Integrated Reporting Applications
0.1.1 - ci-build
Integrated Reporting Applications, published by IHE Radiology Technical Committee. This is not an authorized publication; it is the continuous build for version 0.1.1). This version is based on the current content of https://github.com/IHE/RAD.RTC-IMR/ and changes regularly. See the Directory of published versions
Active as of 2023-03-08 |
Definitions for the patientcontext resource profile.
Guidance on how to interpret the contents of this table can be found here.
1. Patient | |
2. Patient.identifier | |
Note | This is a business identifier, not a resource identifier (see discussion) |
Control | 10..* |
Slicing | This element introduces a set of slices on Patient.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
|
3. Patient.identifier:patientID | |
SliceName | patientID |
Note | This is a business identifier, not a resource identifier (see discussion) |
Control | 1..1 |
Must Support | true |
4. Patient.identifier:patientID.type | |
Control | 0..? |
5. Patient.identifier:patientID.type.coding | |
Control | 1..? |
Pattern Value | <valueCoding xmlns="http://hl7.org/fhir"> <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/> <code value="MR"/> <display value="Medical Record Number"/> </valueCoding> |
6. Patient.identifier:patientID.value | |
Control | 1..? |
Must Support | true |
Guidance on how to interpret the contents of this table can be found here.
1. Patient | |
Definition | Demographics and other administrative information about an individual or animal receiving care or other health-related services. |
Control | 0..* |
Summary | false |
Alternate Names | SubjectOfCare Client Resident |
Invariants | Defined on this element dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (: contained.contained.empty()) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (: contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (: text.`div`.exists()) |
2. Patient.implicitRules | |
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. |
Control | 0..1 |
Type | uri |
Is Modifier | true |
Summary | true |
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
3. Patient.contained | |
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning. |
Control | 0..* This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5 |
Type | Resource |
Summary | false |
Alternate Names | inline resources, anonymous resources, contained resources |
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels. |
4. Patient.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Control | 0..* |
Type | Extension |
Is Modifier | true |
Summary | true |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
Alternate Names | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
5. Patient.identifier | |
Definition | An identifier for this patient. |
Note | This is a business identifier, not a resource identifier (see discussion) |
Control | 10..* |
Type | Identifier |
Summary | true |
Requirements | Patients are almost always assigned specific numerical identifiers. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
Slicing | This element introduces a set of slices on Patient.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
|
6. Patient.identifier:patientID | |
SliceName | patientID |
Definition | An identifier for this patient. |
Note | This is a business identifier, not a resource identifier (see discussion) |
Control | 10..1* |
Type | Identifier |
Must Support | true |
Summary | true |
Requirements | Patients are almost always assigned specific numerical identifiers. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
7. Patient.identifier:patientID.use | |
Definition | The purpose of this identifier. |
Control | 0..1 |
Binding | The codes SHALL be taken from IdentifierUse Identifies the purpose for this identifier, if known . |
Type | code |
Is Modifier | true |
Summary | true |
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. |
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
8. Patient.identifier:patientID.value | |
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system. |
Control | 10..1 |
Type | string |
Must Support | true |
Summary | true |
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the http://hl7.org/fhir/StructureDefinition/rendered-value). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe. |
Example | General:123456 |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
9. Patient.active | |
Definition | Whether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules. It is often used to filter patient lists to exclude inactive patients Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death. |
Control | 0..1 |
Type | boolean |
Is Modifier | true |
Summary | true |
Requirements | Need to be able to mark a patient record as not to be used because it was created in error. |
Comments | If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient. |
Meaning if Missing | This resource is generally assumed to be active if no value is provided for the active element |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
10. Patient.deceased[x] | |
Definition | Indicates if the individual is deceased or not. |
Control | 0..1 |
Type | Choice of: boolean, dateTime |
[x] Note | See Choice of Data Types for further information about how to use [x] |
Is Modifier | true |
Summary | true |
Requirements | The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive. |
Comments | If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
11. Patient.link | |
Definition | Link to a Patient or RelatedPerson resource that concerns the same actual individual. |
Control | 0..* |
Type | BackboneElement |
Is Modifier | true |
Summary | true |
Requirements | There are multiple use cases:
|
Comments | There is no assumption that linked patient records have mutual links. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
12. Patient.link.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Control | 0..* |
Type | Extension |
Is Modifier | true |
Summary | true |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
Alternate Names | extensions, user content, modifiers |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
13. Patient.link.other | |
Definition | Link to a Patient or RelatedPerson resource that concerns the same actual individual. |
Control | 1..1 |
Type | Reference(Patient|RelatedPerson) |
Summary | true |
Comments | Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
14. Patient.link.type | |
Definition | The type of link between this patient resource and another patient resource. |
Control | 1..1 |
Binding | The codes SHALL be taken from LinkType The type of link between this patient resource and another Patient resource, or Patient/RelatedPerson when using the |
Type | code |
Summary | true |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
Guidance on how to interpret the contents of this table can be found here.
