname')
given | Σ | 0..* | string | Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name
telecom | Σ | 0..* | ContactPoint | A contact detail for the individual
system | Σ C | 1..1 | code | phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value | Σ | 1..1 | string | The actual contact point details
use | ?!Σ | 0..1 | code | home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.
birthDate | S Σ | 0..1 | date | The date of birth for the individual
deceased[x] | ?!Σ | 0..1 |  | Indicates if the individual is deceased or not
deceasedBoolean |  |  | boolean |
deceasedDateTime |  |  | dateTime |
address | Σ | 0..* | Address | An address for the individual
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:preferred |  | 0..1 | boolean | HL7 Preferred Address Flag extension URL: http://hl7.org/fhir/StructureDefinition/iso21090-preferred
extension:noFixedAddress |  | 0..1 | boolean | No Fixed Address indicator URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-nofixedaddress
use | ?!Σ | 0..1 | code | home | work | temp | old | billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
link | ?!Σ | 0..* | BackboneElement | Link to another patient resource that concerns the same actual person
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
other | Σ | 1..1 | Reference(Patient | RelatedPerson) | The other patient or related person resource that the link refers to
type | Σ | 1..1 | code | replaced-by | replaces | refer | seealso Binding: LinkType (required): The type of link between this patient resource and another patient resource.
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Patient.identifier.use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
Patient.identifier.type | Base | extensible | IdentifierType | 📍4.0.1 | FHIR Std.
Patient.identifier:JHN.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
Patient.identifier:JHN.​type | Base | extensible | IdentifierType | 📍4.0.1 | FHIR Std.
Patient.name.use | Base | required | NameUse | 📍4.0.1 | FHIR Std.
Patient.telecom.system | Base | required | ContactPointSystem | 📍4.0.1 | FHIR Std.
Patient.telecom.use | Base | required | ContactPointUse | 📍4.0.1 | FHIR Std.
Patient.address.use | Base | required | AddressUse | 📍4.0.1 | FHIR Std.
Patient.link.type | Base | required | LinkType | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Patient | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Patient | 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 | error | Patient | 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 | error | Patient | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Patient | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
ipa-pat-2 | error | Patient.name | Either Patient.name.given and/or Patient.name.family and/or Patient.name.text SHALL be present or a Data Absent Reason Extension SHALL be present. | `(family.exists() or given.exists() or text.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()`

Differential View

This structure is derived from Patient

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Patient |  | 0..* | Patient | Patient Profile
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:aboriginalidentitygroup |  | 0..1 | Coding | Extension: Aboriginal Identity Group URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-aboriginalidentitygroup Binding: Aboriginal Identity Group (preferred): One of aboriginal identity codes
extension:aboriginalidentityindicator |  | 0..1 | Coding | Extension: Aboriginal Identity Indicator URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-aboriginalidentityindicator Binding: Aboriginal Identity Indicator (preferred): One of self-reported codes identity as an aboriginal person
extension:birthsex |  | 0..1 | Coding | Extension: Sex at Birth URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-patientbirthsex Binding: Birth Sex (example): Code for sex assigned at birth
extension:ethnicity |  | 0..1 | Coding | Extension: ethnicity extension URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-ethnicity Binding: EthnicityCode (preferred): One of self-reported ethnic group codes representing the ethnicity concept and should not be confused with citizenship or nationality.
Slices for identifier |  | 0..* | IdentifierCABaseline | An identifier for this patient Slice: Unordered, Open by pattern:type
identifier:All Slices |  |  |  | Content/Rules for all slices
type |  | 0..1 | CodeableConcept | Description of identifier
system |  | 1..1 | uri | The namespace for the identifier value
value |  | 1..1 | string | The value that is unique within the system.
identifier:JHN |  | 0..* | Identifier | Jurisdictional Health Number
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:versionCode |  | 0..1 | string | Health Number Version Code URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-identifierversion
type |  | 1..1 | CodeableConcept | Description of identifier Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: JHN
system |  | 1..1 | uri | A Health Number Naming System from the Canadian URI Registry
value |  | 1..1 | string | The value that is unique within the system.
name | S C | 0..* | HumanName | A name associated with the patient Constraints: ipa-pat-2
family |  | 0..1 | string | Family name (often called 'Surname')
given |  | 0..* | string | Given names (not always 'first'). Includes middle names
telecom |  | 0..* | ContactPoint | A contact detail for the individual
system |  | 1..1 | code | phone | fax | email | pager | url | sms | other
value |  | 1..1 | string | The actual contact point details
birthDate | S | 0..1 | date | The date of birth for the individual
address |  | 0..* | Address | An address for the individual
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:preferred |  | 0..1 | boolean | HL7 Preferred Address Flag extension URL: http://hl7.org/fhir/StructureDefinition/iso21090-preferred
extension:noFixedAddress |  | 0..1 | boolean | No Fixed Address indicator URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-nofixedaddress
Documentation for this format

