De-Identification, Anonymization, Redaction Toolkit Services
0.1.0 - STU1 Release 1 - Standard for Trial-Use United States of America flag

De-Identification, Anonymization, Redaction Toolkit Services, published by HL7 International / Cross Group Projects. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-darts/ and changes regularly. See the Directory of published versions

Resource Profile: De-Identified UDS Plus Patient

Official URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/de-identified-uds-plus-patient Version: 0.1.0
Standards status: Trial-use Maturity Level: 1 Computable Name: DeIdentifiedUDSPlusPatient

This Patient profile represents a Patient availing HRSA services.

All canonical (Official) URLs will be changed in the future and are not available currently on the web.

Introduction

This profile is used to represent de-identified patient information. The de-identification process has to remove all data elements not explicitly identified as "SUPPORTED" in the profile.

The HHS De-identification Guidance is to be followed to ensure appropriate level of de-identification is performed.

According to the HHS guidance the following data elements have to be removed or de-identified

  • Patient Name

  • Address that is more specific than a state

    • First 3 digits of Zipcodes can be included if the population of all zipcodes starting with the same 3 digits are > 20000 people, in all other cases, the zipcodes have to be masked to 00000.
  • All dates should not have a precision of more than the year. This means month and day cannot be included.
  • Demographics including birthdate, deceased indicator
  • Patient contact details such as telephone numbers, fax, email, URLs,
  • Patient personal identifiers such as SSN, Drivers License,
  • Business identifiers such as MRNs, certificate numbers, Account numbers
  • Biometrics such as fingerprints, photos

In FHIR Resources, text elements which provide human readable information to the providers may be generated using programs and tools from the data present within the resource. For e.g a Patient resource text element may contain information such as the full name, Gender and Date of Birth. This type of information will enable identification of the individuals. In order to avoid inadvertent revealing of PII/PHI, text elements cannot be included in the De-identified FHIR resource and the submission will be rejected when text elements are present by the validation process.

Age Computation

The Data Submitter has to compute the age based as of December 31st of the previous year for inclusion in the UDS+ report.

Id Generation

The original patient resource id should not be included in the De-identified patient instance. Instead a new id should be created and provided as part of the FHIR resource. This Data Submitter should be capable of using the generated id to relink the data to the original patient. All resource references to the Patient submitted as part of the UDS+ report should refer to newly generated de-identified id.

Usage of Data Absent Reason Extension

For the UDS+ reporting, the patient data is de-identified and in the process zip codes may be masked to a value of "00000". In these cases the dataAbsentReason extension must be added to identify that the data is "masked". If the zip code is not known, a value of "00000" must be sent with a dataAbsentReason of "unknown". If the zip code is outside the country, a value of "00000" must be sent with a dataAbsentReason of "unsupported".

Birth Sex Additional Constraints

NullFlavors are not allowed for BirthSex reporting for UDS+ even though they are allowed in US Core.

Race and Ethnicity Additional Constraints

US Core allows Race and Ethnicity to be described as only text or rolled up to the OMB categories, however for UDS+ reporting detailed race and ethnicity have to be captured and reported as part of the profile. If the reported race and ethncity values are not null flavors then detailed values are mandatory.

Sexual Orientation Additional Constraints

Health Centers which have not implemented the methods to capture Sexual Orientation, should use the null flavor coded value of "NASK" specifically.

Gender Identity Additional Constraints

Health Centers which have not implemented the methods to capture Gender Identity, should use the null flavor coded value of "NASK" specifically.

