CH EMED EPR
1.0.1-ci-build - ci-build Switzerland flag

CH EMED EPR, published by CARA. This guide is not an authorized publication; it is the continuous build for version 1.0.1-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/CARA-ch/ch-emed-epr/ and changes regularly. See the Directory of published versions

Resource Profile: CHEMEDEPRPatient - Detailed Descriptions

Draft as of 2024-04-05

Definitions for the ch-emed-epr-patient resource profile.

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

0. Patient
2. Patient.meta
4. Patient.meta.extension
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standards StatusDraft (from Normative)
6. Patient.meta.versionId
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standards StatusDraft (from Normative)
8. Patient.meta.lastUpdated
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standards StatusDraft (from Normative)
10. Patient.meta.source
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standards StatusDraft (from Normative)
12. Patient.meta.security
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standards StatusDraft (from Normative)
14. Patient.meta.tag
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standards StatusDraft (from Normative)
16. Patient.implicitRules
Comments

...All modifiers SHALL be documented in the profile, in order to be usable.

Control0..0
LOINC Code
18. Patient.modifierExtension
Comments

...All modifiers SHALL be documented in the profile, in order to be usable.

Control0..0
LOINC Code
20. Patient.identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
LOINC Code
22. Patient.identifier.extension
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standards StatusDraft (from Normative)
24. Patient.identifier.type
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standards StatusDraft (from Normative)
26. Patient.identifier.period
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element is not supported
Standards StatusDraft (from Normative)
28. Patient.identifier.assigner
Definition

Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

Short✕ This element will be removed in PML(C) documents
Comments

✕ Unsupported reference. It'll be stripped when generating PML(C) documents.

TypeReference(CH EMED EPR Organization)
Standards StatusDraft (from Normative)
30. Patient.identifier:EPR-SPID
Slice NameEPR-SPID
NoteThis is a business identifier, not a resource identifier (see discussion)
LOINC Code
32. Patient.identifier:EPR-SPID.value
Invariantsepr-spid-length-error: EPR-SPID must be exactly 18 characters long (matches('^[0-9]{18}$'))
epr-spid-modulus-10-error: EPR-SPID must pass the modulus 10 check - https://www.gs1.org/services/how-calculate-check-digit-manually ((((10-((68+(substring(8,1).toInteger()*3)+(substring(9,1).toInteger()*1)+(substring(10,1).toInteger()*3)+(substring(11,1).toInteger()*1)+(substring(12,1).toInteger()*3)+(substring(13,1).toInteger()*1)+(substring(14,1).toInteger()*3)+(substring(15,1).toInteger()*1)+(substring(16,1).toInteger()*3))mod(10)))mod(10))=substring(17,1).toInteger()))
epr-spid-startswith76133761-error: EPR-SPID must start with 76133761 (startsWith('76133761'))
34. Patient.identifier:AHVN13
Slice NameAHVN13
NoteThis is a business identifier, not a resource identifier (see discussion)
LOINC Code
36. Patient.identifier:AHVN13.value
Invariantsahvn13-digit-check-error: AHVN13 / NAVS13 must pass digit check - https://www.gs1.org/services/how-calculate-check-digit-manually ((((10-(28+(substring(3,1).toInteger()*3)+(substring(4,1).toInteger()*1)+(substring(5,1).toInteger()*3)+(substring(6,1).toInteger()*1)+(substring(7,1).toInteger()*3)+(substring(8,1).toInteger()*1)+(substring(9,1).toInteger()*3)+(substring(10,1).toInteger()*1)+(substring(11,1).toInteger()*3))mod(10))mod(10))=substring(12,1).toInteger()))
ahvn13-length-error: AHVN13 / NAVS13 must be exactly 13 characters long (matches('^[0-9]{13}$'))
ahvn13-startswith756-error: AHVN13 / NAVS13 must start with 756 (startsWith('756'))
38. Patient.identifier:insuranceCardNumber
Slice NameinsuranceCardNumber
NoteThis is a business identifier, not a resource identifier (see discussion)
LOINC Code
40. Patient.identifier:insuranceCardNumber.value
Invariantsveka-length-error: Insurance card number must be exactly 20 characters long (matches('^[0-9]{20}$'))
veka-startswith807560-error: Insurance card number must start with 807560 (startsWith('807560'))
42. Patient.contact
LOINC Code
44. Patient.contact.organization
Short✕ This element will be removed in PML(C) documents
Comments

✕ Unsupported reference. It'll be stripped when generating PML(C) documents.

Standards StatusDraft (from Normative)
LOINC Code
46. Patient.generalPractitioner
Short✕ This element will be removed in PML(C) documents
Comments

✕ Unsupported reference. It'll be stripped when generating PML(C) documents.

Standards StatusDraft (from Normative)
LOINC Code
48. Patient.managingOrganization
Short✕ This element will be removed in PML(C) documents
Comments

✕ Unsupported reference. It'll be stripped when generating PML(C) documents.

Standards StatusDraft (from Normative)
LOINC Code
50. Patient.link
Short✕ This element will be removed in PML(C) documents
Comments

✕ Unsupported reference. It'll be stripped when generating PML(C) documents.

Standards StatusDraft (from Normative)
LOINC Code

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

0. Patient
Definition

The CH Core Patient is based upon the core FHIR Patient Resource and designed to meet the applicable patient demographic data elements in Switzerland. See also https://www.bfs.admin.ch/bfs/de/home/register/personenregister/registerharmonisierung/nomenklaturen.html for further information


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

ShortCH Core Patient EPR (to include the patient in an EPR document)Information about an individual or animal receiving health care services
Control0..*
Is Modifierfalse
Summaryfalse
Alternate NamesSubjectOfCare Client Resident
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
ch-pat-1: At least one HumanName with given and family name must be provided. (name.where(family.exists() and given.exists()).count()>0 or name.empty())
ch-pat-2: gender unknown is currently not used in Switzerland in eCH and the EPR (gender.empty() or gender!='unknown')
2. Patient.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. All modifiers SHALL be documented in the profile, in order to be usable.


Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..01
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Patient.extension:placeOfBirth
Slice NameplaceOfBirth
Definition

The registered place of birth of the patient.

ShortPlace of birth of patient
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(Place of Birth according to eCH-0011) (Extension Type: Address(Address for Place of Birth))
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
LOINC Code
6. Patient.extension:placeOfOrigin
Slice NameplaceOfOrigin
Definition

The registered place of origin of the patient.

ShortPlace of origin(s) of patient
Control0..*
This element is affected by the following invariants: ele-1
TypeExtension(Place of Origin according to eCH-0011) (Extension Type: Address)
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
LOINC Code
8. Patient.extension:citizenship
Slice Namecitizenship
Definition

The content of the country code element (if present) SHALL be selected EITHER from ValueSet ISO Country Alpha-2 http://hl7.org/fhir/ValueSet/iso3166-1-2 OR MAY be selected from ISO Country Alpha-3 Value Set http://hl7.org/fhir/ValueSet/iso3166-1-3, if the country is not specified in value Set ISO Country Alpha-2 http://hl7.org/fhir/ValueSet/iso3166-1-2.