#### Constraints

Id | Grade | Path(s) | Description | Expression
ipa-pat-2 | error | Patient.name | Either Patient.name.given and/or Patient.name.family and/or Patient.name.text SHALL be present or a Data Absent Reason Extension SHALL be present. | `(family.exists() or given.exists() or text.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()`

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Patient |  | 0..* | Patient | Patient Profile
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:aboriginalidentitygroup |  | 0..1 | Coding | Extension: Aboriginal Identity Group URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-aboriginalidentitygroup Binding: Aboriginal Identity Group (preferred): One of aboriginal identity codes
extension:aboriginalidentityindicator |  | 0..1 | Coding | Extension: Aboriginal Identity Indicator URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-aboriginalidentityindicator Binding: Aboriginal Identity Indicator (preferred): One of self-reported codes identity as an aboriginal person
extension:birthsex |  | 0..1 | Coding | Extension: Sex at Birth URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-patientbirthsex Binding: Birth Sex (example): Code for sex assigned at birth
extension:ethnicity |  | 0..1 | Coding | Extension: ethnicity extension URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-ethnicity Binding: EthnicityCode (preferred): One of self-reported ethnic group codes representing the ethnicity concept and should not be confused with citizenship or nationality.
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for identifier | Σ | 0..* | IdentifierCABaseline | An identifier for this patient Slice: Unordered, Open by pattern:type
identifier:All Slices |  |  |  | Content/Rules for all slices
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system | Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | Σ | 1..1 | string | The value that is unique within the system. Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
identifier:JHN | Σ | 0..* | Identifier | Jurisdictional Health Number
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:versionCode |  | 0..1 | string | Health Number Version Code URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-identifierversion
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 1..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: JHN
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
system | Σ | 1..1 | uri | A Health Number Naming System from the Canadian URI Registry Example General: http://www.acme.com/identifiers/patient
value | Σ | 1..1 | string | The value that is unique within the system. Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
active | ?!Σ | 0..1 | boolean | Whether this patient's record is in active use
name | S Σ C | 0..* | HumanName | A name associated with the patient Constraints: ipa-pat-2
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
text | Σ | 0..1 | string | Text representation of the full name
family | Σ | 0..1 | string | Family name (often called 'Surname')
given | Σ | 0..* | string | Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name
prefix | Σ | 0..* | string | Parts that come before the name This repeating element order: Prefixes appear in the correct order for presenting the name
suffix | Σ | 0..* | string | Parts that come after the name This repeating element order: Suffixes appear in the correct order for presenting the name
period | Σ | 0..1 | Period | Time period when name was/is in use
telecom | Σ | 0..* | ContactPoint | A contact detail for the individual
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ C | 1..1 | code | phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value | Σ | 1..1 | string | The actual contact point details
use | ?!Σ | 0..1 | code | home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.
rank | Σ | 0..1 | positiveInt | Specify preferred order of use (1 = highest)
period | Σ | 0..1 | Period | Time period when the contact point was/is in use
gender | Σ | 0..1 | code | male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
birthDate | S Σ | 0..1 | date | The date of birth for the individual
deceased[x] | ?!Σ | 0..1 |  | Indicates if the individual is deceased or not
deceasedBoolean |  |  | boolean |
deceasedDateTime |  |  | dateTime |
address | Σ | 0..* | Address | An address for the individual
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:preferred |  | 0..1 | boolean | HL7 Preferred Address Flag extension URL: http://hl7.org/fhir/StructureDefinition/iso21090-preferred
extension:noFixedAddress |  | 0..1 | boolean | No Fixed Address indicator URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-nofixedaddress
use | ?!Σ | 0..1 | code | home | work | temp | old | billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
type | Σ | 0..1 | code | postal | physical | both Binding: AddressType (required): The type of an address (physical / postal). Example General: both
text | Σ | 0..1 | string | Text representation of the address Example General: 137 Nowhere Street, Erewhon 9132