Examples Examples of identifiable data and its corresponding de-identifiable data is present in Reporting Guidance.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Patient 0..* Patient De-Identified UDS Plus Patient
... id SΣ 0..1 id The de-identified patient identifier created by the health center to send data to HRSA.
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 4..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:uds-plus-race SC 1..1 (Complex) Indicates the race of the Patient.
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-race profiled by http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-race-extension
Constraints: us-core-23
.... extension:uds-plus-ethnicty S 1..1 (Complex) Indicates the ethnicity of the Patient.
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity profiled by http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-ethnicity-extension
.... extension:uds-plus-birthsex S 1..1 code Indicates the birth sex of the Patient.
URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-birthsex-extension
Binding: Uds Plus Birth Sex Codes (required): The set of codes to be used for UDS+ reporting.
.... extension:uds-plus-age-extension S 1..1 Quantity Age of the Patient computed using birthDate and the reporting period reference
URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-age-extension
.... extension:uds-plus-gender-identity-extension S 0..1 CodeableConcept Gender Identity of the pateient
URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-gender-identity-extension
Binding: Uds Plus Gender Identity Codes (extensible): The set of codes to be used for UDS+ reporting.
.... extension:uds-plus-agriculture-worker-status S 0..1 code Agriculture Status of the patient
URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/udsplus-agriculture-worker-status
Binding: Uds Plus Agriculture Worker Status Codes (extensible)
.... extension:uds-plus-housing-status S 0..1 code Housing Status of the patient
URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-housing-status-extension
Binding: Uds Plus Housing Status Codes (extensible)
.... extension:uds-plus-veteran-status S 0..1 boolean Veteran Status of the patient
URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-veteran-status-extension
... active ?!Σ 0..1 boolean Whether this patient's record is in active use
... Slices for deceased[x] ?!Σ 0..1 Indicates if the individual is deceased or not
Slice: Unordered, Open by type:$this
.... deceasedBoolean boolean
.... deceasedDateTime dateTime
.... deceased[x]:deceasedBoolean ?!SΣ 0..1 boolean Can only have deceased boolean.
... address SΣ 1..1 Address Included only to support zip code
.... 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
.... postalCode SΣ 1..1 string ZipCode must be included in the profile
Example General: 9132
..... Slices for extension Content/Rules for all slices
...... extension:dataAbsentReason S 0..1 (Complex) Reason why the data is not present
URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
....... extension 0..0 Extension
Slice: Unordered, Open by value:url
....... url 1..1 uri "http://hl7.org/fhir/StructureDefinition/data-absent-reason"
....... value[x] S 1..1 code Value of extension
Binding: DataAbsentReason (required)
... communication 0..* BackboneElement A language which may be used to communicate with the patient about his or her health
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... language S 1..1 CodeableConcept ​Language must be included in the profile
Binding: http://hl7.org/fhir/us/core/ValueSet/simple-language (extensible): The set of languages that the patient uses

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Patient.address.use Base required AddressUse 📍4.0.1 FHIR Std.
Patient.address.postalCode.​extension:dataAbsentReason.​value[x] Base required DataAbsentReason 📦4.0.1 FHIR Std.
Patient.communication.​language Base extensible ​ http://hl7.org/fhir/us/core/ValueSet/simple-language Not State Unknown
Patient.link.type Base required LinkType 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Patient If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Patient If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Patient If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Patient If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Patient A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
us-core-23 error Patient.extension:uds-plus-race If "ASKU" or "UNK" are present, then no other OMB race categories can be present. extension.where(url = 'ombCategory').value.where(code in 'ASKU'|'UNK').exists() implies extension.where(url = 'ombCategory').count() = 1

