Canadian Baseline
1.1.0 - CI Build Canada flag

Canadian Baseline, published by HL7 Canada - FHIR Implementation Work Group. This guide is not an authorized publication; it is the continuous build for version 1.1.0 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: 1.1.0
Draft as of 2022-02-11 Computable Name: PatientProfile

Proposed constraints and extensions on the Patient Resource

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

Usage:

Formal Views of Profile Content

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

This structure is derived from Patient

NameFlagsCard.TypeDescription & Constraintsdoco
.. Patient 0..* Patient Patient Profile
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... 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

.... 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

.... 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

.... 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 intended for computation
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
...... versionCode 0..* string Health Number Version Code
URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-identifierversion
..... type 1..1 CodeableConcept Description of identifier
Fixed Value: As shown (Jurisdictional health number)
...... coding 1..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
... name SC 0..* HumanName A name associated with the patient
ca-baseline-name: Patient.name.given or Patient.name.family or both SHALL be present
.... family 0..1 string Family name (often called 'Surname')
.... given 0..* string Given names (not always 'first'). Includes middle names
.... 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
..... preferred 0..1 boolean HL7 Preferred Address Flag extension
URL: http://hl7.org/fhir/StructureDefinition/iso21090-preferred
..... noFixedAddress 0..1 boolean No Fixed Address indicator
URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-nofixedaddress

doco Documentation for this format

Constraints

IdGradePath(s)DetailsRequirements
ca-baseline-nameerrorPatient.namePatient.name.given or Patient.name.family or both SHALL be present
: family.exists() or given.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. 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
.... 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


.... 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


.... 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


.... 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
.... 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
...... versionCode 0..* 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.


Fixed Value: As shown (Jurisdictional health number)
...... id 0..0 string Unique id for inter-element referencing
...... extension 0..0 Extension Additional content defined by implementations
...... coding 1..1 Coding Code defined by a terminology system
Fixed Value: (complex)
....... id 0..0 string Unique id for inter-element referencing
....... extension 0..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..0 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: JHN
....... display 0..0 string Representation defined by the system
....... userSelected 0..0 boolean If this coding was chosen directly by the user
...... text 0..0 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
Example General: 123456
... active ?!Σ 0..1 boolean Whether this patient's record is in active use
... name SΣC 0..* HumanName A name associated with the patient
ca-baseline-name: Patient.name.given or Patient.name.family or both SHALL be present
.... 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 ΣC 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 SΣ 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
..... preferred 0..1 boolean HL7 Preferred Address Flag extension
URL: http://hl7.org/fhir/StructureDefinition/iso21090-preferred
..... 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.


doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Patient.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Patient.identifier.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
Patient.identifier:JHN.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Patient.identifier:JHN.typeextensibleFixed Value: JHN
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
Patient.name.userequiredNameUse
http://hl7.org/fhir/ValueSet/name-use|4.0.1
from the FHIR Standard
Patient.telecom.systemrequiredContactPointSystem
http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
from the FHIR Standard
Patient.telecom.userequiredContactPointUse
http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1
from the FHIR Standard
Patient.address.userequiredAddressUse
http://hl7.org/fhir/ValueSet/address-use|4.0.1
from the FHIR Standard
Patient.link.typerequiredLinkType
http://hl7.org/fhir/ValueSet/link-type|4.0.1
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
ca-baseline-nameerrorPatient.namePatient.name.given or Patient.name.family or both SHALL be present
: family.exists() or given.exists()
dom-2errorPatientIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorPatientIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource 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-4errorPatientIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorPatientIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practicePatientA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. 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
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... 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


.... 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


.... 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


.... 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 0..* IdentifierCABaseline An identifier intended for computation
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
...... versionCode 0..* 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.