ShortCitizenship(s) of patient
Control0..*
This element is affected by the following invariants: ele-1
TypeExtension(citizenship) (Complex Extension)
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ch-pat-3: ISO Country Alpha-2 or ISO Country Alpha-3 code (((extension.where(url='code').value.coding.code.length()=2) and extension.where(url='code').value.coding.code.memberOf('http://hl7.org/fhir/ValueSet/iso3166-1-2')) or ((extension.where(url='code').value.coding.code.length() = 3) and extension.where(url='code').value.coding.code.memberOf('http://hl7.org/fhir/ValueSet/iso3166-1-3')))
LOINC Code
10. Patient.extension:religion
Slice Namereligion
Definition

The patient's professed religious affiliations.

ShortReligion of patient
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(religion) (Extension Type: CodeableConcept)
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
LOINC Code
12. Patient.modifierExtension
Definition

An Extension


May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

ShortExtensionExtensions that cannot be ignored
Comments

All modifiers SHALL be documented in the profile, in order to be usable.


There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..0*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
Requirements

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

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

An identifier for this patient.

ShortAn identifier for this patient
NoteThis is a business identifier, not a resource identifier (see discussion)
Control10..*
TypeIdentifier
Is Modifierfalse
Summarytrue
Requirements

Patients are almost always assigned specific numerical identifiers.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Patient.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • pattern @ $this
  • 16. Patient.identifier.extension
    Definition

    Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.


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

    Short✕ This element is not supportedAdditional content defined by implementations
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

      The purpose of this identifier.

      Shortusual | official | temp | secondary | old (If known)
      Comments

      Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

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

      Identifies the purpose for this identifier, if known .

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

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

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

      Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.


      A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

      Short✕ This element is not supportedDescription of identifier
      Comments

      This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

      Control0..1
      BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type
      (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

      A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

      TypeCodeableConcept
      Is Modifierfalse
      Summarytrue
      Requirements

      Allows users to make use of identifiers when the identifier system is not known.

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

      Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.


      Time period during which identifier is/was valid for use.

      Short✕ This element is not supportedTime period when id is/was valid for use
      Control0..1
      TypePeriod
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      24. Patient.identifier.assigner
      Definition

      Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.


      Organization that issued/manages the identifier.

      Short✕ This element will be removed in PML(C) documentsOrganization that issued id (may be just text)
      Comments

      ✕ Unsupported reference. It'll be stripped when generating PML(C) documents.


      The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

      Control0..1
      TypeReference(CH EMED EPR Organization, Organization)
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. Patient.identifier:EPR-SPID
      Slice NameEPR-SPID
      Definition

      An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.


      An identifier for this patient.

      ShortAn identifier intended for computationAn identifier for this patient
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..0*
      This element is affected by the following invariants: ele-1
      TypeIdentifier(EPR-SPID Identifier)
      Is Modifierfalse
      Requirements

      Patients are almost always assigned specific numerical identifiers.

      Pattern Value{
        "system" : "urn:oid:2.16.756.5.30.1.127.3.10.3"
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      31. Patient.identifier:AHVN13
      Slice NameAHVN13
      Definition

      An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.


      An identifier for this patient.

      ShortAn identifier intended for computationAn identifier for this patient
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..0*
      This element is affected by the following invariants: ele-1
      TypeIdentifier(AHVN13 / NAVS13 Identifier)
      Is Modifierfalse
      Requirements

      Patients are almost always assigned specific numerical identifiers.

      Pattern Value{
        "system" : "urn:oid:2.16.756.5.32"
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. Patient.identifier:LocalPid
      Slice NameLocalPid
      Definition

      An identifier for this patient.

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

      Patients are almost always assigned specific numerical identifiers.

      Pattern Value{
        "type" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "MR"
          }]
        }
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      38. Patient.identifier:insuranceCardNumber
      Slice NameinsuranceCardNumber
      Definition

      An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.


      An identifier for this patient.

      ShortAn identifier intended for computationAn identifier for this patient
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..*
      This element is affected by the following invariants: ele-1
      TypeIdentifier(Insurance Card Number (Identifier))
      Is Modifierfalse
      Requirements

      Patients are almost always assigned specific numerical identifiers.

      Pattern Value{
        "system" : "urn:oid:2.16.756.5.30.1.123.100.1.1.1"
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      40. Patient.identifier:insuranceCardNumber.use
      Definition

      The purpose of this identifier.

      Shortusual | official | temp | secondary | old (If known)
      Comments

      Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

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

      Identifies the purpose for this identifier, if known .

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

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

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

      Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

      ShortThe namespace for the identifier value
      Comments

      Identifier.system is always case sensitive.

      Control10..1
      Typeuri
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

      Fixed Valueurn:oid:2.16.756.5.30.1.123.100.1.1.1
      Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      44. Patient.identifier:insuranceCardNumber.value
      Definition

      The portion of the identifier typically relevant to the user and which is unique within the context of the system.

      ShortThe value that is unique
      Comments

      If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

      Control10..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Example<br/><b>General</b>:123456
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      veka-length: Insurance card number must be exactly 20 characters long (matches('^[0-9]{20}$'))
      veka-startswith807560: Insurance card number must start with 807560 (startsWith('807560'))
      veka-length-error: Insurance card number must be exactly 20 characters long (matches('^[0-9]{20}$'))
      veka-startswith807560-error: Insurance card number must start with 807560 (startsWith('807560'))
      46. Patient.active
      Definition

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

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

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

      ShortWhether this patient's record is in active use
      Comments

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

      Control0..1
      Typeboolean
      Is Modifiertrue because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

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

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

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


      A name associated with the individual.

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

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


      A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.

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

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ch-core-hm-1: if officalName with eCH-011 Extension is specified, it can only be put on a name where use attribute is official (family.extension.where(url='http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-ech-11-name' and value='officialName').empty() or (family.extension.where(url='http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-ech-11-name' and value='officialName').exists() and use='official'))
      ch-core-hm-2: if orginalName with eCH-011 Extension is specified, it can only be put on a name where use attribute is maiden (family.extension.where(url='http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-ech-11-name' and value='originalName').empty() or ((family.extension.where(url='http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-ech-11-name' and value='originalName').exists() and use='maiden')))
      ch-core-hm-3: ch-ext-ech-11-name can only be put on a family name (descendants().extension.where(url='http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-ech-11-name').count()=family.extension.where(url='http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-ech-11-name').count())
      ch-core-hm-4: ch-ext-ech-11-firstname can only be put on a given name (descendants().extension.where(url='http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-ech-11-firstname').count()=given.extension.where(url='http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-ech-11-firstname').count())
      50. Patient.telecom
      Definition

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

      ShortA contact detail for the individual
      Comments

      A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).

