CA Baseline Patient Profile

This profile is seeking community and implementer feedback on whether further relaxation of the 1..1 cardinality is needed on the Patient.identifier.type & .system & .value elements.

Due Diligence Reviews identified the above elements as 1..1 cardinality but not in the equivalent eReferral Specification profile. This variance is believed to be due to the eReferral Specification profile not necessarily expecting a Patient to always have a health card (or at minimum a health card number). General consensus from Due Diligence Review is that the cardinalities should not be relaxed in the CA Baseline. Feedback can be provided through the Simplifier issue log for this profile.
Feedback can be provided through the Simplifier issue log for this profile.

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

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

Mandatory Data Elements

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

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

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

Data Absent Reason

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

Must Support Data Elements

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

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

Must Support elements:

• an identifier
• a patient name
• a birth date

Usage Note

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

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

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

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

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

This structure is derived from Patient

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

Constraints

Id	Grade	Path(s)	Details	Requirements
ca-baseline-name	error	Patient.name	Patient.name.given or Patient.name.family or both SHALL be present : family.exists() or given.exists()

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

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Patient.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Patient.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Patient.identifier:JHN.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Patient.identifier:JHN.type	extensible	Fixed Value: JHN http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Patient.name.use	required	NameUse http://hl7.org/fhir/ValueSet/name-use|4.0.1 from the FHIR Standard
Patient.telecom.system	required	ContactPointSystem http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1 from the FHIR Standard
Patient.telecom.use	required	ContactPointUse http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1 from the FHIR Standard
Patient.address.use	required	AddressUse http://hl7.org/fhir/ValueSet/address-use|4.0.1 from the FHIR Standard
Patient.link.type	required	LinkType http://hl7.org/fhir/ValueSet/link-type|4.0.1 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
ca-baseline-name	error	Patient.name	Patient.name.given or Patient.name.family or both SHALL be present : family.exists() or given.exists()
dom-2	error	Patient	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Patient	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Patient	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Patient	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Patient	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

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

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Patient.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Patient.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Patient.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Patient.identifier:JHN.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Patient.identifier:JHN.type	extensible	Fixed Value: JHN http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Patient.name.use	required	NameUse http://hl7.org/fhir/ValueSet/name-use|4.0.1 from the FHIR Standard
Patient.telecom.system	required	ContactPointSystem http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1 from the FHIR Standard
Patient.telecom.use	required	ContactPointUse http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1 from the FHIR Standard
Patient.gender	required	AdministrativeGender http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1 from the FHIR Standard
Patient.address.use	required	AddressUse http://hl7.org/fhir/ValueSet/address-use|4.0.1 from the FHIR Standard
Patient.address.type	required	AddressType http://hl7.org/fhir/ValueSet/address-type|4.0.1 from the FHIR Standard
Patient.maritalStatus	extensible	Marital Status Codes http://hl7.org/fhir/ValueSet/marital-status from the FHIR Standard
Patient.contact.relationship	extensible	PatientContactRelationship http://hl7.org/fhir/ValueSet/patient-contactrelationship from the FHIR Standard
Patient.contact.gender	required	AdministrativeGender http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1 from the FHIR Standard
Patient.communication.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Patient.link.type	required	LinkType http://hl7.org/fhir/ValueSet/link-type|4.0.1 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
ca-baseline-name	error	Patient.name	Patient.name.given or Patient.name.family or both SHALL be present : family.exists() or given.exists()
dom-2	error	Patient	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Patient	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Patient	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Patient	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Patient	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
pat-1	error	Patient.contact	SHALL at least contain a contact's details or a reference to an organization : name.exists() or telecom.exists() or address.exists() or organization.exists()

Differential View

This structure is derived from Patient

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

Constraints

Id	Grade	Path(s)	Details	Requirements
ca-baseline-name	error	Patient.name	Patient.name.given or Patient.name.family or both SHALL be present : family.exists() or given.exists()

Key Elements View

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

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Patient.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Patient.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Patient.identifier:JHN.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Patient.identifier:JHN.type	extensible	Fixed Value: JHN http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Patient.name.use	required	NameUse http://hl7.org/fhir/ValueSet/name-use|4.0.1 from the FHIR Standard
Patient.telecom.system	required	ContactPointSystem http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1 from the FHIR Standard
Patient.telecom.use	required	ContactPointUse http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1 from the FHIR Standard
Patient.address.use	required	AddressUse http://hl7.org/fhir/ValueSet/address-use|4.0.1 from the FHIR Standard
Patient.link.type	required	LinkType http://hl7.org/fhir/ValueSet/link-type|4.0.1 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
ca-baseline-name	error	Patient.name	Patient.name.given or Patient.name.family or both SHALL be present : family.exists() or given.exists()
dom-2	error	Patient	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Patient	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Patient	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Patient	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Patient	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Snapshot View

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

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Patient.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Patient.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Patient.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Patient.identifier:JHN.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Patient.identifier:JHN.type	extensible	Fixed Value: JHN http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Patient.name.use	required	NameUse http://hl7.org/fhir/ValueSet/name-use|4.0.1 from the FHIR Standard
Patient.telecom.system	required	ContactPointSystem http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1 from the FHIR Standard
Patient.telecom.use	required	ContactPointUse http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1 from the FHIR Standard
Patient.gender	required	AdministrativeGender http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1 from the FHIR Standard
Patient.address.use	required	AddressUse http://hl7.org/fhir/ValueSet/address-use|4.0.1 from the FHIR Standard
Patient.address.type	required	AddressType http://hl7.org/fhir/ValueSet/address-type|4.0.1 from the FHIR Standard
Patient.maritalStatus	extensible	Marital Status Codes http://hl7.org/fhir/ValueSet/marital-status from the FHIR Standard
Patient.contact.relationship	extensible	PatientContactRelationship http://hl7.org/fhir/ValueSet/patient-contactrelationship from the FHIR Standard
Patient.contact.gender	required	AdministrativeGender http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1 from the FHIR Standard
Patient.communication.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Patient.link.type	required	LinkType http://hl7.org/fhir/ValueSet/link-type|4.0.1 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
ca-baseline-name	error	Patient.name	Patient.name.given or Patient.name.family or both SHALL be present : family.exists() or given.exists()
dom-2	error	Patient	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Patient	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Patient	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Patient	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Patient	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
pat-1	error	Patient.contact	SHALL at least contain a contact's details or a reference to an organization : name.exists() or telecom.exists() or address.exists() or organization.exists()

This structure is derived from Patient

Identifiers

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

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

• Canadian Passport Number
• Jurisdictional Person Identification
• Jurisdictional Health Number

Canadian Passport Number (PPN)

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

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

Example:

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

Jurisdictional Patient Identifier Number (JPID)

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

URIs used with this identifier type:

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

Example:

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

Jurisdictional Health Number (JHN)

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

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

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

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

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

Version Code

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

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

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

Example:

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