This structure is derived from Patient

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Patient 0..* Patient De-Identified UDS Plus Patient
... id S 0..1 id The de-identified patient identifier created by the health center to send data to HRSA.
... text 0..0 Cannot include any text in the resource as part of the de-identified data.
... contained 0..0 Cannot include any contained resources in the resource as part of the de-identified data.
.... extension:uds-plus-race S 1..1 (Complex) Indicates the race of the Patient.
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-race profiled by http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-race-extension
.... extension:uds-plus-ethnicty S 1..1 (Complex) Indicates the ethnicity of the Patient.
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity profiled by http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-ethnicity-extension
.... extension:uds-plus-birthsex S 1..1 code Indicates the birth sex of the Patient.
URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-birthsex-extension
Binding: Uds Plus Birth Sex Codes (required): The set of codes to be used for UDS+ reporting.
.... extension:uds-plus-age-extension S 1..1 Quantity Age of the Patient computed using birthDate and the reporting period reference
URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-age-extension
.... extension:uds-plus-gender-identity-extension S 0..1 CodeableConcept Gender Identity of the pateient
URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-gender-identity-extension
Binding: Uds Plus Gender Identity Codes (extensible): The set of codes to be used for UDS+ reporting.
.... extension:uds-plus-agriculture-worker-status S 0..1 code Agriculture Status of the patient
URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/udsplus-agriculture-worker-status
Binding: Uds Plus Agriculture Worker Status Codes (extensible)
.... extension:uds-plus-housing-status S 0..1 code Housing Status of the patient
URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-housing-status-extension
Binding: Uds Plus Housing Status Codes (extensible)
.... extension:uds-plus-veteran-status S 0..1 boolean Veteran Status of the patient
URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-veteran-status-extension
... identifier 0..0 Cannot include any identifier in the resource as part of the de-identified data.
... name 0..0 Cannot include any name in the resource as part of the de-identified data.
... telecom 0..0 Cannot include any telecom information in the resource as part of the de-identified data.
... birthDate 0..0 Cannot include any date of birth information in the resource as part of the de-identified data.
... deceasedBoolean S 0..1 boolean Can only have deceased boolean.
... address S 1..1 Address Included only to support zip code
.... text 0..0 Text cannot be included in the profile
.... line 0..0 Street names cannot be included in the profile
.... postalCode S 1..1 string ZipCode must be included in the profile
..... Slices for extension Content/Rules for all slices
...... extension:dataAbsentReason S 0..1 (Complex) Reason why the data is not present
URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
....... value[x] S 1..1 code Value of extension
... maritalStatus 0..0 Cannot include information not required for UDS+
... multipleBirth[x] 0..0 Cannot include information not required for UDS+
... photo 0..0 Cannot include information not required for UDS+
... contact 0..0 Cannot include information not required for UDS+
... communication
.... language S 1..1 CodeableConcept ​Language must be included in the profile
Binding: http://hl7.org/fhir/us/core/ValueSet/simple-language (extensible): The set of languages that the patient uses
... generalPractitioner 0..0 Cannot include information not required for UDS+
... managingOrganization 0..0 Cannot include information not required for UDS+
... link 0..0 Cannot include information not required for UDS+

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Patient.communication.​language Base extensible ​ http://hl7.org/fhir/us/core/ValueSet/simple-language Not State Unknown
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Patient 0..* Patient De-Identified UDS Plus Patient
... id SΣ 0..1 id The de-identified patient identifier created by the health center to send data to HRSA.
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 4..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:uds-plus-race SC 1..1 (Complex) Indicates the race of the Patient.
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-race profiled by http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-race-extension
Constraints: us-core-23
.... extension:uds-plus-ethnicty S 1..1 (Complex) Indicates the ethnicity of the Patient.
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity profiled by http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-ethnicity-extension
.... extension:uds-plus-birthsex S 1..1 code Indicates the birth sex of the Patient.
URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-birthsex-extension
Binding: Uds Plus Birth Sex Codes (required): The set of codes to be used for UDS+ reporting.
.... extension:uds-plus-age-extension S 1..1 Quantity Age of the Patient computed using birthDate and the reporting period reference
URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-age-extension
.... extension:uds-plus-gender-identity-extension S 0..1 CodeableConcept Gender Identity of the pateient
URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-gender-identity-extension
Binding: Uds Plus Gender Identity Codes (extensible): The set of codes to be used for UDS+ reporting.
.... extension:uds-plus-agriculture-worker-status S 0..1 code Agriculture Status of the patient
URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/udsplus-agriculture-worker-status
Binding: Uds Plus Agriculture Worker Status Codes (extensible)
.... extension:uds-plus-housing-status S 0..1 code Housing Status of the patient
URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-housing-status-extension
Binding: Uds Plus Housing Status Codes (extensible)
.... extension:uds-plus-veteran-status S 0..1 boolean Veteran Status of the patient
URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-veteran-status-extension
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... active ?!Σ 0..1 boolean Whether this patient's record is in active use
... gender Σ 0..1 code male | female | other | unknown
Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
... Slices for deceased[x] ?!Σ 0..1 Indicates if the individual is deceased or not
Slice: Unordered, Open by type:$this
.... deceasedBoolean boolean
.... deceasedDateTime dateTime
.... deceased[x]:deceasedBoolean ?!SΣ 0..1 boolean Can only have deceased boolean.
... address SΣ 1..1 Address Included only to support zip code
.... 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 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
.... 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 SΣ 1..1 string ZipCode must be included in the profile
Example General: 9132
..... id 0..1 string xml:id (or equivalent in JSON)
..... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
...... extension:dataAbsentReason S 0..1 (Complex) Reason why the data is not present
URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
....... id 0..1 id Unique id for inter-element referencing
....... extension 0..0 Extension
Slice: Unordered, Open by value:url
....... url 1..1 uri "http://hl7.org/fhir/StructureDefinition/data-absent-reason"
....... value[x] S 1..1 code Value of extension
Binding: DataAbsentReason (required)
..... value 0..1 string Primitive value for string
Max Length:1048576
.... 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"}
... 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 S 1..1 CodeableConcept ​Language must be included in the profile
Binding: http://hl7.org/fhir/us/core/ValueSet/simple-language (extensible): The set of languages that the patient uses
.... preferred 0..1 boolean Language preference indicator