Fixed Value: As shown (Jurisdictional health number)
...... id 0..0 string Unique id for inter-element referencing
...... extension 0..0 Extension Additional content defined by implementations
...... coding 1..1 Coding Code defined by a terminology system
Fixed Value: (complex)
....... id 0..0 string Unique id for inter-element referencing
....... extension 0..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..0 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: JHN
....... display 0..0 string Representation defined by the system
....... userSelected 0..0 boolean If this coding was chosen directly by the user
...... text 0..0 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
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 SΣC 0..* HumanName A name associated with the patient
ca-baseline-name: Patient.name.given or Patient.name.family or both SHALL be present
.... 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 ΣC 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 SΣ 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
..... preferred 0..1 boolean HL7 Preferred Address Flag extension
URL: http://hl7.org/fhir/StructureDefinition/iso21090-preferred
..... 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
pat-1: SHALL at least contain a contact's details or a reference to an organization
.... 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 BindingsPurpose
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.


doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Patient.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Patient.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Patient.identifier.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
Patient.identifier:JHN.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Patient.identifier:JHN.typeextensibleFixed Value: JHN
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
Patient.name.userequiredNameUse
http://hl7.org/fhir/ValueSet/name-use|4.0.1
from the FHIR Standard
Patient.telecom.systemrequiredContactPointSystem
http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
from the FHIR Standard
Patient.telecom.userequiredContactPointUse
http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1
from the FHIR Standard
Patient.genderrequiredAdministrativeGender
http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1
from the FHIR Standard
Patient.address.userequiredAddressUse
http://hl7.org/fhir/ValueSet/address-use|4.0.1
from the FHIR Standard
Patient.address.typerequiredAddressType
http://hl7.org/fhir/ValueSet/address-type|4.0.1
from the FHIR Standard
Patient.maritalStatusextensibleMarital Status Codes
http://hl7.org/fhir/ValueSet/marital-status
from the FHIR Standard
Patient.contact.relationshipextensiblePatientContactRelationship
http://hl7.org/fhir/ValueSet/patient-contactrelationship
from the FHIR Standard
Patient.contact.genderrequiredAdministrativeGender
http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1
from the FHIR Standard
Patient.communication.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Patient.link.typerequiredLinkType
http://hl7.org/fhir/ValueSet/link-type|4.0.1
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
ca-baseline-nameerrorPatient.namePatient.name.given or Patient.name.family or both SHALL be present
: family.exists() or given.exists()
dom-2errorPatientIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorPatientIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource 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-4errorPatientIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorPatientIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practicePatientA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
pat-1errorPatient.contactSHALL at least contain a contact's details or a reference to an organization
: name.exists() or telecom.exists() or address.exists() or organization.exists()

Differential View

This structure is derived from Patient

NameFlagsCard.TypeDescription & Constraintsdoco
.. Patient 0..* Patient Patient Profile
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... 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

.... 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

.... 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

.... 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 intended for computation
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
...... versionCode 0..* string Health Number Version Code
URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-identifierversion
..... type 1..1 CodeableConcept Description of identifier
Fixed Value: As shown (Jurisdictional health number)
...... coding 1..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
... name SC 0..* HumanName A name associated with the patient
ca-baseline-name: Patient.name.given or Patient.name.family or both SHALL be present
.... family 0..1 string Family name (often called 'Surname')
.... given 0..* string Given names (not always 'first'). Includes middle names
.... 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
..... preferred 0..1 boolean HL7 Preferred Address Flag extension
URL: http://hl7.org/fhir/StructureDefinition/iso21090-preferred
..... noFixedAddress 0..1 boolean No Fixed Address indicator
URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-nofixedaddress

doco Documentation for this format

Constraints

IdGradePath(s)DetailsRequirements
ca-baseline-nameerrorPatient.namePatient.name.given or Patient.name.family or both SHALL be present
: family.exists() or given.exists()

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. 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
.... 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


.... 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


.... 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


.... 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
.... 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
...... versionCode 0..* 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.