      Control0..*
      TypeContactPoint
      Is Modifierfalse
      Summarytrue
      Requirements

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      SlicingThis element introduces a set of slices on Patient.telecom. The slices are unordered and Open, and can be differentiated using the following discriminators:
      • value @ system
      • 52. Patient.telecom.system
        Definition

        Telecommunications form for contact point - what communications system is required to make use of the contact.

        Shortphone | fax | email | pager | url | sms | other
        Control10..1
        This element is affected by the following invariants: cpt-2
        BindingThe codes SHALL be taken from ContactPointSystemhttp://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
        (required to http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1)

        Telecommunications form for contact point.

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

        The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

        ShortThe actual contact point details
        Comments

        Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

        Control10..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need to support legacy numbers that are not in a tightly controlled format.

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

        Identifies the purpose for the contact point.

        Shorthome | work | temp | old | mobile - purpose of this contact point
        Comments

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

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

        Use of contact point.

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

        Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

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

        Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc.


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

        ShortCH Core ContactPoint eCH-0046 EmailA contact detail for the individual
        Comments

        A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).

        Control0..*
        This element is affected by the following invariants: ele-1
        TypeContactPoint(CH Core ContactPoint eCH-0046 Email)
        Is Modifierfalse
        Requirements

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

        Invariantscpt-2: A system is required if a value is provided. (value.empty() or system.exists())
        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        60. Patient.telecom:phone
        Slice Namephone
        Definition

        Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc.


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

        ShortCH Core ContactPoint eCH-0046 PhoneA contact detail for the individual
        Comments

        A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).

        Control0..*
        This element is affected by the following invariants: ele-1
        TypeContactPoint(CH Core ContactPoint eCH-0046 Phone)
        Is Modifierfalse
        Requirements

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

        Invariantscpt-2: A system is required if a value is provided. (value.empty() or system.exists())
        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        62. Patient.telecom:internet
        Slice Nameinternet
        Definition

        Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc.


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

        ShortCH Core ContactPoint eCH-0046 InternetA contact detail for the individual
        Comments

        A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).

        Control0..*
        This element is affected by the following invariants: ele-1
        TypeContactPoint(CH Core ContactPoint eCH-0046 Internet)
        Is Modifierfalse
        Requirements

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

        Invariantscpt-2: A system is required if a value is provided. (value.empty() or system.exists())
        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        64. Patient.gender
        Definition

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

        Shortmale | female | othermale | female | other | unknown
        Comments

        The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex.

        Control10..1
        BindingThe codes SHALL be taken from AdministrativeGenderhttp://hl7.org/fhir/ValueSet/administrative-gender|4.0.1
        (required to http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1)

        The gender of a person used for administrative purposes.

        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

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

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

        The date of birth for the individual.

        ShortThe date of birth for the individual
        Comments

        At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternity/infant care systems).

        Control10..1
        Typedate
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Age of the individual drives many clinical processes.

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

        Indicates if the individual is deceased or not.

        ShortIndicates if the individual is deceased or not
        Comments

        If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.

        Control0..1
        TypeChoice of: boolean, dateTime
        [x] NoteSee Choice of Data Types for further information about how to use [x]
        Is Modifiertrue because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

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

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

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

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

        Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.

        Control0..*
        TypeBackboneElement
        Is Modifierfalse
        Summaryfalse
        Requirements

        Need to track people you can contact about the patient.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        pat-1: SHALL at least contain a contact's details or a reference to an organization (name.exists() or telecom.exists() or address.exists() or organization.exists())
        pat-1: SHALL at least contain a contact's details or a reference to an organization (name.exists() or telecom.exists() or address.exists() or organization.exists())
        SlicingThis element introduces a set of slices on Patient.contact. The slices are unordered and Open, and can be differentiated using the following discriminators:
        • value @ relationship
        • 72. Patient.contact.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

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

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

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

          Short✕ This element will be removed in PML(C) documentsOrganization that is associated with the contact
          Comments

          ✕ Unsupported reference. It'll be stripped when generating PML(C) documents.

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

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

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

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

          ShortContact data if it is not address of patientA contact party (e.g. guardian, partner, friend) for the patient
          Comments

          Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.

          Control0..1*
          TypeBackboneElement
          Is Modifierfalse
          Summaryfalse
          Requirements

          Need to track people you can contact about the patient.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          pat-1: SHALL at least contain a contact's details or a reference to an organization (name.exists() or telecom.exists() or address.exists() or organization.exists())
          pat-1: SHALL at least contain a contact's details or a reference to an organization (name.exists() or telecom.exists() or address.exists() or organization.exists())
          78. Patient.contact:contact.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

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

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

          The nature of the relationship between the patient and the contact person.

          ShortThe kind of relationship
          Control10..1*
          BindingUnless not suitable, these codes SHALL be taken from PatientContactRelationshiphttp://hl7.org/fhir/ValueSet/patient-contactrelationship
          (extensible to http://hl7.org/fhir/ValueSet/patient-contactrelationship)

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

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

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

          Pattern Value{
            "coding" : [{
              "system" : "http://fhir.ch/ig/ch-core/CodeSystem/ech-11",
              "code" : "contactData"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          82. Patient.contact:contact.telecom
          Definition

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

          ShortA contact detail for the person
          Comments

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

          Control0..0*
          TypeContactPoint
          Is Modifierfalse
          Summaryfalse
          Requirements

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

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

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


          Address for the contact person.

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

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

          Control10..1
          This element is affected by the following invariants: ele-1
          TypeAddress(CH Core Postal Address)
          Is Modifierfalse
          Requirements

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

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ch-addr-2: For a Swiss address, a canton abbreviation from the value set 'eCH-0007 Canton Abbreviation' must be used. (country.extension.where(url = 'http://hl7.org/fhir/StructureDefinition/iso21090-SC-coding').empty() or (country.extension.where(url = 'http://hl7.org/fhir/StructureDefinition/iso21090-SC-coding').value.code.startsWith('CH') = false) or (country.extension.where(url = 'http://hl7.org/fhir/StructureDefinition/iso21090-SC-coding').value.code.startsWith('CH').exists() and (state.empty() or state.memberOf('http://fhir.ch/ig/ch-core/ValueSet/ech-7-cantonabbreviation'))))
          86. Patient.contact:nameOfParent
          Slice NamenameOfParent
          Definition

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

          ShortName of parentA contact party (e.g. guardian, partner, friend) for the patient
          Comments

          Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.