1. Patient | |
Definition | Demographics and other administrative information about an individual or animal receiving care or other health-related services. |
Control | 0..* |
Summary | false |
Alternate Names | SubjectOfCare Client Resident |
2. Patient.id | |
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. |
Control | 0..1 |
Type | id |
Summary | true |
Comments | Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case. |
3. Patient.meta | |
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. |
Control | 0..1 |
Type | Meta |
Summary | true |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
4. Patient.implicitRules | |
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. |
Control | 0..1 |
Type | uri |
Is Modifier | true |
Summary | true |
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
5. Patient.language | |
Definition | The base language in which the resource is written. |
Control | 0..1 |
Binding | The codes SHALL be taken from AllLanguages IETF language tag for a human languag |
Type | code |
Summary | false |
Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
6. Patient.text | |
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. |
Control | 0..1 This element is affected by the following invariants: dom-6 |
Type | Narrative |
Summary | false |
Alternate Names | narrative, html, xhtml, display |
Comments | Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
7. Patient.contained | |
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning. |
Control | 0..* This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5 |
Type | Resource |
Summary | false |
Alternate Names | inline resources, anonymous resources, contained resources |
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels. |
8. Patient.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Control | 0..* |
Type | Extension |
Summary | false |
Alternate Names | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
9. Patient.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Control | 0..* |
Type | Extension |
Is Modifier | true |
Summary | true |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
Alternate Names | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
10. Patient.identifier | |
Definition | An identifier for this patient. |
Note | This is a business identifier, not a resource identifier (see discussion) |
Control | 1..* |
Type | Identifier |
Summary | true |
Requirements | Patients are almost always assigned specific numerical identifiers. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
Slicing | This element introduces a set of slices on Patient.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
|
11. Patient.identifier:patientID | |
SliceName | patientID |
Definition | An identifier for this patient. |
Note | This is a business identifier, not a resource identifier (see discussion) |
Control | 1..1 |
Type | Identifier |
Must Support | true |
Summary | true |
Requirements | Patients are almost always assigned specific numerical identifiers. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
12. Patient.identifier:patientID.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Control | 0..1 This element is affected by the following invariants: ele-1 |
Type | id |
XML Representation | In the XML format, this property is represented as an attribute. |
Summary | false |
13. Patient.identifier:patientID.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Control | 0..* |
Type | Extension |
Summary | false |
Alternate Names | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
Slicing | This element introduces a set of slices on Patient.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
|
14. Patient.identifier:patientID.use | |
Definition | The purpose of this identifier. |
Control | 0..1 |
Binding | The codes SHALL be taken from IdentifierUse Identifies the purpose for this identifier, if known |
Type | code |
Is Modifier | true |
Summary | true |
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. |
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
15. Patient.identifier:patientID.type | |
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. |
Control | 0..1 |
Binding | The codes SHALL be taken from IdentifierTypeCodes; other codes may be used where these codes are not suitable A coded type for an identifier that can be used to determine which identifier to use for a specific purpose |
Type | CodeableConcept |
Summary | true |
Requirements | Allows users to make use of identifiers when the identifier system is not known. |
Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
16. Patient.identifier:patientID.type.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Control | 0..1 This element is affected by the following invariants: ele-1 |
Type | id |
XML Representation | In the XML format, this property is represented as an attribute. |
Summary | false |
17. Patient.identifier:patientID.type.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Control | 0..* |
Type | Extension |
Summary | false |
Alternate Names | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
Slicing | This element introduces a set of slices on Patient.identifier.type.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
|
18. Patient.identifier:patientID.type.coding | |
Definition | A reference to a code defined by a terminology system. |
Control | 1..* |
Type | Coding |
Summary | true |
Requirements | Allows for alternative encodings within a code system, and translations to other code systems. |
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. |
Pattern Value | <valueCoding xmlns="http://hl7.org/fhir"> <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/> <code value="MR"/> <display value="Medical Record Number"/> </valueCoding> |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
19. Patient.identifier:patientID.type.text | |
Definition | A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. |
Control | 0..1 |
Type | string |
Summary | true |
Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. |
Comments | Very often the text is the same as a displayName of one of the codings. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
20. Patient.identifier:patientID.system | |
Definition | Establishes the namespace for the value - that is, an absolute URL that describes a set values that are unique. |
Control | 0..1 |
Type | uri |
Summary | true |
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. |
Comments | Identifier.system is always case sensitive. |
Example | General:http://www.acme.com/identifiers/patient |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
21. Patient.identifier:patientID.value | |
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system. |
Control | 1..1 |
Type | string |
Must Support | true |
Summary | true |