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Patient.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Patient.gender Base required AdministrativeGender 📍4.0.1 FHIR Std.
Patient.address.use Base required AddressUse 📍4.0.1 FHIR Std.
Patient.address.type Base required AddressType 📍4.0.1 FHIR Std.
Patient.address.postalCode.​extension:dataAbsentReason.​value[x] Base required DataAbsentReason 📦4.0.1 FHIR Std.
Patient.contact.relationship Base extensible Patient Contact Relationship 📍4.0.1 FHIR Std.
Patient.contact.gender Base required AdministrativeGender 📍4.0.1 FHIR Std.
Patient.communication.​language Base extensible ​ http://hl7.org/fhir/us/core/ValueSet/simple-language Not State Unknown
Patient.link.type Base required LinkType 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Patient If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Patient If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Patient If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Patient If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Patient A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
us-core-23 error Patient.extension:uds-plus-race If "ASKU" or "UNK" are present, then no other OMB race categories can be present. extension.where(url = 'ombCategory').value.where(code in 'ASKU'|'UNK').exists() implies extension.where(url = 'ombCategory').count() = 1

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Patient 0..* Patient De-Identified UDS Plus Patient
... id SΣ 0..1 id The de-identified patient identifier created by the health center to send data to HRSA.
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 4..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:uds-plus-race SC 1..1 (Complex) Indicates the race of the Patient.
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-race profiled by http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-race-extension
Constraints: us-core-23
.... extension:uds-plus-ethnicty S 1..1 (Complex) Indicates the ethnicity of the Patient.
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity profiled by http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-ethnicity-extension
.... extension:uds-plus-birthsex S 1..1 code Indicates the birth sex of the Patient.
URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-birthsex-extension
Binding: Uds Plus Birth Sex Codes (required): The set of codes to be used for UDS+ reporting.
.... extension:uds-plus-age-extension S 1..1 Quantity Age of the Patient computed using birthDate and the reporting period reference
URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-age-extension
.... extension:uds-plus-gender-identity-extension S 0..1 CodeableConcept Gender Identity of the pateient
URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-gender-identity-extension
Binding: Uds Plus Gender Identity Codes (extensible): The set of codes to be used for UDS+ reporting.
.... extension:uds-plus-agriculture-worker-status S 0..1 code Agriculture Status of the patient
URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/udsplus-agriculture-worker-status
Binding: Uds Plus Agriculture Worker Status Codes (extensible)
.... extension:uds-plus-housing-status S 0..1 code Housing Status of the patient
URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-housing-status-extension
Binding: Uds Plus Housing Status Codes (extensible)
.... extension:uds-plus-veteran-status S 0..1 boolean Veteran Status of the patient
URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-veteran-status-extension
... active ?!Σ 0..1 boolean Whether this patient's record is in active use
... Slices for deceased[x] ?!Σ 0..1 Indicates if the individual is deceased or not
Slice: Unordered, Open by type:$this
.... deceasedBoolean boolean
.... deceasedDateTime dateTime
.... deceased[x]:deceasedBoolean ?!SΣ 0..1 boolean Can only have deceased boolean.
... address SΣ 1..1 Address Included only to support zip code
.... 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
.... postalCode SΣ 1..1 string ZipCode must be included in the profile
Example General: 9132
..... Slices for extension Content/Rules for all slices
...... extension:dataAbsentReason S 0..1 (Complex) Reason why the data is not present
URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
....... extension 0..0 Extension
Slice: Unordered, Open by value:url
....... url 1..1 uri "http://hl7.org/fhir/StructureDefinition/data-absent-reason"
....... value[x] S 1..1 code Value of extension
Binding: DataAbsentReason (required)
... communication 0..* BackboneElement A language which may be used to communicate with the patient about his or her health
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... language S 1..1 CodeableConcept ​Language must be included in the profile
Binding: http://hl7.org/fhir/us/core/ValueSet/simple-language (extensible): The set of languages that the patient uses