line | Σ | 0..* | string | Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label Example General: 137 Nowhere Street
city | Σ | 0..1 | string | Name of city, town etc. Example General: Erewhon
district | Σ | 0..1 | string | District name (aka county) Example General: Madison
state | Σ | 0..1 | string | Sub-unit of country (abbreviations ok)
postalCode | Σ | 0..1 | string | Postal code for area Example General: 9132
country | Σ | 0..1 | string | Country (e.g. can be ISO 3166 2 or 3 letter code)
period | Σ | 0..1 | Period | Time period when address was/is in use Example General: {"start":"2010-03-23","end":"2010-07-01"}
maritalStatus |  | 0..1 | CodeableConcept | Marital (civil) status of a patient Binding: Marital Status Codes (extensible): The domestic partnership status of a person.
multipleBirth[x] |  | 0..1 |  | Whether patient is part of a multiple birth
multipleBirthBoolean |  |  | boolean |
multipleBirthInteger |  |  | integer |
photo |  | 0..* | Attachment | Image of the patient
contact | C | 0..* | BackboneElement | A contact party (e.g. guardian, partner, friend) for the patient Constraints: pat-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
relationship |  | 0..* | CodeableConcept | The kind of relationship Binding: PatientContactRelationship (extensible): The nature of the relationship between a patient and a contact person for that patient.
name |  | 0..1 | HumanName | A name associated with the contact person
telecom |  | 0..* | ContactPoint | A contact detail for the person
address |  | 0..1 | Address | Address for the contact person
gender |  | 0..1 | code | male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
organization | C | 0..1 | Reference(Organization) | Organization that is associated with the contact
period |  | 0..1 | Period | The period during which this contact person or organization is valid to be contacted relating to this patient
communication |  | 0..* | BackboneElement | A language which may be used to communicate with the patient about his or her health
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
language |  | 1..1 | CodeableConcept | The language which can be used to communicate with the patient about his or her health Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
preferred |  | 0..1 | boolean | Language preference indicator
generalPractitioner |  | 0..* | Reference(Organization | Practitioner | PractitionerRole) | Patient's nominated primary care provider
managingOrganization | Σ | 0..1 | Reference(Organization) | Organization that is the custodian of the patient record
link | ?!Σ | 0..* | BackboneElement | Link to another patient resource that concerns the same actual person
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
other | Σ | 1..1 | Reference(Patient | RelatedPerson) | The other patient or related person resource that the link refers to
type | Σ | 1..1 | code | replaced-by | replaces | refer | seealso Binding: LinkType (required): The type of link between this patient resource and another patient resource.
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Patient.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Patient.identifier.use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
Patient.identifier.type | Base | extensible | IdentifierType | 📍4.0.1 | FHIR Std.
Patient.identifier:JHN.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
Patient.identifier:JHN.​type | Base | extensible | IdentifierType | 📍4.0.1 | FHIR Std.
Patient.name.use | Base | required | NameUse | 📍4.0.1 | FHIR Std.
Patient.telecom.system | Base | required | ContactPointSystem | 📍4.0.1 | FHIR Std.
Patient.telecom.use | Base | required | ContactPointUse | 📍4.0.1 | FHIR Std.
Patient.gender | Base | required | AdministrativeGender | 📍4.0.1 | FHIR Std.
Patient.address.use | Base | required | AddressUse | 📍4.0.1 | FHIR Std.
Patient.address.type | Base | required | AddressType | 📍4.0.1 | FHIR Std.
Patient.maritalStatus | Base | extensible | MaritalStatus | 📍4.0.1 | FHIR Std.
Patient.contact.relationship | Base | extensible | Patient Contact Relationship | 📍4.0.1 | FHIR Std.
Patient.contact.gender | Base | required | AdministrativeGender | 📍4.0.1 | FHIR Std.
Patient.communication.​language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Patient.link.type | Base | required | LinkType | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Patient | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Patient | 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 | error | Patient | 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 | error | Patient | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Patient | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
ipa-pat-2 | error | Patient.name | Either Patient.name.given and/or Patient.name.family and/or Patient.name.text SHALL be present or a Data Absent Reason Extension SHALL be present. | `(family.exists() or given.exists() or text.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()`
pat-1 | error | Patient.contact | 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()`

This structure is derived from Patient

Summary

Mandatory: 0 element(7 nested mandatory elements)
Must-Support: 2 elements

Structures

This structure refers to these other structures:

- Identifier DataType Profile (CA Baseline) (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-identifier)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-aboriginalidentitygroup
- http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-aboriginalidentityindicator
- http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-patientbirthsex
- http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-ethnicity
- http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-identifierversion
- http://hl7.org/fhir/StructureDefinition/iso21090-preferred
- http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-nofixedaddress

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Patient.identifier

Other representations of profile: CSV, Excel, Schematron

### Notes:

## Identifiers

Multiple individual healthcare identifiers may be provided in Patient.identifier element.

However, to support particular types of federal patient and person health numbers used by all jurisdictions across Canada following optional types are defined to uniquely identifying patients:

- Canadian Passport Number
- Jurisdictional Person Identification
- Jurisdictional Health Number

### Canadian Passport Number (PPN)

A unique number assigned to the document affirming that a person is a citizen of Canada.

URI to use with this identifier type: https://fhir.infoway-inforoute.ca/NamingSystem/ca-passport-number

Example:

    {
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code": "PPN"
          }
        ]
      },
      "system": "https://fhir.infoway-inforoute.ca/NamingSystem/ca-passport-number",
      "value": "AB123456",
      "period": {
        "start": "2005-05-11",
        "end": "2015-05-11"
      }
    }

### Jurisdictional Patient Identifier Number (JPID)

This patient identifier type identifies a number issued in Canada to administer various government programs.

URIs used with this identifier type:

- Canada, Social Insurance Number (SIN) - https://fhir.infoway-inforoute.ca/NamingSystem/ca-social-insurance-number
- Canada Permanent Resident Card Number - https://fhir.infoway-inforoute.ca/NamingSystem/ca-permanent-resident-card-number
- Canada First Nation Indian registry number (band ID) - https://fhir.infoway-inforoute.ca/NamingSystem/ca-federal-firstnation-band-id
- Indigenous and Northern Affairs Canada health card number - https://fhir.infoway-inforoute.ca/NamingSystem/ca-indigenous-northern-affairs-number
- Interim Federal Health Program identifier - https://fhir.infoway-inforoute.ca/NamingSystem/ca-interim-federal-health-id

Example:

    {
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code": "JPID"
          }
        ]
      },
      "system": "https://fhir.infoway-inforoute.ca/NamingSystem/ca-social-insurance-number",
      "value": "923456789"
      }
    }

### Jurisdictional Health Number (JHN)

Following URIs are registered to identify health card numbers for provinces and territories:

- Alberta - https://fhir.infoway-inforoute.ca/NamingSystem/ca-ab-patient-healthcare-id
- British Columbia - https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-patient-healthcare-id
- Manitoba - https://fhir.infoway-inforoute.ca/NamingSystem/ca-mb-patient-healthcare-id
- New Brunswick - https://fhir.infoway-inforoute.ca/NamingSystem/ca-nb-patient-healthcare-id
- Newfoundland and Labrador - https://fhir.infoway-inforoute.ca/NamingSystem/ca-nl-patient-healthcare-id
- Northwest Terrirories - https://fhir.infoway-inforoute.ca/NamingSystem/ca-nt-patient-healthcare-id
- Nova Scotia - https://fhir.infoway-inforoute.ca/NamingSystem/ca-ns-patient-healthcare-id
- Nunavut - https://fhir.infoway-inforoute.ca/NamingSystem/ca-nu-patient-healthcare-id
- Ontario - https://fhir.infoway-inforoute.ca/NamingSystem/ca-on-patient-hcn
- Prince Edward Island - https://fhir.infoway-inforoute.ca/NamingSystem/ca-pe-patient-healthcare-id
- Quebec - https://fhir.infoway-inforoute.ca/NamingSystem/ca-qc-patient-healthcare-id
- Saskatchewan - https://fhir.infoway-inforoute.ca/NamingSystem/ca-sk-patient-healthcare-id
- Yukon - https://fhir.infoway-inforoute.ca/NamingSystem/ca-yt-patient-healthcare-id