Fixed Value: As shown (Jurisdictional health number)
...... id 0..0 string Unique id for inter-element referencing
...... extension 0..0 Extension Additional content defined by implementations
...... coding 1..1 Coding Code defined by a terminology system
Fixed Value: (complex)
....... id 0..0 string Unique id for inter-element referencing
....... extension 0..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..0 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: JHN
....... display 0..0 string Representation defined by the system
....... userSelected 0..0 boolean If this coding was chosen directly by the user
...... text 0..0 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
Example General: 123456
... active ?!Σ 0..1 boolean Whether this patient's record is in active use
... name SΣC 0..* HumanName A name associated with the patient
ca-baseline-name: Patient.name.given or Patient.name.family or both SHALL be present
.... 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 ΣC 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 SΣ 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
..... preferred 0..1 boolean HL7 Preferred Address Flag extension
URL: http://hl7.org/fhir/StructureDefinition/iso21090-preferred
..... 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.


doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Patient.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Patient.identifier.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
Patient.identifier:JHN.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Patient.identifier:JHN.typeextensibleFixed Value: JHN
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
Patient.name.userequiredNameUse
http://hl7.org/fhir/ValueSet/name-use|4.0.1
from the FHIR Standard
Patient.telecom.systemrequiredContactPointSystem
http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
from the FHIR Standard
Patient.telecom.userequiredContactPointUse
http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1
from the FHIR Standard
Patient.address.userequiredAddressUse
http://hl7.org/fhir/ValueSet/address-use|4.0.1
from the FHIR Standard
Patient.link.typerequiredLinkType
http://hl7.org/fhir/ValueSet/link-type|4.0.1
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
ca-baseline-nameerrorPatient.namePatient.name.given or Patient.name.family or both SHALL be present
: family.exists() or given.exists()
dom-2errorPatientIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorPatientIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource 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-4errorPatientIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorPatientIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practicePatientA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. 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
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... 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


.... 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


.... 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


.... 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 0..* IdentifierCABaseline An identifier intended for computation
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
...... versionCode 0..* 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.


Fixed Value: As shown (Jurisdictional health number)
...... id 0..0 string Unique id for inter-element referencing
...... extension 0..0 Extension Additional content defined by implementations
...... coding 1..1 Coding Code defined by a terminology system
Fixed Value: (complex)
....... id 0..0 string Unique id for inter-element referencing
....... extension 0..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..0 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: JHN
....... display 0..0 string Representation defined by the system
....... userSelected 0..0 boolean If this coding was chosen directly by the user
...... text 0..0 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
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 SΣC 0..* HumanName A name associated with the patient
ca-baseline-name: Patient.name.given or Patient.name.family or both SHALL be present
.... 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 ΣC 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 SΣ 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
..... preferred 0..1 boolean HL7 Preferred Address Flag extension
URL: http://hl7.org/fhir/StructureDefinition/iso21090-preferred
..... 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
pat-1: SHALL at least contain a contact's details or a reference to an organization
.... 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 BindingsPurpose
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.


doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Patient.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Patient.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Patient.identifier.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
Patient.identifier:JHN.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Patient.identifier:JHN.typeextensibleFixed Value: JHN
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
Patient.name.userequiredNameUse
http://hl7.org/fhir/ValueSet/name-use|4.0.1
from the FHIR Standard
Patient.telecom.systemrequiredContactPointSystem
http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
from the FHIR Standard
Patient.telecom.userequiredContactPointUse
http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1
from the FHIR Standard
Patient.genderrequiredAdministrativeGender
http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1
from the FHIR Standard
Patient.address.userequiredAddressUse
http://hl7.org/fhir/ValueSet/address-use|4.0.1
from the FHIR Standard
Patient.address.typerequiredAddressType
http://hl7.org/fhir/ValueSet/address-type|4.0.1
from the FHIR Standard
Patient.maritalStatusextensibleMarital Status Codes
http://hl7.org/fhir/ValueSet/marital-status
from the FHIR Standard
Patient.contact.relationshipextensiblePatientContactRelationship
http://hl7.org/fhir/ValueSet/patient-contactrelationship
from the FHIR Standard
Patient.contact.genderrequiredAdministrativeGender
http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1
from the FHIR Standard
Patient.communication.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Patient.link.typerequiredLinkType
http://hl7.org/fhir/ValueSet/link-type|4.0.1
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
ca-baseline-nameerrorPatient.namePatient.name.given or Patient.name.family or both SHALL be present
: family.exists() or given.exists()
dom-2errorPatientIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorPatientIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource 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-4errorPatientIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorPatientIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practicePatientA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
pat-1errorPatient.contactSHALL at least contain a contact's details or a reference to an organization
: name.exists() or telecom.exists() or address.exists() or organization.exists()

 

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.