          Control0..*
          TypeBackboneElement
          Is Modifierfalse
          Summaryfalse
          Requirements

          Need to track people you can contact about the patient.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          pat-1: SHALL at least contain a contact's details or a reference to an organization (name.exists() or telecom.exists() or address.exists() or organization.exists())
          pat-1: SHALL at least contain a contact's details or a reference to an organization (name.exists() or telecom.exists() or address.exists() or organization.exists())
          88. Patient.contact:nameOfParent.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

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

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

          The nature of the relationship between the patient and the contact person.

          ShortThe kind of relationship
          Control10..1*
          BindingUnless not suitable, these codes SHALL be taken from PatientContactRelationshiphttp://hl7.org/fhir/ValueSet/patient-contactrelationship
          (extensible to http://hl7.org/fhir/ValueSet/patient-contactrelationship)

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

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

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

          Pattern Value{
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
              "code" : "PRN"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          92. Patient.contact:nameOfParent.name
          Definition

          A name associated with the contact person.

          ShortA name associated with the contact person
          Control10..1
          TypeHumanName
          Is Modifierfalse
          Summaryfalse
          Requirements

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

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

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

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

          If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.

          Control0..*
          TypeBackboneElement
          Is Modifierfalse
          Summaryfalse
          Requirements

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

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          SlicingThis element introduces a set of slices on Patient.communication. The slices are unordered and Open, and can be differentiated using the following discriminators:
          • value @ preferred
          • 96. Patient.communication.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

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

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

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

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

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

            Control1..1
            BindingThe codes SHOULD be taken from CommonLanguageshttp://hl7.org/fhir/ValueSet/languages
            (preferred to http://hl7.org/fhir/ValueSet/languages)

            A human language.

            Additional BindingsPurpose
            AllLanguagesMax Binding
            TypeCodeableConcept
            Is Modifierfalse
            Summaryfalse
            Requirements

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

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

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

            ShortLanguage of correspondenceA language which may be used to communicate with the patient about his or her health
            Comments

            If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.

            Control0..1*
            TypeBackboneElement
            Is Modifierfalse
            Summaryfalse
            Requirements

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

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

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

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

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

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

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

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

            Control1..1
            BindingThe codes SHOULD be taken from CommonLanguageshttp://hl7.org/fhir/ValueSet/languages
            (preferred to http://hl7.org/fhir/ValueSet/languages)

            A human language.

            Additional BindingsPurpose
            AllLanguagesMax Binding
            TypeCodeableConcept
            Is Modifierfalse
            Summaryfalse
            Requirements

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

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

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

            ShortLanguage preference indicator
            Comments

            This language is specifically identified for communicating healthcare information.

            Control10..1
            Typeboolean
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Requirements

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

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

            Patient's nominated care provider.

            Short✕ This element will be removed in PML(C) documentsPatient's nominated primary care provider
            Comments

            ✕ Unsupported reference. It'll be stripped when generating PML(C) documents.


            This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues.

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

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

            Organization that is the custodian of the patient record.

            Short✕ This element will be removed in PML(C) documentsOrganization that is the custodian of the patient record
            Comments

            ✕ Unsupported reference. It'll be stripped when generating PML(C) documents.


            There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association).

            Control0..1
            TypeReference(Organization)
            Is Modifierfalse
            Summarytrue
            Requirements

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

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

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

            Short✕ This element will be removed in PML(C) documentsLink to another patient resource that concerns the same actual person
            Comments

            ✕ Unsupported reference. It'll be stripped when generating PML(C) documents.


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

            Control0..*
            TypeBackboneElement
            Is Modifiertrue because This element is labeled as a modifier because it might not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'
            Summarytrue
            Requirements

            There are multiple use cases:

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

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

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

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

            The other patient resource that the link refers to.

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

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

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

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

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

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

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

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

            0. Patient
            Definition

            The CH Core Patient is based upon the core FHIR Patient Resource and designed to meet the applicable patient demographic data elements in Switzerland. See also https://www.bfs.admin.ch/bfs/de/home/register/personenregister/registerharmonisierung/nomenklaturen.html for further information

            ShortCH Core Patient EPR (to include the patient in an EPR document)
            Control0..*
            Is Modifierfalse
            Summaryfalse
            Alternate NamesSubjectOfCare Client Resident
            Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
            dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
            dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
            dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
            dom-6: A resource should have narrative for robust management (text.`div`.exists())
            ch-pat-1: At least one HumanName with given and family name must be provided. (name.where(family.exists() and given.exists()).count()>0 or name.empty())
            ch-pat-2: gender unknown is currently not used in Switzerland in eCH and the EPR (gender.empty() or gender!='unknown')
            2. Patient.id
            Definition

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

            ShortLogical id of this artifact
            Comments

            The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

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

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

            ShortMetadata about the resource
            Control0..1
            TypeMeta
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            6. Patient.meta.id
            Definition

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

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

            Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

            Short✕ This element is not supported
            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on Patient.meta.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 10. Patient.meta.versionId
              Definition

              Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

              Short✕ This element is not supported
              Comments

              The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

              Control0..1
              Typeid
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              12. Patient.meta.lastUpdated
              Definition

              Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

              Short✕ This element is not supported
              Comments

              This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

              Control0..1
              Typeinstant
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              14. Patient.meta.source
              Definition

              Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

              Short✕ This element is not supported
              Comments

              In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

              This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

              Control0..1
              Typeuri
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              16. Patient.meta.profile
              Definition

              A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

              ShortProfiles this resource claims to conform to
              Comments

              It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

              Control0..*
              Typecanonical(StructureDefinition)
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              18. Patient.meta.security
              Definition

              Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

              Short✕ This element is not supported
              Comments

              The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

              Control0..*
              BindingUnless not suitable, these codes SHALL be taken from All Security Labels
              (extensible to http://hl7.org/fhir/ValueSet/security-labels)

              Security Labels from the Healthcare Privacy and Security Classification System.

              TypeCoding
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              20. Patient.meta.tag
              Definition

              Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

              Short✕ This element is not supported
              Comments

              The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

              Control0..*
              BindingFor example codes, see CommonTags
              (example to http://hl7.org/fhir/ValueSet/common-tags)

              Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

              TypeCoding
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              22. Patient.implicitRules
              Definition

              A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

              ShortA set of rules under which this content was created
              Comments

              Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. All modifiers SHALL be documented in the profile, in order to be usable.

              Control0..0
              Typeuri
              Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              24. Patient.language
              Definition

              The base language in which the resource is written.

              ShortLanguage of the resource content
              Comments

              Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

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

              A human language.

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

              A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

              ShortText summary of the resource, for human interpretation
              Comments

              Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

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

              These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

              ShortContained, inline Resources
              Comments

              This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

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

              An Extension

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

                The registered place of birth of the patient.

                ShortPlace of birth of patient
                Control0..1
                This element is affected by the following invariants: ele-1
                TypeExtension(Place of Birth according to eCH-0011) (Extension Type: Address(Address for Place of Birth))
                Is Modifierfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                34. Patient.extension:placeOfOrigin
                Slice NameplaceOfOrigin
                Definition

                The registered place of origin of the patient.