Following identifier types identify health card numbers issued in Canada to let a patient to be recognized for services and stay connected to related support programs:

- Canada Veteran's Affairs health card number - https://fhir.infoway-inforoute.ca/NamingSystem/ca-veterans-affairs-health-id
- Canada Correctional Service health card number - https://fhir.infoway-inforoute.ca/NamingSystem/ca-correctional-service-health-id
- Canada Royal Canadian Mounted Police (RCMP) health card number - https://fhir.infoway-inforoute.ca/NamingSystem/ca-royal-mounted-police-health-id
- Canada Armed Forces health card number - https://fhir.infoway-inforoute.ca/NamingSystem/ca-armed-forces-health-id

The full list of identifiers can be found on Canadian URI Registry. Canada Health Infoway provides Canadian URI Registry search tool to simplify search.

Version Code

The Version Code extension is added to indicate the currency/validity of an identifier.

The rational is that the version code is current captured separately from the JHN because, in Ontario at least, the JHN is a stable identifier whereas the version code changes over time.

- The working assumption is that it is useful to have this stable identifier but not all of the Ontario specs reviewed stored it as a separate field. In one case, it appears to be an Patient.identifier.coding.value instead of the identifier …
- Example JHN and Patient Information from Ontario Health Care Validation Reference Manual
- Question: would specific examples like this be helpful to illustrate Canadian requirements?

Example:

    {
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code": "JHN"
          }
        ]
      },
      "system": "https://fhir.infoway-inforoute.ca/NamingSystem/ca-armed-forces-health-id",
      "value": "A98765439"
      }
    }

## Patient Gender and Sex

Many systems and organizations only provide a single attribute to represent all aspects of a patient's gender and sex with a single value. However, there are many considerations around sex and gender documentation and interoperability.

The FHIR Specification provides guidance and background for representing patient gender.

In addition to that Canadian Patient profile defines following extensions:

- Gender Identity - an indication from the patient about what gender they consider themselves to be.
- Sex assigned at Birth - the sex assigned at birth, as documented on the birth registration.
- Preferred Pronoun - an indication from the patient about what pronoun to use in correspondence.

!! TO BE COMPLETED !!

## Telecom

A Patient may have multiple ways to be contacted with different uses or applicable periods. This Patient profile allows multiple contact points (e.g. a telephone number or an email address) by which the individual may be contacted.

To indicate the preferred way to contact use Patient.telecom.rank attribute (i.e., the ContactPoint.rank component) that specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.

## Address

The Patient profile is provided for use in a Canadian context where some constraint on content is desirable to guarantee the quality of the Canadian address whilst still supporting other type of address (e.g., other countries or UNstructured addresses).

### Canadian postal code

If an address in the Patient resource instance represents Canadian address, it SHOULD follow Canadian postal code format.

The Canadian Postal Code SHOULD be a six-character uniformly structured uppercase alphanumeric code in the form of "ANA NAN", where "A" represents an alphabetic character and "N" represents a numeric character, with one space between the first three and the last three characters.

A hyphen SHOULD NOT be used (example of UNacceptable format: T0L-1K0).

### Preferred

The Patient.address MAY have a Preferred extension. This is the FHIR standard defined extension used as a flag denoting whether parent address item is preferred.

### No Fixed Address

The Patient.address MAY have a No Fixed Address extension. This extension is to indicate that there is an assertion that there is no fixed address (e.g., homeless).

## Marital Status

The binding for the Patient.maritalStatus element is extensible meaning that to be conformant, codes in this element SHALL be from the specified value set if any of the codes within the value set can apply to the concept being communicated.

Systems can send additional codes (Stats Canada, SNOMED CT, etc.) but can only do that if they also send the relevant HL7-assigned codes.