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Patient.address.use Base required AddressUse 📍4.0.1 FHIR Std.
Patient.address.postalCode.​extension:dataAbsentReason.​value[x] Base required DataAbsentReason 📦4.0.1 FHIR Std.
Patient.communication.​language Base extensible ​ http://hl7.org/fhir/us/core/ValueSet/simple-language Not State Unknown
Patient.link.type Base required LinkType 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Patient If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Patient If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Patient If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Patient If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Patient A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
us-core-23 error Patient.extension:uds-plus-race If "ASKU" or "UNK" are present, then no other OMB race categories can be present. extension.where(url = 'ombCategory').value.where(code in 'ASKU'|'UNK').exists() implies extension.where(url = 'ombCategory').count() = 1

Differential View

This structure is derived from Patient

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Patient 0..* Patient De-Identified UDS Plus Patient
... id S 0..1 id The de-identified patient identifier created by the health center to send data to HRSA.
... text 0..0 Cannot include any text in the resource as part of the de-identified data.
... contained 0..0 Cannot include any contained resources in the resource as part of the de-identified data.
.... extension:uds-plus-race S 1..1 (Complex) Indicates the race of the Patient.
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-race profiled by http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-race-extension
.... extension:uds-plus-ethnicty S 1..1 (Complex) Indicates the ethnicity of the Patient.
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity profiled by http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-ethnicity-extension
.... extension:uds-plus-birthsex S 1..1 code Indicates the birth sex of the Patient.
URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-birthsex-extension
Binding: Uds Plus Birth Sex Codes (required): The set of codes to be used for UDS+ reporting.
.... extension:uds-plus-age-extension S 1..1 Quantity Age of the Patient computed using birthDate and the reporting period reference
URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-age-extension
.... extension:uds-plus-gender-identity-extension S 0..1 CodeableConcept Gender Identity of the pateient
URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-gender-identity-extension
Binding: Uds Plus Gender Identity Codes (extensible): The set of codes to be used for UDS+ reporting.
.... extension:uds-plus-agriculture-worker-status S 0..1 code Agriculture Status of the patient
URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/udsplus-agriculture-worker-status
Binding: Uds Plus Agriculture Worker Status Codes (extensible)
.... extension:uds-plus-housing-status S 0..1 code Housing Status of the patient
URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-housing-status-extension
Binding: Uds Plus Housing Status Codes (extensible)
.... extension:uds-plus-veteran-status S 0..1 boolean Veteran Status of the patient
URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-veteran-status-extension
... identifier 0..0 Cannot include any identifier in the resource as part of the de-identified data.
... name 0..0 Cannot include any name in the resource as part of the de-identified data.
... telecom 0..0 Cannot include any telecom information in the resource as part of the de-identified data.
... birthDate 0..0 Cannot include any date of birth information in the resource as part of the de-identified data.
... deceasedBoolean S 0..1 boolean Can only have deceased boolean.
... address S 1..1 Address Included only to support zip code
.... text 0..0 Text cannot be included in the profile
.... line 0..0 Street names cannot be included in the profile
.... postalCode S 1..1 string ZipCode must be included in the profile
..... Slices for extension Content/Rules for all slices
...... extension:dataAbsentReason S 0..1 (Complex) Reason why the data is not present
URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
....... value[x] S 1..1 code Value of extension
... maritalStatus 0..0 Cannot include information not required for UDS+
... multipleBirth[x] 0..0 Cannot include information not required for UDS+
... photo 0..0 Cannot include information not required for UDS+
... contact 0..0 Cannot include information not required for UDS+
... communication
.... language S 1..1 CodeableConcept ​Language must be included in the profile
Binding: http://hl7.org/fhir/us/core/ValueSet/simple-language (extensible): The set of languages that the patient uses
... generalPractitioner 0..0 Cannot include information not required for UDS+
... managingOrganization 0..0 Cannot include information not required for UDS+
... link 0..0 Cannot include information not required for UDS+