                ShortPlace of origin(s) of patient
                Control0..*
                This element is affected by the following invariants: ele-1
                TypeExtension(Place of Origin according to eCH-0011) (Extension Type: Address)
                Is Modifierfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                36. Patient.extension:citizenship
                Slice Namecitizenship
                Definition

                The content of the country code element (if present) SHALL be selected EITHER from ValueSet ISO Country Alpha-2 http://hl7.org/fhir/ValueSet/iso3166-1-2 OR MAY be selected from ISO Country Alpha-3 Value Set http://hl7.org/fhir/ValueSet/iso3166-1-3, if the country is not specified in value Set ISO Country Alpha-2 http://hl7.org/fhir/ValueSet/iso3166-1-2.

                ShortCitizenship(s) of patient
                Control0..*
                This element is affected by the following invariants: ele-1
                TypeExtension(citizenship) (Complex Extension)
                Is Modifierfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                ch-pat-3: ISO Country Alpha-2 or ISO Country Alpha-3 code (((extension.where(url='code').value.coding.code.length()=2) and extension.where(url='code').value.coding.code.memberOf('http://hl7.org/fhir/ValueSet/iso3166-1-2')) or ((extension.where(url='code').value.coding.code.length() = 3) and extension.where(url='code').value.coding.code.memberOf('http://hl7.org/fhir/ValueSet/iso3166-1-3')))
                38. Patient.extension:religion
                Slice Namereligion
                Definition

                The patient's professed religious affiliations.

                ShortReligion of patient
                Control0..1
                This element is affected by the following invariants: ele-1
                TypeExtension(religion) (Extension Type: CodeableConcept)
                Is Modifierfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                40. Patient.modifierExtension
                Definition

                An Extension

                ShortExtension
                Comments

                All modifiers SHALL be documented in the profile, in order to be usable.

                Control0..0
                TypeExtension
                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                42. Patient.identifier
                Definition

                An identifier for this patient.

                ShortAn identifier for this patient
                NoteThis is a business identifier, not a resource identifier (see discussion)
                Control1..*
                TypeIdentifier
                Is Modifierfalse
                Summarytrue
                Requirements

                Patients are almost always assigned specific numerical identifiers.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                SlicingThis element introduces a set of slices on Patient.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
                • pattern @ $this
                • 44. Patient.identifier.id
                  Definition

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

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

                  Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

                  Short✕ This element is not supported
                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  SlicingThis element introduces a set of slices on Patient.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 48. Patient.identifier.use
                    Definition

                    The purpose of this identifier.

                    Shortusual | official | temp | secondary | old (If known)
                    Comments

                    Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

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

                    Identifies the purpose for this identifier, if known .

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

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

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

                    Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

                    Short✕ This element is not supported
                    Comments

                    This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                    Control0..1
                    BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                    (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

                    A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                    TypeCodeableConcept
                    Is Modifierfalse
                    Summarytrue
                    Requirements

                    Allows users to make use of identifiers when the identifier system is not known.

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

                    Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                    ShortThe namespace for the identifier value
                    Comments

                    Identifier.system is always case sensitive.

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

                    There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                    Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    54. Patient.identifier.value
                    Definition

                    The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                    ShortThe value that is unique
                    Comments

                    If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                    Control0..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Example<br/><b>General</b>:123456
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    56. Patient.identifier.period
                    Definition

                    Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

                    Short✕ This element is not supported
                    Control0..1
                    TypePeriod
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    58. Patient.identifier.assigner
                    Definition

                    Implementers should not set or read this element. This element is only kept as optional to allow submission of documents that would contain a value, since those documents are still readable by others. The meaning of this element is undefined in this profile.

                    Short✕ This element will be removed in PML(C) documents
                    Comments

                    ✕ Unsupported reference. It'll be stripped when generating PML(C) documents.

                    Control0..1
                    TypeReference(CH EMED EPR Organization)
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    60. Patient.identifier:EPR-SPID
                    Slice NameEPR-SPID
                    Definition

                    An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.

                    ShortAn identifier intended for computation
                    NoteThis is a business identifier, not a resource identifier (see discussion)
                    Control0..0
                    This element is affected by the following invariants: ele-1
                    TypeIdentifier(EPR-SPID Identifier)
                    Is Modifierfalse
                    Requirements

                    Patients are almost always assigned specific numerical identifiers.

                    Pattern Value{
                      "system" : "urn:oid:2.16.756.5.30.1.127.3.10.3"
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    70. Patient.identifier:AHVN13
                    Slice NameAHVN13
                    Definition

                    An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.

                    ShortAn identifier intended for computation
                    NoteThis is a business identifier, not a resource identifier (see discussion)
                    Control0..0
                    This element is affected by the following invariants: ele-1
                    TypeIdentifier(AHVN13 / NAVS13 Identifier)
                    Is Modifierfalse
                    Requirements

                    Patients are almost always assigned specific numerical identifiers.

                    Pattern Value{
                      "system" : "urn:oid:2.16.756.5.32"
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    80. Patient.identifier:LocalPid
                    Slice NameLocalPid
                    Definition

                    An identifier for this patient.

                    ShortLocal patient identifier(s)
                    NoteThis is a business identifier, not a resource identifier (see discussion)
                    Control0..*
                    TypeIdentifier
                    Is Modifierfalse
                    Summarytrue
                    Requirements

                    Patients are almost always assigned specific numerical identifiers.

                    Pattern Value{
                      "type" : {
                        "coding" : [{
                          "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                          "code" : "MR"
                        }]
                      }
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    82. Patient.identifier:insuranceCardNumber
                    Slice NameinsuranceCardNumber
                    Definition

                    An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.

                    ShortAn identifier intended for computation
                    NoteThis is a business identifier, not a resource identifier (see discussion)
                    Control0..*
                    This element is affected by the following invariants: ele-1
                    TypeIdentifier(Insurance Card Number (Identifier))
                    Is Modifierfalse
                    Requirements

                    Patients are almost always assigned specific numerical identifiers.

                    Pattern Value{
                      "system" : "urn:oid:2.16.756.5.30.1.123.100.1.1.1"
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    84. Patient.identifier:insuranceCardNumber.id
                    Definition

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

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

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

                    ShortAdditional content defined by implementations
                    Comments

                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                      The purpose of this identifier.

                      Shortusual | official | temp | secondary | old (If known)
                      Comments

                      Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

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

                      Identifies the purpose for this identifier, if known .

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

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

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      90. Patient.identifier:insuranceCardNumber.type
                      Definition

                      A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                      ShortDescription of identifier
                      Comments

                      This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                      Control0..1
                      BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                      (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

                      A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Summarytrue
                      Requirements

                      Allows users to make use of identifiers when the identifier system is not known.