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the http://hl7.org/fhir/StructureDefinition/rendered-value). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe. |
Example | General:123456 |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
22. Patient.identifier:patientID.period | |
Definition | Time period during which identifier is/was valid for use. |
Control | 0..1 |
Type | Period |
Summary | true |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
23. Patient.identifier:patientID.assigner | |
Definition | Organization that issued/manages the identifier. |
Control | 0..1 |
Type | Reference(Organization) |
Summary | true |
Comments | The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
24. Patient.active | |
Definition | Whether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules. It is often used to filter patient lists to exclude inactive patients Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death. |
Control | 0..1 |
Type | boolean |
Is Modifier | true |
Summary | true |
Requirements | Need to be able to mark a patient record as not to be used because it was created in error. |
Comments | If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient. |
Meaning if Missing | This resource is generally assumed to be active if no value is provided for the active element |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
25. Patient.name | |
Definition | A name associated with the individual. |
Control | 0..* |
Type | HumanName |
Summary | true |
Requirements | Need to be able to track the patient by multiple names. Examples are your official name and a partner name. |
Comments | A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns. Animal names may be communicated as given names, and optionally may include a family name. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
26. Patient.telecom | |
Definition | A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted. |
Control | 0..* |
Type | ContactPoint |
Summary | true |
Requirements | People have (primary) ways to contact them in some way such as phone, email. |
Comments | A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone). |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
27. Patient.gender | |
Definition | Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes. |
Control | 0..1 |
Binding | The codes SHALL be taken from AdministrativeGender The gender of a person used for administrative purposes |
Type | code |
Summary | true |
Requirements | Needed for identification of the individual, in combination with (at least) name and birth date. |
Comments | The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
28. Patient.birthDate | |
Definition | The date of birth for the individual. |
Control | 0..1 |
Type | date |
Summary | true |
Requirements | Age of the individual drives many clinical processes. |
Comments | Partial dates are allowed if the specific date of birth is unknown. There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternity/infant care systems). |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
LOINC Code | 21112-8 |
29. Patient.deceased[x] | |
Definition | Indicates if the individual is deceased or not. |
Control | 0..1 |
Type | Choice of: boolean, dateTime |
[x] Note | See Choice of Data Types for further information about how to use [x] |
Is Modifier | true |
Summary | true |
Requirements | The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive. |
Comments | If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
30. Patient.address | |
Definition | An address for the individual. |
Control | 0..* |
Type | Address |
Summary | true |
Requirements | May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification. |
Comments | Patient may have multiple addresses with different uses or applicable periods. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
31. Patient.maritalStatus | |
Definition | This field contains a patient's most recent marital (civil) status. |
Control | 0..1 |
Binding | The codes SHALL be taken from MaritalStatusCodes; other codes may be used where these codes are not suitable The domestic partnership status of a person |
Type | CodeableConcept |
Summary | false |
Requirements | Most, if not all systems capture it. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
32. Patient.multipleBirth[x] | |
Definition | Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer). |
Control | 0..1 |
Type | Choice of: boolean, integer |
[x] Note | See Choice of Data Types for further information about how to use [x] |
Summary | false |
Requirements | For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs. |
Comments | Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in triplets would be valueInteger=2 and the third born would have valueInteger=3 If a boolean value was provided for this triplets example, then all 3 patient records would have valueBoolean=true (the ordering is not indicated). |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
33. Patient.photo | |
Definition | Image of the patient. |
Control | 0..* |
Type | Attachment |
Summary | false |
Requirements | Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too. |
Comments | Guidelines:
|
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
34. Patient.contact | |
Definition | A contact party (e.g. guardian, partner, friend) for the patient. |
Control | 0..* |
Type | BackboneElement |
Summary | false |
Requirements | Need to track people you can contact about the patient. |
Comments | Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) pat-1: SHALL at least contain a contact's details or a reference to an organization (: name.exists() or telecom.exists() or address.exists() or organization.exists()) |
35. Patient.contact.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Control | 0..1 This element is affected by the following invariants: ele-1 |
Type | string |
XML Representation | In the XML format, this property is represented as an attribute. |
Summary | false |
36. Patient.contact.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Control | 0..* |
Type | Extension |
Summary | false |
Alternate Names | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
37. Patient.contact.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Control | 0..* |
Type | Extension |
Is Modifier | true |
Summary | true |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
Alternate Names | extensions, user content, modifiers |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
38. Patient.contact.relationship | |
Definition | The nature of the relationship between the patient and the contact person. |
Control | 0..* |
Binding | The codes SHALL be taken from PatientContactRelationship; other codes may be used where these codes are not suitable The nature of the relationship between a patient and a contact person for that patient |
Type | CodeableConcept |