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Patient.communication.​language Base extensible ​ http://hl7.org/fhir/us/core/ValueSet/simple-language Not State Unknown

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Patient 0..* Patient De-Identified UDS Plus Patient
... id SΣ 0..1 id The de-identified patient identifier created by the health center to send data to HRSA.
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 4..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:uds-plus-race SC 1..1 (Complex) Indicates the race of the Patient.
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-race profiled by http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-race-extension
Constraints: us-core-23
.... extension:uds-plus-ethnicty S 1..1 (Complex) Indicates the ethnicity of the Patient.
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity profiled by http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-ethnicity-extension
.... extension:uds-plus-birthsex S 1..1 code Indicates the birth sex of the Patient.
URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-birthsex-extension
Binding: Uds Plus Birth Sex Codes (required): The set of codes to be used for UDS+ reporting.
.... extension:uds-plus-age-extension S 1..1 Quantity Age of the Patient computed using birthDate and the reporting period reference
URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-age-extension
.... extension:uds-plus-gender-identity-extension S 0..1 CodeableConcept Gender Identity of the pateient
URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-gender-identity-extension
Binding: Uds Plus Gender Identity Codes (extensible): The set of codes to be used for UDS+ reporting.
.... extension:uds-plus-agriculture-worker-status S 0..1 code Agriculture Status of the patient
URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/udsplus-agriculture-worker-status
Binding: Uds Plus Agriculture Worker Status Codes (extensible)
.... extension:uds-plus-housing-status S 0..1 code Housing Status of the patient
URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-housing-status-extension
Binding: Uds Plus Housing Status Codes (extensible)
.... extension:uds-plus-veteran-status S 0..1 boolean Veteran Status of the patient
URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-veteran-status-extension
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... active ?!Σ 0..1 boolean Whether this patient's record is in active use
... gender Σ 0..1 code male | female | other | unknown
Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
... Slices for deceased[x] ?!Σ 0..1 Indicates if the individual is deceased or not
Slice: Unordered, Open by type:$this
.... deceasedBoolean boolean
.... deceasedDateTime dateTime
.... deceased[x]:deceasedBoolean ?!SΣ 0..1 boolean Can only have deceased boolean.
... address SΣ 1..1 Address Included only to support zip code
.... 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 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
.... 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 SΣ 1..1 string ZipCode must be included in the profile
Example General: 9132
..... id 0..1 string xml:id (or equivalent in JSON)
..... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
...... extension:dataAbsentReason S 0..1 (Complex) Reason why the data is not present
URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
....... id 0..1 id Unique id for inter-element referencing
....... extension 0..0 Extension
Slice: Unordered, Open by value:url
....... url 1..1 uri "http://hl7.org/fhir/StructureDefinition/data-absent-reason"
....... value[x] S 1..1 code Value of extension
Binding: DataAbsentReason (required)
..... value 0..1 string Primitive value for string
Max Length:1048576
.... 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"}
... 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 S 1..1 CodeableConcept ​Language must be included in the profile
Binding: http://hl7.org/fhir/us/core/ValueSet/simple-language (extensible): The set of languages that the patient uses
.... preferred 0..1 boolean Language preference indicator

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Patient.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Patient.gender Base required AdministrativeGender 📍4.0.1 FHIR Std.
Patient.address.use Base required AddressUse 📍4.0.1 FHIR Std.
Patient.address.type Base required AddressType 📍4.0.1 FHIR Std.
Patient.address.postalCode.​extension:dataAbsentReason.​value[x] Base required DataAbsentReason 📦4.0.1 FHIR Std.
Patient.contact.relationship Base extensible Patient Contact Relationship 📍4.0.1 FHIR Std.
Patient.contact.gender Base required AdministrativeGender 📍4.0.1 FHIR Std.
Patient.communication.​language Base extensible ​ http://hl7.org/fhir/us/core/ValueSet/simple-language Not State Unknown
Patient.link.type Base required LinkType 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Patient If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Patient If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Patient If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Patient If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Patient A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
us-core-23 error Patient.extension:uds-plus-race If "ASKU" or "UNK" are present, then no other OMB race categories can be present. extension.where(url = 'ombCategory').value.where(code in 'ASKU'|'UNK').exists() implies extension.where(url = 'ombCategory').count() = 1

 

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