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

                      Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                      ShortThe namespace for the identifier value
                      Comments

                      Identifier.system is always case sensitive.

                      Control1..1
                      Typeuri
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

                      There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                      Fixed Valueurn:oid:2.16.756.5.30.1.123.100.1.1.1
                      Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      94. Patient.identifier:insuranceCardNumber.value
                      Definition

                      The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                      ShortThe value that is unique
                      Comments

                      If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                      Control1..1
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Example<br/><b>General</b>:123456
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      veka-length: Insurance card number must be exactly 20 characters long (matches('^[0-9]{20}$'))
                      veka-startswith807560: Insurance card number must start with 807560 (startsWith('807560'))
                      veka-length-error: Insurance card number must be exactly 20 characters long (matches('^[0-9]{20}$'))
                      veka-startswith807560-error: Insurance card number must start with 807560 (startsWith('807560'))
                      96. Patient.identifier:insuranceCardNumber.period
                      Definition

                      Time period during which identifier is/was valid for use.

                      ShortTime period when id is/was valid for use
                      Control0..1
                      TypePeriod
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      98. Patient.identifier:insuranceCardNumber.period.id
                      Definition

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

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

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

                      ShortAdditional content defined by implementations
                      Comments

                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                        The start of the period. The boundary is inclusive.

                        ShortStarting time with inclusive boundary
                        Comments

                        If the low element is missing, the meaning is that the low boundary is not known.

                        Control0..1
                        This element is affected by the following invariants: per-1
                        TypedateTime
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        104. Patient.identifier:insuranceCardNumber.period.end
                        Definition

                        The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

                        ShortExpiration date of the insurance card
                        Comments

                        The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

                        Control0..1
                        This element is affected by the following invariants: per-1
                        TypedateTime
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        106. Patient.identifier:insuranceCardNumber.assigner
                        Definition

                        Organization that issued/manages the identifier.

                        ShortOrganization that issued id (may be just text)
                        Comments

                        The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                        Control0..1
                        TypeReference(Organization)
                        Is Modifierfalse
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        108. Patient.active
                        Definition

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

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

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

                        ShortWhether this patient's record is in active use
                        Comments

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

                        Control0..1
                        Typeboolean
                        Is Modifiertrue because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

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

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

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

                        ShortName of a human - parts and usage
                        Comments

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

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

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

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ch-core-hm-1: if officalName with eCH-011 Extension is specified, it can only be put on a name where use attribute is official (family.extension.where(url='http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-ech-11-name' and value='officialName').empty() or (family.extension.where(url='http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-ech-11-name' and value='officialName').exists() and use='official'))
                        ch-core-hm-2: if orginalName with eCH-011 Extension is specified, it can only be put on a name where use attribute is maiden (family.extension.where(url='http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-ech-11-name' and value='originalName').empty() or ((family.extension.where(url='http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-ech-11-name' and value='originalName').exists() and use='maiden')))
                        ch-core-hm-3: ch-ext-ech-11-name can only be put on a family name (descendants().extension.where(url='http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-ech-11-name').count()=family.extension.where(url='http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-ech-11-name').count())
                        ch-core-hm-4: ch-ext-ech-11-firstname can only be put on a given name (descendants().extension.where(url='http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-ech-11-firstname').count()=given.extension.where(url='http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-ech-11-firstname').count())
                        112. Patient.telecom
                        Definition

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

                        ShortA contact detail for the individual
                        Comments

                        A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).

                        Control0..*
                        TypeContactPoint
                        Is Modifierfalse
                        Summarytrue
                        Requirements

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

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        SlicingThis element introduces a set of slices on Patient.telecom. The slices are unordered and Open, and can be differentiated using the following discriminators:
                        • value @ system
                        • 114. Patient.telecom.id
                          Definition

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

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

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

                          ShortAdditional content defined by implementations
                          Comments

                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                            Telecommunications form for contact point - what communications system is required to make use of the contact.

                            Shortphone | fax | email | pager | url | sms | other
                            Control1..1
                            This element is affected by the following invariants: cpt-2
                            BindingThe codes SHALL be taken from ContactPointSystem
                            (required to http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1)

                            Telecommunications form for contact point.

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

                            The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

                            ShortThe actual contact point details
                            Comments

                            Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

                            Control1..1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            Need to support legacy numbers that are not in a tightly controlled format.

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

                            Identifies the purpose for the contact point.

                            Shorthome | work | temp | old | mobile - purpose of this contact point
                            Comments

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

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

                            Use of contact point.

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

                            Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

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

                            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.

                            ShortSpecify preferred order of use (1 = highest)
                            Comments

                            Note that rank does not necessarily follow the order in which the contacts are represented in the instance.

                            Control0..1
                            TypepositiveInt
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            126. Patient.telecom.period
                            Definition

                            Time period when the contact point was/is in use.

                            ShortTime period when the contact point was/is in use
                            Control0..1
                            TypePeriod
                            Is Modifierfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            128. Patient.telecom:email
                            Slice Nameemail
                            Definition

                            Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc.

                            ShortCH Core ContactPoint eCH-0046 Email
                            Comments

                            A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).

                            Control0..*
                            This element is affected by the following invariants: ele-1
                            TypeContactPoint(CH Core ContactPoint eCH-0046 Email)
                            Is Modifierfalse
                            Requirements

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

                            Invariantscpt-2: A system is required if a value is provided. (value.empty() or system.exists())
                            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            130. Patient.telecom:phone
                            Slice Namephone
                            Definition

                            Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc.

                            ShortCH Core ContactPoint eCH-0046 Phone
                            Comments

                            A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).

                            Control0..*
                            This element is affected by the following invariants: ele-1
                            TypeContactPoint(CH Core ContactPoint eCH-0046 Phone)
                            Is Modifierfalse
                            Requirements

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

                            Invariantscpt-2: A system is required if a value is provided. (value.empty() or system.exists())
                            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            132. Patient.telecom:internet
                            Slice Nameinternet
                            Definition

                            Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc.

                            ShortCH Core ContactPoint eCH-0046 Internet
                            Comments

                            A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).

                            Control0..*
                            This element is affected by the following invariants: ele-1
                            TypeContactPoint(CH Core ContactPoint eCH-0046 Internet)
                            Is Modifierfalse
                            Requirements

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

                            Invariantscpt-2: A system is required if a value is provided. (value.empty() or system.exists())
                            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            134. Patient.gender
                            Definition

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

                            Shortmale | female | other
                            Comments

                            The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex.

                            Control1..1
                            BindingThe codes SHALL be taken from AdministrativeGender
                            (required to http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1)

                            The gender of a person used for administrative purposes.

                            Typecode
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

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

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

                            The date of birth for the individual.

                            ShortThe date of birth for the individual
                            Comments

                            At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternity/infant care systems).

                            Control1..1
                            Typedate
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            Age of the individual drives many clinical processes.

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

                            Indicates if the individual is deceased or not.

                            ShortIndicates if the individual is deceased or not
                            Comments

                            If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.

                            Control0..1
                            TypeChoice of: boolean, dateTime
                            [x] NoteSee Choice of Data Types for further information about how to use [x]
                            Is Modifiertrue because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

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

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

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

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

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

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

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

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ch-addr-2: For a Swiss address, a canton abbreviation from the value set 'eCH-0007 Canton Abbreviation' must be used. (country.extension.where(url = 'http://hl7.org/fhir/StructureDefinition/iso21090-SC-coding').empty() or (country.extension.where(url = 'http://hl7.org/fhir/StructureDefinition/iso21090-SC-coding').value.code.startsWith('CH') = false) or (country.extension.where(url = 'http://hl7.org/fhir/StructureDefinition/iso21090-SC-coding').value.code.startsWith('CH').exists() and (state.empty() or state.memberOf('http://fhir.ch/ig/ch-core/ValueSet/ech-7-cantonabbreviation'))))
                            142. Patient.maritalStatus
                            Definition

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

                            ShortMarital (civil) status of a patient
                            Control0..1
                            BindingUnless not suitable, these codes SHALL be taken from ChCoreMaritalStatus
                            (extensible to http://fhir.ch/ig/ch-core/ValueSet/ch-core-maritalstatus)
                            TypeCodeableConcept
                            Is Modifierfalse
                            Summaryfalse
                            Requirements

                            Most, if not all systems capture it.

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

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

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

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

                            ShortAdditional content defined by implementations
                            Comments

                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                              Extension for eCH-0011 - MaritalData - separation

                              ShortMaritalData Separation
                              Control0..1
                              TypeExtension(Marital Data - Separation Type) (Extension Type: CodeableConcept)
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              150. Patient.maritalStatus.coding
                              Definition

                              A reference to a code defined by a terminology system.

                              ShortCode defined by a terminology system
                              Comments

                              Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                              Control0..*
                              TypeCoding
                              Is Modifierfalse
                              Summarytrue
                              Requirements

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

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

                              A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                              ShortPlain text representation of the concept
                              Comments

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

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

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

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

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

                              ShortWhether patient is part of a multiple birth
                              Comments

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

                              Control0..1
                              TypeChoice of: boolean, integer
                              [x] NoteSee Choice of Data Types for further information about how to use [x]
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summaryfalse
                              Requirements

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

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

                              Image of the patient.

                              ShortImage of the patient
                              Comments

                              Guidelines:

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

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

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

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

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

                              Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.

                              Control0..*
                              TypeBackboneElement
                              Is Modifierfalse
                              Summaryfalse
                              Requirements

                              Need to track people you can contact about the patient.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              pat-1: SHALL at least contain a contact's details or a reference to an organization (name.exists() or telecom.exists() or address.exists() or organization.exists())
                              SlicingThis element introduces a set of slices on Patient.contact. The slices are unordered and Open, and can be differentiated using the following discriminators:
                              • value @ relationship
                              • 160. Patient.contact.id
                                Definition

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

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

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

                                ShortAdditional content defined by implementations
                                Comments

                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                Control0..*
                                TypeExtension
                                Is Modifierfalse
                                Summaryfalse
                                Alternate Namesextensions, user content
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                164. Patient.contact.modifierExtension
                                Definition

                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                ShortExtensions that cannot be ignored even if unrecognized
                                Comments

                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

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

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

                                The nature of the relationship between the patient and the contact person.

                                ShortThe kind of relationship
                                Control0..*
                                BindingUnless not suitable, these codes SHALL be taken from PatientContactRelationship
                                (extensible to http://hl7.org/fhir/ValueSet/patient-contactrelationship)

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

                                TypeCodeableConcept
                                Is Modifierfalse
                                Summaryfalse
                                Requirements

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

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

                                A name associated with the contact person.

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

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

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

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

                                ShortA contact detail for the person
                                Comments

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

                                Control0..*
                                TypeContactPoint
                                Is Modifierfalse
                                Summaryfalse
                                Requirements

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

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

                                Address for the contact person.

                                ShortAddress for the contact person
                                Control0..1
                                TypeAddress
                                Is Modifierfalse
                                Summaryfalse
                                Requirements

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

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

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

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

                                The gender of a person used for administrative purposes.

                                Typecode
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summaryfalse
                                Requirements

                                Needed to address the person correctly.

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

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

                                Short✕ This element will be removed in PML(C) documents
                                Comments

                                ✕ Unsupported reference. It'll be stripped when generating PML(C) documents.

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

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

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

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

                                ShortThe period during which this contact person or organization is valid to be contacted relating to this patient
                                Control0..1
                                TypePeriod
                                Is Modifierfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                180. Patient.contact:contact
                                Slice Namecontact
                                Definition

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

                                ShortContact data if it is not address of patient
                                Comments

                                Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.

                                Control0..1
                                TypeBackboneElement
                                Is Modifierfalse
                                Summaryfalse
                                Requirements

                                Need to track people you can contact about the patient.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                pat-1: SHALL at least contain a contact's details or a reference to an organization (name.exists() or telecom.exists() or address.exists() or organization.exists())
                                182. Patient.contact:contact.id
                                Definition

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

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

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

                                ShortAdditional content defined by implementations
                                Comments

                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                Control0..*
                                TypeExtension
                                Is Modifierfalse
                                Summaryfalse
                                Alternate Namesextensions, user content
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                186. Patient.contact:contact.modifierExtension
                                Definition

                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                ShortExtensions that cannot be ignored even if unrecognized
                                Comments

                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

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

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

                                The nature of the relationship between the patient and the contact person.

                                ShortThe kind of relationship
                                Control1..1
                                BindingUnless not suitable, these codes SHALL be taken from PatientContactRelationship
                                (extensible to http://hl7.org/fhir/ValueSet/patient-contactrelationship)

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

                                TypeCodeableConcept
                                Is Modifierfalse
                                Summaryfalse
                                Requirements

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

                                Pattern Value{
                                  "coding" : [{
                                    "system" : "http://fhir.ch/ig/ch-core/CodeSystem/ech-11",
                                    "code" : "contactData"
                                  }]
                                }
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                190. Patient.contact:contact.name
                                Definition

                                A name associated with the contact person.

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

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

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

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

                                ShortA contact detail for the person
                                Comments

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

                                Control0..0
                                TypeContactPoint
                                Is Modifierfalse
                                Summaryfalse
                                Requirements

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

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

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

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

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

                                Control1..1
                                This element is affected by the following invariants: ele-1
                                TypeAddress(CH Core Postal Address)
                                Is Modifierfalse
                                Requirements

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

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ch-addr-2: For a Swiss address, a canton abbreviation from the value set 'eCH-0007 Canton Abbreviation' must be used. (country.extension.where(url = 'http://hl7.org/fhir/StructureDefinition/iso21090-SC-coding').empty() or (country.extension.where(url = 'http://hl7.org/fhir/StructureDefinition/iso21090-SC-coding').value.code.startsWith('CH') = false) or (country.extension.where(url = 'http://hl7.org/fhir/StructureDefinition/iso21090-SC-coding').value.code.startsWith('CH').exists() and (state.empty() or state.memberOf('http://fhir.ch/ig/ch-core/ValueSet/ech-7-cantonabbreviation'))))
                                196. Patient.contact:contact.gender
                                Definition

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

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

                                The gender of a person used for administrative purposes.

                                Typecode
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summaryfalse
                                Requirements

                                Needed to address the person correctly.

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

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

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

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

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

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

                                ShortThe period during which this contact person or organization is valid to be contacted relating to this patient
                                Control0..1
                                TypePeriod
                                Is Modifierfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                202. Patient.contact:nameOfParent
                                Slice NamenameOfParent
                                Definition

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

                                ShortName of parent
                                Comments

                                Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.

                                Control0..*
                                TypeBackboneElement
                                Is Modifierfalse
                                Summaryfalse
                                Requirements

                                Need to track people you can contact about the patient.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                pat-1: SHALL at least contain a contact's details or a reference to an organization (name.exists() or telecom.exists() or address.exists() or organization.exists())
                                204. Patient.contact:nameOfParent.id
                                Definition

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

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

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

                                ShortAdditional content defined by implementations
                                Comments

                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                Control0..*
                                TypeExtension
                                Is Modifierfalse
                                Summaryfalse
                                Alternate Namesextensions, user content
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                208. Patient.contact:nameOfParent.modifierExtension
                                Definition

                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                ShortExtensions that cannot be ignored even if unrecognized
                                Comments

                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

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

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

                                The nature of the relationship between the patient and the contact person.

                                ShortThe kind of relationship
                                Control1..1
                                BindingUnless not suitable, these codes SHALL be taken from PatientContactRelationship
                                (extensible to http://hl7.org/fhir/ValueSet/patient-contactrelationship)

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

                                TypeCodeableConcept
                                Is Modifierfalse
                                Summaryfalse
                                Requirements

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

                                Pattern Value{
                                  "coding" : [{
                                    "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
                                    "code" : "PRN"
                                  }]
                                }
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                212. Patient.contact:nameOfParent.name
                                Definition

                                A name associated with the contact person.

                                ShortA name associated with the contact person
                                Control1..1
                                TypeHumanName
                                Is Modifierfalse
                                Summaryfalse
                                Requirements

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

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

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

                                ShortA contact detail for the person
                                Comments

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

                                Control0..*
                                TypeContactPoint
                                Is Modifierfalse
                                Summaryfalse
                                Requirements

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

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

                                Address for the contact person.

                                ShortAddress for the contact person
                                Control0..1
                                TypeAddress
                                Is Modifierfalse
                                Summaryfalse
                                Requirements

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

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

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

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

                                The gender of a person used for administrative purposes.

                                Typecode
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summaryfalse
                                Requirements

                                Needed to address the person correctly.

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

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

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

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

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

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

                                ShortThe period during which this contact person or organization is valid to be contacted relating to this patient
                                Control0..1
                                TypePeriod
                                Is Modifierfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                224. Patient.communication
                                Definition

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

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

                                If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.

                                Control0..*
                                TypeBackboneElement
                                Is Modifierfalse
                                Summaryfalse
                                Requirements

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

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                SlicingThis element introduces a set of slices on Patient.communication. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                • value @ preferred
                                • 226. Patient.communication.id
                                  Definition

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

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

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

                                  ShortAdditional content defined by implementations
                                  Comments

                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                  Control0..*
                                  TypeExtension
                                  Is Modifierfalse
                                  Summaryfalse
                                  Alternate Namesextensions, user content
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  230. Patient.communication.modifierExtension
                                  Definition

                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                  ShortExtensions that cannot be ignored even if unrecognized
                                  Comments

                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

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

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

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

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

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

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

                                  A human language.

                                  Additional BindingsPurpose
                                  AllLanguagesMax Binding
                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Summaryfalse
                                  Requirements

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

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

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

                                  ShortLanguage preference indicator
                                  Comments

                                  This language is specifically identified for communicating healthcare information.

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

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

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

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

                                  ShortLanguage of correspondence
                                  Comments

                                  If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.

                                  Control0..1
                                  TypeBackboneElement
                                  Is Modifierfalse
                                  Summaryfalse
                                  Requirements

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

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

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

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

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

                                  ShortAdditional content defined by implementations
                                  Comments

                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                  Control0..*
                                  TypeExtension
                                  Is Modifierfalse
                                  Summaryfalse
                                  Alternate Namesextensions, user content
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  242. Patient.communication:languageOfCorrespondence.modifierExtension
                                  Definition

                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                  ShortExtensions that cannot be ignored even if unrecognized
                                  Comments

                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

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

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

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

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

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

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

                                  A human language.

                                  Additional BindingsPurpose
                                  AllLanguagesMax Binding
                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Summaryfalse
                                  Requirements

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

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

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

                                  ShortLanguage preference indicator
                                  Comments

                                  This language is specifically identified for communicating healthcare information.

                                  Control1..1
                                  Typeboolean
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summaryfalse
                                  Requirements

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

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

                                  Patient's nominated care provider.

                                  Short✕ This element will be removed in PML(C) documents
                                  Comments

                                  ✕ Unsupported reference. It'll be stripped when generating PML(C) documents.

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

                                  Organization that is the custodian of the patient record.

                                  Short✕ This element will be removed in PML(C) documents
                                  Comments

                                  ✕ Unsupported reference. It'll be stripped when generating PML(C) documents.

                                  Control0..1
                                  TypeReference(Organization)
                                  Is Modifierfalse
                                  Summarytrue
                                  Requirements

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

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

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

                                  Short✕ This element will be removed in PML(C) documents
                                  Comments

                                  ✕ Unsupported reference. It'll be stripped when generating PML(C) documents.

                                  Control0..*
                                  TypeBackboneElement
                                  Is Modifiertrue because This element is labeled as a modifier because it might not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'
                                  Summarytrue
                                  Requirements

                                  There are multiple use cases:

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

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

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

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

                                  ShortAdditional content defined by implementations
                                  Comments

                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                  Control0..*
                                  TypeExtension
                                  Is Modifierfalse
                                  Summaryfalse
                                  Alternate Namesextensions, user content
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  258. Patient.link.modifierExtension
                                  Definition

                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                  ShortExtensions that cannot be ignored even if unrecognized
                                  Comments

                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

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

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

                                  The other patient resource that the link refers to.

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

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

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

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

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

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

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