Summary | false |
Requirements | Used to determine which contact person is the most relevant to approach, depending on circumstances. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
39. Patient.contact.name | |
Definition | A name associated with the contact person. |
Control | 0..1 This element is affected by the following invariants: pat-1 |
Type | HumanName |
Summary | false |
Requirements | Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
40. Patient.contact.telecom | |
Definition | A contact detail for the person, e.g. a telephone number or an email address. |
Control | 0..* This element is affected by the following invariants: pat-1 |
Type | ContactPoint |
Summary | false |
Requirements | People have (primary) ways to contact them in some way such as phone, email. |
Comments | Contact may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
41. Patient.contact.address | |
Definition | Address for the contact person. |
Control | 0..1 This element is affected by the following invariants: pat-1 |
Type | Address |
Summary | false |
Requirements | Need to keep track where the contact person can be contacted per postal mail or visited. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
42. Patient.contact.gender | |
Definition | Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes. |
Control | 0..1 |
Binding | The codes SHALL be taken from AdministrativeGender The gender of a person used for administrative purposes |
Type | code |
Summary | false |
Requirements | Needed to address the person correctly. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
43. Patient.contact.organization | |
Definition | Organization on behalf of which the contact is acting or for which the contact is working. |
Control | 0..1 This element is affected by the following invariants: pat-1 |
Type | Reference(Organization) |
Summary | false |
Requirements | For guardians or business related contacts, the organization is relevant. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
44. Patient.contact.period | |
Definition | The period during which this contact person or organization is valid to be contacted relating to this patient. |
Control | 0..1 |
Type | Period |
Summary | false |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
45. Patient.communication | |
Definition | A language which may be used to communicate with the patient about his or her health. |
Control | 0..* |
Type | BackboneElement |
Summary | false |
Requirements | If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest. |
Comments | If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
46. Patient.communication.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Control | 0..1 This element is affected by the following invariants: ele-1 |
Type | string |
XML Representation | In the XML format, this property is represented as an attribute. |
Summary | false |
47. Patient.communication.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Control | 0..* |
Type | Extension |
Summary | false |
Alternate Names | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
48. Patient.communication.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Control | 0..* |
Type | Extension |
Is Modifier | true |
Summary | true |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
Alternate Names | extensions, user content, modifiers |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
49. Patient.communication.language | |
Definition | The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-AU" for Australian English. |
Control | 1..1 |
Binding | The codes SHALL be taken from AllLanguages IETF language tag for a human languag |
Type | CodeableConcept |
Summary | false |
Requirements | Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect. |
Comments | The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
50. Patient.communication.preferred | |
Definition | Indicates whether or not the patient prefers this language (over other languages he masters up a certain level). |
Control | 0..1 |
Type | boolean |
Summary | false |
Requirements | People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method. |
Comments | This language is specifically identified for communicating healthcare information. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
51. Patient.generalPractitioner | |
Definition | Patient's nominated care provider. |
Control | 0..* |
Type | Reference(Organization|Practitioner|PractitionerRole) |
Summary | false |
Alternate Names | careProvider |
Comments | This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues. Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
52. Patient.managingOrganization | |
Definition | Organization that is the custodian of the patient record. |
Control | 0..1 |
Type | Reference(Organization) |
Summary | true |
Requirements | Need to know who recognizes this patient record, manages and updates it. |
Comments | There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association). |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
53. Patient.link | |
Definition | Link to a Patient or RelatedPerson resource that concerns the same actual individual. |
Control | 0..* |
Type | BackboneElement |
Is Modifier | true |
Summary | true |
Requirements | There are multiple use cases:
|
Comments | There is no assumption that linked patient records have mutual links. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
54. Patient.link.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Control | 0..1 This element is affected by the following invariants: ele-1 |
Type | string |
XML Representation | In the XML format, this property is represented as an attribute. |
Summary | false |
55. Patient.link.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Control | 0..* |
Type | Extension |
Summary | false |
Alternate Names | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
56. Patient.link.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Control | 0..* |
Type | Extension |
Is Modifier | true |
Summary | true |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
Alternate Names | extensions, user content, modifiers |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
57. Patient.link.other | |
Definition | Link to a Patient or RelatedPerson resource that concerns the same actual individual. |
Control | 1..1 |
Type | Reference(Patient|RelatedPerson) |
Summary | true |
Comments | Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
58. Patient.link.type | |
Definition | The type of link between this patient resource and another patient resource. |
Control | 1..1 |
Binding | The codes SHALL be taken from LinkType
The type of link between this patient resource and another Patient resource, or Patient/RelatedPerson when using the seealso cod
|
Type | code |
Summary | true |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |