IKNL PZP STU3
1.0.0-alpha1 - consultation International flag

IKNL PZP STU3, published by IKNL. This guide is not an authorized publication; it is the continuous build for version 1.0.0-alpha1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IKNL/PZP-FHIR-STU3/ and changes regularly. See the Directory of published versions

Resource Profile: ACPPatient - Detailed Descriptions

Draft as of 2025-10-23

Definitions for the ACP-Patient resource profile.

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

0. Patient
Definition

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

ShortPatientInformation about an individual or animal receiving health care services
Control0..*
Alternate NamesSubjectOfCare Client Resident, Patiënt
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.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-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.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-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
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.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

Control0..1
Typeuri
Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
4. Patient.extension:preferredPharmacy
Slice NamepreferredPharmacy
Definition

Optional Extension Element - found in all resources.

ShortReferences a patient's preferered pharmacy
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(nl-core-preferred-pharmacy) (Extension Type: Reference)
Alternate NamesVerwijst naar de voorkeursapotheek van de patiënt
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. Patient.extension:nationality
Slice Namenationality
Definition

The nationality of the patient.

ShortNationality
Control0..*
This element is affected by the following invariants: ele-1
TypeExtension(nationality) (Complex Extension)
Alternate NamesNationaliteit
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. Patient.extension:nationality.extension:code
Slice Namecode
Definition

An Extension

ShortExtensionAdditional Content defined by implementations
Control0..1*
TypeExtension
10. Patient.extension:nationality.extension:code.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Shortidentifies the meaning of the extension
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Control1..1
Typeuri
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed Valuecode
12. Patient.extension:nationality.extension:code.valueCodeableConcept:valueCodeableConcept
Slice NamevalueCodeableConcept
Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

ShortValue of extension
Control0..1
BindingUnless not suitable, these codes SHALL be taken from For codes, see NationaliteitCodelijst (2017-12-31T00:00:00)
(extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.7.6.3--20171231000000|2017-12-31T00:00:00)

Indicates the country of citizenship.

TypeCodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal
14. Patient.extension:nationality.extension:period
Slice Nameperiod
Definition

An Extension

ShortExtensionAdditional Content defined by implementations
Control0..1*
TypeExtension
16. Patient.extension:nationality.extension:period.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Shortidentifies the meaning of the extension
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Control1..1
Typeuri
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed Valueperiod
18. Patient.extension:nationality.extension:period.valuePeriod:valuePeriod
Slice NamevaluePeriod
Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

ShortValue of extension
Control0..1
TypePeriod, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal, CodeableConcept
20. Patient.extension:nationality.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Shortidentifies the meaning of the extension
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Control1..1
Typeuri
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed Valuehttp://hl7.org/fhir/StructureDefinition/patient-nationality
22. Patient.extension:nationality.value[x]
Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

ShortValue of extension
Control0..01
TypeChoice of: base64Binary, boolean, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, Meta
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
24. Patient.extension:legalStatus
Slice NamelegalStatus
Definition

The legal situation that applies to the patient during the intervention. The code of the legal status is based on the Vektis/AZR code list COD232-VEKT Legal Status.

ShortlegalStatus
Comments

The concept LegalStatus of the HCIM FreedomRestrictingMeasures plays an important role in the context of mental healthcare (GGZ). This concept will become an independent HCIM with the next release of HCIM (2018 release).

The LegalStatus concept and associated ValueSet will be split in two concepts: legal status and representative. These concepts are currently captured in one ValueSet. It is possible to have a legal status AND a representative. Therefore, we allow this extension to have a cardinality of 0..2.

Control0..2
This element is affected by the following invariants: ele-1
TypeExtension(Patient LegalStatus) (Extension Type: CodeableConcept)
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
26. Patient.extension:legalStatus.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Shortidentifies the meaning of the extension
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Control1..1
Typeuri
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/zib-patient-legalstatus
28. Patient.extension:legalStatus.value[x]
Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

ShortValue of extension
Control0..1
TypeCodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
SlicingThis element introduces a set of slices on Patient.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
  • type @ $this
  • 30. Patient.extension:legalStatus.value[x]:valueCodeableConcept
    Slice NamevalueCodeableConcept
    Definition

    The legal situation that applies to the patient during the intervention. The code of the legal status is based on the Vektis/AZR code list COD232-VEKT Legal Status.


    Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

    ShortLegalStatusValue of extension
    Control10..1
    BindingUnless not suitable, these codes SHALL be taken from For codes, see JuridischeStatusCodelijst (2017-12-31T00:00:00)
    (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.14.3.2--20171231000000|2017-12-31T00:00:00)
    TypeCodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Alternate NamesJuridischeStatus
    32. Patient.extension:legalStatus.value[x]:valueCodeableConcept.coding
    Definition

    A reference to a code defined by a terminology system.

    ShortCode defined by a terminology system
    Comments

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

    Control10..*
    TypeCoding
    Summarytrue
    Requirements

    Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

    34. Patient.extension:legalStatus.value[x]:valueCodeableConcept.coding.system
    Definition

    The identification of the code system that defines the meaning of the symbol in the code.

    ShortIdentity of the terminology system
    Comments

    The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

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

    Need to be unambiguous about the source of the definition of the symbol.

    36. Patient.extension:legalStatus.value[x]:valueCodeableConcept.coding.code
    Definition

    A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

    ShortSymbol in syntax defined by the system
    Control10..1
    Typecode
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

    Need to refer to a particular code in the system.

    38. Patient.extension:lifeStance
    Slice NamelifeStance
    Definition

    Optional Extension Element - found in all resources.

    ShortOptional Extensions Element
    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension(HCIM LifeStance) (Extension Type: CodeableConcept)
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    40. Patient.extension:lifeStance.url
    Definition

    Source of the definition for the extension code - a logical name or a URL.

    Shortidentifies the meaning of the extension
    Comments

    The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

    Control1..1
    Typeuri
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/zib-LifeStance
    42. Patient.extension:lifeStance.value[x]
    Definition

    Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

    ShortValue of extension
    Control10..1
    TypeCodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    SlicingThis element introduces a set of slices on Patient.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
    • type @ $this
    • 44. Patient.extension:lifeStance.value[x]:valueCodeableConcept
      Slice NamevalueCodeableConcept
      Definition

      Patient’s life stance and/or religion.


      Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

      ShortLifeStanceValue of extension
      Control10..1
      BindingThe codes SHOULD be taken from For codes, see LevensovertuigingCodelijst (2017-12-31T00:00:00)
      (preferred to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.7.5.1--20171231000000|2017-12-31T00:00:00)

      LevensovertuigingCodelijst

      TypeCodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Alternate NamesLevensovertuiging
      46. Patient.extension:lifeStance.value[x]:valueCodeableConcept.coding
      Definition

      A reference to a code defined by a terminology system.

      ShortCode defined by a terminology system
      Comments

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

      Control10..1*
      TypeCoding
      Summarytrue
      Requirements

      Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

      48. Patient.extension:lifeStance.value[x]:valueCodeableConcept.coding.system
      Definition

      The identification of the code system that defines the meaning of the symbol in the code.

      ShortIdentity of the terminology system
      Comments

      The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

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

      Need to be unambiguous about the source of the definition of the symbol.

      50. Patient.extension:lifeStance.value[x]:valueCodeableConcept.coding.code
      Definition

      A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

      ShortSymbol in syntax defined by the system
      Control10..1
      Typecode
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      Need to refer to a particular code in the system.

      52. Patient.extension:legallyCapableMedicalTreatmentDecisions
      Slice NamelegallyCapableMedicalTreatmentDecisions
      Definition

      An extension to indicate the patient's legal capability regarding medical treatment decisions, and to provide a comment on this capability.

      Shortext LegallyCapable regarding medical treatment decisions
      Control0..1
      This element is affected by the following invariants: ACP-Patient-1
      TypeExtension(ext LegallyCapable regarding medical treatment decisions) (Complex Extension)
      54. Patient.extension:legallyCapableMedicalTreatmentDecisions.extension:legallyCapable
      Slice NamelegallyCapable
      Definition

      An Extension

      ShortExtensionAdditional Content defined by implementations
      Control0..1*
      TypeExtension
      56. Patient.extension:legallyCapableMedicalTreatmentDecisions.extension:legallyCapable.extension
      Definition

      An Extension


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

      ShortExtensionAdditional Content defined by implementations
      Comments

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

      Control0..0*
      TypeExtension
      Alternate Namesextensions, user content
      SlicingThis element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 58. Patient.extension:legallyCapableMedicalTreatmentDecisions.extension:legallyCapable.url
        Definition

        Source of the definition for the extension code - a logical name or a URL.

        Shortidentifies the meaning of the extension
        Comments

        The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

        Control1..1
        Typeuri
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        Fixed ValuelegallyCapable
        60. Patient.extension:legallyCapableMedicalTreatmentDecisions.extension:legallyCapableComment
        Slice NamelegallyCapableComment
        Definition

        An Extension

        ShortExtensionAdditional Content defined by implementations
        Control0..1*
        TypeExtension
        62. Patient.extension:legallyCapableMedicalTreatmentDecisions.extension:legallyCapableComment.extension
        Definition

        An Extension


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

        ShortExtensionAdditional Content defined by implementations
        Comments

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

        Control0..0*
        TypeExtension
        Alternate Namesextensions, user content
        SlicingThis element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 64. Patient.extension:legallyCapableMedicalTreatmentDecisions.extension:legallyCapableComment.url
          Definition

          Source of the definition for the extension code - a logical name or a URL.

          Shortidentifies the meaning of the extension
          Comments

          The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

          Control1..1
          Typeuri
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          Fixed ValuelegallyCapableComment
          66. Patient.extension:legallyCapableMedicalTreatmentDecisions.url
          Definition

          Source of the definition for the extension code - a logical name or a URL.

          Shortidentifies the meaning of the extension
          Comments

          The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

          Control1..1
          Typeuri
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          Fixed Valuehttps://api.iknl.nl/docs/pzp/stu3/StructureDefinition/ext-LegallyCapable-MedicalTreatmentDecisions
          68. Patient.extension:legallyCapableMedicalTreatmentDecisions.value[x]
          Definition

          Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

          ShortValue of extension
          Control0..01
          TypeChoice of: base64Binary, boolean, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, Meta
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          70. 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. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          ShortExtensions that cannot be ignored
          Comments

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

          Control0..*
          TypeExtension
          Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
          Alternate Namesextensions, user content
          72. Patient.identifier
          Definition

          The Burgerservicenummer or BSN, as one of the possible patient identification numbers, should at least be sent unless there is a reason not to. Reasons for not sending the burgerservicenummer include but are not limited to, research and apps without a contract for processing data (Dutch: bewerkingsovereenkomst).


          An identifier for this patient.

          ShortPatientIdentificationNumberAn identifier for this patient
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..*
          TypeIdentifier
          Summarytrue
          Requirements

          Patients are almost always assigned specific numerical identifiers.

          Alternate NamesIdentificatienummer
          SlicingThis element introduces a set of slices on Patient.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ system
          • 74. Patient.identifier:BSN
            Slice NameBSN
            Definition

            An identifier for this patient.

            ShortBSNAn identifier for this patient
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..1*
            TypeIdentifier
            Summarytrue
            Requirements

            Patients are almost always assigned specific numerical identifiers.

            Alternate NamesBSN
            76. Patient.identifier:BSN.use
            Definition

            The purpose of this identifier.

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

            This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

            Control0..1
            BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|3.0.2
            (required to http://hl7.org/fhir/ValueSet/identifier-use|3.0.2)

            Identifies the purpose for this identifier, if known .

            Typecode
            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

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

            78. Patient.identifier:BSN.system
            Definition

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

            ShortThe namespace for the identifier value
            Control10..1
            Typeuri
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

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

            Fixed Valuehttp://fhir.nl/fhir/NamingSystem/bsn
            ExampleGeneral: http://www.acme.com/identifiers/patient
            80. Patient.identifier:BSN.value
            Definition

            Burgerservicenummer is the Dutch person identification number which is also allowed for use in healthcare.


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

            ShortBSN (Burgerservicenummer (Dutch person identification number))The value that is unique
            Comments

            The official format according to the 'Logisch Ontwerp BSN 1.4.pdf' is N8..9 and SHALL conform to an 11-proof algorithm. In order to check if the number is 11-proof the number, if N8, SHALL be prefixed with a leading zero. The expected format in FHIR is N9 with leading zero applied to any N8 bsn.


            If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension.

            Control10..1
            Typestring
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Alternate NamesBSN
            ExampleGeneral: 123456
            Example of a burgerservicenummer: 123456782
            82. Patient.active
            Definition

            This field determines the status of the 'patient' record in the context of the organization that owns the record. Note that the record is not the medical record, but rather the actual patient 'resource'. Obviously when the patient 'resource' is not active, then by extension his medical record might also be inactive. Patient.active='false' may be used discourage use of the record, but that it is kept beause there is (medical) data attached to it. Another use case is a patient moving to a different GP practice. Patient.active would be 'false' in the system of the previous GP.


            Whether this patient record is in active use.

            ShortWhether this patient's record is in active use
            Comments

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

            This element is labeled as a modifier because when the patient record is marked as not active it is not expected to be used/referenced without being changed back to active.

            Control0..1
            Typeboolean
            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

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

            Default Valuetrue
            84. Patient.name
            Definition

            A name associated with the individual.

            ShortNameInformationA name associated with the patient
            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.

            Control0..*
            TypeHumanName(nl-core-humanname)
            Summarytrue
            Requirements

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

            Alternate NamesNaamgegevens
            86. Patient.name.extension:humannameAssemblyOrder
            Slice NamehumannameAssemblyOrder
            Definition

            A code that represents the preferred display order of the components of this human name.

            ShortPreferred display order of name parts
            Control0..1
            TypeExtension(assembly-order) (Extension Type: code)
            88. Patient.name.extension:humannameAssemblyOrder.url
            Definition

            Source of the definition for the extension code - a logical name or a URL.

            Shortidentifies the meaning of the extension
            Comments

            The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

            Control1..1
            Typeuri
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            Fixed Valuehttp://hl7.org/fhir/StructureDefinition/humanname-assembly-order
            90. Patient.name.extension:humannameAssemblyOrder.valueCode:valueCode
            Slice NamevalueCode
            Definition

            Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

            ShortValue of extension
            Control0..1
            BindingThe codes SHALL be taken from For codes, see HumanNameAssemblyOrder
            (required to http://hl7.org/fhir/ValueSet/name-assembly-order|3.0.2)

            A code that represents the preferred display order of the components of a human name

            Typecode, date, dateTime, Meta, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal, CodeableConcept
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            92. Patient.name.use
            Definition

            Identifies the purpose for this name.

            Shortusual | official | temp | nickname | anonymous | old | maiden
            Comments

            This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one. Applications can assume that a name is current unless it explicitly says that it is temporary or old.

            Control0..1
            BindingThe codes SHALL be taken from NameUsehttp://hl7.org/fhir/ValueSet/name-use|3.0.2
            (required to http://hl7.org/fhir/ValueSet/name-use|3.0.2)

            The use of a human name

            Typecode
            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

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

            94. Patient.name.given
            Definition

            Note that in order to mark the type of a given name, the FHIR standard extension for ISO 21090 EN Qualifiers is to be used. Examples include call me name (Dutch: roepnaam) and initials. Each initial is expected to be delimited by a dot.


            Given name.

            ShortGivenGiven names (not always 'first'). Includes middle names
            Comments

            Note that in order to mark the type of a given name, the FHIR standard extension for ISO 21090 EN Qualifiers is to be used. Examples include call me name (Dutch: roepnaam) and initials. Each initial is expected to be delimited by a dot. To be conformant to the HCIM for NameInformation, at least the following qualifiers SHALL be supported: BR, IN and CL. The qualifier BR maps to the HCIM concept FirstNames, IN maps to Initials and CL to GivenName.

            Please see the compatibility note on the containing element as well!


            If only initials are recorded, they may be used in place of the full name. Not called "first name" since given names do not always come first.

            Control0..*
            Typestring
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Alternate Namesfirst name, middle name, Voornamen, Initialen, Roepnaam
            96. Patient.name.given.extension:iso21090EnQualifier
            Slice Nameiso21090EnQualifier
            Definition

            A set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type.

            ShortLS | AC | NB | PR | HON | BR | AD | SP | MID | CL | IN | VV
            Comments

            Used to indicate additional information about the name part and how it should be used.

            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(EN-qualifier) (Extension Type: code)
            Is Modifierfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            98. Patient.name.given.extension:iso21090EnQualifier.url
            Definition

            Source of the definition for the extension code - a logical name or a URL.

            Shortidentifies the meaning of the extension
            Comments

            The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

            Control1..1
            Typeuri
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            Fixed Valuehttp://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier
            100. Patient.name.given.extension:iso21090EnQualifier.valueCode:valueCode
            Slice NamevalueCode
            Definition

            Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

            ShortValue of extension
            Control0..1
            BindingThe codes SHALL be taken from For codes, see EntityNamePartQualifier
            (required to http://hl7.org/fhir/ValueSet/name-part-qualifier|3.0.2)

            A set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type

            Typecode, date, dateTime, Meta, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal, CodeableConcept
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            102. Patient.telecom
            Definition

            A contact detail for the individual. Note that there is no support for multiple use values like 'mobile business'.


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

            ShortA contact detail for the individual
            Comments

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

            Control0..*
            TypeContactPoint(nl-core-contactpoint)
            Summarytrue
            Requirements

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

            104. Patient.gender
            Definition

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

            ShortGendermale | female | other | unknown
            Comments

            The gender may 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 M and F, though the vast majority of systems and contexts only support M and F. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific gender aspect of interest (anatomical, chromosonal, 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, chromosonal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overrideable error, not a "hard" error.

            Control0..1
            BindingThe codes SHALL be taken from AdministrativeGenderhttp://hl7.org/fhir/ValueSet/administrative-gender|3.0.2
            (required to http://hl7.org/fhir/ValueSet/administrative-gender|3.0.2)
            Typecode
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Needed for identification of the individual, in combination with (at least) name and birth date. Gender of individual drives many clinical processes.

            Alternate NamesGeslacht
            106. Patient.gender.extension:GeslachtCodelijst
            Slice NameGeslachtCodelijst
            Definition

            Patient’s administrative gender.

            ShortGender
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(HCIM extension code-specification) (Extension Type: CodeableConcept)
            Alternate NamesBevat de specifieke code conform de zib, bij een FHIR-element die een verplichte koppeling heeft met een bepaalde FHIR waardelijst of een FHIR element die niet gecodeerd is gedefinieerd, terwijl de zib dit wel doet., Geslacht
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            108. Patient.gender.extension:GeslachtCodelijst.url
            Definition

            Source of the definition for the extension code - a logical name or a URL.

            Shortidentifies the meaning of the extension
            Comments

            The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

            Control1..1
            Typeuri
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/code-specification
            110. Patient.gender.extension:GeslachtCodelijst.value[x]
            Definition

            Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

            ShortValue of extension
            Control10..1
            TypeCodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            SlicingThis element introduces a set of slices on Patient.gender.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
            • type @ $this
            • 112. Patient.gender.extension:GeslachtCodelijst.value[x]:valueCodeableConcept
              Slice NamevalueCodeableConcept
              Definition

              Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

              ShortValue of extension
              Control10..1
              BindingUnless not suitable, these codes SHALL be taken from For codes, see GeslachtCodelijst (2017-12-31T00:00:00)
              (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.0.1.1--20171231000000|2017-12-31T00:00:00)

              GeslachtCodelijst

              TypeCodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              114. Patient.birthDate
              Definition

              The date of birth for the individual.

              ShortPatients date of birth. The date of birth is mandatory for a patient. An incomplete date, e.g. only year or only year + month, is permitted.The date of birth for the individual
              Comments

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

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

              Age of the individual drives many clinical processes.

              Alternate NamesGeboortedatum
              LOINC Code21112-8
              116. Patient.deceased[x]
              Definition

              Indicates if the individual is deceased or not.

              ShortDeathIndicator/DateOfDeathIndicates if the individual is deceased or not
              Comments

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

              This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.

              Control0..1
              TypeChoice of: boolean, dateTime
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

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

              Alternate NamesOverlijdensindicator/DatumOverlijden
              118. Patient.address
              Definition

              Addresses for the individual.

              ShortAddressInformationAddresses for the individual
              Comments

              Patient may have multiple addresses with different uses or applicable periods.

              Control0..*
              TypeAddress(nl-core-address)
              Summarytrue
              Requirements

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

              Alternate NamesAdresgegevens
              120. Patient.animal
              Definition

              This patient is known to be an animal.

              ShortThis patient is known to be an animal (non-human)
              Comments

              The animal element is labeled "Is Modifier" since patients may be non-human. Systems SHALL either handle patient details appropriately (e.g. inform users patient is not human) or reject declared animal records. The absense of the animal element does not imply that the patient is a human. If a system requires such a positive assertion that the patient is human, an extension will be required. (Do not use a species of homo-sapiens in animal species, as this would incorrectly infer that the patient is an animal).

              Control0..1
              TypeBackboneElement
              Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
              Summarytrue
              Requirements

              Many clinical systems are extended to care for animal patients as well as human.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
              ele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
              122. Patient.animal.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 that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

              ShortExtensions that cannot be ignored
              Comments

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

              Control0..*
              TypeExtension
              Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
              Summarytrue
              Alternate Namesextensions, user content, modifiers
              124. Patient.animal.species
              Definition

              Identifies the high level taxonomic categorization of the kind of animal.

              ShortE.g. Dog, Cow
              Comments

              If the patient is non-human, at least a species SHALL be specified. Species SHALL be a widely recognised taxonomic classification. It may or may not be Linnaean taxonomy and may or may not be at the level of species. If the level is finer than species--such as a breed code--the code system used SHALL allow inference of the species. (The common example is that the word "Hereford" does not allow inference of the species Bos taurus, because there is a Hereford pig breed, but the SNOMED CT code for "Hereford Cattle Breed" does.).

              Control1..1
              BindingFor example codes, see AnimalSpecieshttp://hl7.org/fhir/ValueSet/animal-species|3.0.2
              (example to http://hl7.org/fhir/ValueSet/animal-species|3.0.2)

              The species of an animal.

              TypeCodeableConcept
              Summarytrue
              Requirements

              Need to know what kind of animal.

              126. Patient.generalPractitioner
              Definition

              Patient's nominated care provider.

              ShortGeneralPractitionerPatient's nominated primary care provider
              Comments

              This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disablity 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.

              Control0..1*
              TypeReference(nl-core-organization, nl-core-practitioner, Organization, Practitioner)
              Alternate NamescareProvider, Huisarts
              128. Patient.generalPractitioner.extension:practitionerRole
              Slice NamepractitionerRole
              Definition

              Optional Extension Element - found in all resources.

              ShortOptional Extensions Element
              Control0..1
              TypeExtension(PractitionerRole Reference) (Extension Type: Reference)
              130. Patient.link
              Definition

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

              ShortLink to another patient resource that concerns the same actual person
              Comments

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

              This element is labelled as a modifier because it may not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'.

              Control0..*
              TypeBackboneElement
              Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
              Summarytrue
              Requirements

              There are multiple usecases:

              • Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and * Distribution of patient information across multiple servers.
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
              ele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
              132. 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 that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

              ShortExtensions that cannot be ignored
              Comments

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

              Control0..*
              TypeExtension
              Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
              Summarytrue
              Alternate Namesextensions, user content, modifiers
              134. Patient.link.other
              Definition

              The other patient resource that the link refers to.

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

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

              Control1..1
              TypeReference(Patient, RelatedPerson)
              Summarytrue
              136. Patient.link.type
              Definition

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

              Shortreplaced-by | replaces | refer | seealso - type of link
              Control1..1
              BindingThe codes SHALL be taken from LinkTypehttp://hl7.org/fhir/ValueSet/link-type|3.0.2
              (required to http://hl7.org/fhir/ValueSet/link-type|3.0.2)

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

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

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

              0. Patient
              2. Patient.extension:legallyCapableMedicalTreatmentDecisions
              Slice NamelegallyCapableMedicalTreatmentDecisions
              Control0..1
              This element is affected by the following invariants: ACP-Patient-1
              TypeExtension(ext LegallyCapable regarding medical treatment decisions) (Complex Extension)
              4. Patient.extension:legallyCapableMedicalTreatmentDecisions.extension:legallyCapable
              Slice NamelegallyCapable
              6. Patient.extension:legallyCapableMedicalTreatmentDecisions.extension:legallyCapableComment
              Slice NamelegallyCapableComment
              8. Patient.identifier
              NoteThis is a business identifier, not a resource identifier (see discussion)
              10. Patient.name
              12. Patient.name.use
              14. Patient.name.family
              16. Patient.name.family.extension:humannameOwnPrefix
              Slice NamehumannameOwnPrefix
              18. Patient.name.family.extension:humannameOwnName
              Slice NamehumannameOwnName
              20. Patient.name.family.extension:humannamePartnerPrefix
              Slice NamehumannamePartnerPrefix
              22. Patient.name.family.extension:humannamePartnerName
              Slice NamehumannamePartnerName
              24. Patient.name.given
              26. Patient.telecom
              28. Patient.gender
              30. Patient.birthDate
              LOINC Code
              32. Patient.address

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

              0. Patient
              Definition

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

              ShortPatient
              Control0..*
              Alternate NamesSubjectOfCare Client Resident, Patiënt
              Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
              dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.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-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
              2. Patient.id
              Definition

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

              ShortLogical id of this artifact
              Comments

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

              Control0..1
              Typeid
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              4. Patient.meta
              Definition

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

              ShortMetadata about the resource
              Control0..1
              TypeMeta
              Summarytrue
              6. 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.

              ShortA set of rules under which this content was created
              Comments

              Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.

              This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

              Control0..1
              Typeuri
              Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              8. Patient.language
              Definition

              The base language in which the resource is written.

              ShortLanguage of the resource content
              Comments

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

              Control0..1
              BindingUnless not suitable, these codes SHALL be taken from Common Languages
              (extensible to http://hl7.org/fhir/ValueSet/languages|3.0.2)

              A human language.

              Additional BindingsPurpose
              All LanguagesMax Binding
              Typecode
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              10. Patient.text
              Definition

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

              ShortText summary of the resource, for human interpretation
              Comments

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

              Control0..1
              This element is affected by the following invariants: dom-1
              TypeNarrative
              Alternate Namesnarrative, html, xhtml, display
              12. Patient.contained
              Definition

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

              ShortContained, inline Resources
              Comments

              This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.

              Control0..*
              TypeResource
              Alternate Namesinline resources, anonymous resources, contained resources
              14. Patient.extension
              Definition

              An Extension

              ShortExtension
              Control0..*
              TypeExtension
              SlicingThis element introduces a set of slices on Patient.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 16. Patient.extension:preferredPharmacy
                Slice NamepreferredPharmacy
                Definition

                Optional Extension Element - found in all resources.

                ShortReferences a patient's preferered pharmacy
                Control0..1
                This element is affected by the following invariants: ele-1
                TypeExtension(nl-core-preferred-pharmacy) (Extension Type: Reference)
                Alternate NamesVerwijst naar de voorkeursapotheek van de patiënt
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                18. Patient.extension:nationality
                Slice Namenationality
                Definition

                The nationality of the patient.

                ShortNationality
                Control0..*
                This element is affected by the following invariants: ele-1
                TypeExtension(nationality) (Complex Extension)
                Alternate NamesNationaliteit
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                20. Patient.extension:nationality.id
                Definition

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

                Shortxml:id (or equivalent in JSON)
                Control0..1
                Typestring
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                22. Patient.extension:nationality.extension
                Definition

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

                ShortAdditional Content defined by implementations
                Comments

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

                Control0..*
                TypeExtension
                Alternate Namesextensions, user content
                SlicingThis element introduces a set of slices on Patient.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 24. Patient.extension:nationality.extension:code
                  Slice Namecode
                  Definition

                  An Extension

                  ShortExtension
                  Control0..1
                  TypeExtension
                  26. Patient.extension:nationality.extension:code.id
                  Definition

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

                  Shortxml:id (or equivalent in JSON)
                  Control0..1
                  Typestring
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  XML FormatIn the XML format, this property is represented as an attribute.
                  28. Patient.extension:nationality.extension:code.extension
                  Definition

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

                  ShortAdditional Content defined by implementations
                  Comments

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

                  Control0..*
                  TypeExtension
                  Alternate Namesextensions, user content
                  SlicingThis element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 30. Patient.extension:nationality.extension:code.url
                    Definition

                    Source of the definition for the extension code - a logical name or a URL.

                    Shortidentifies the meaning of the extension
                    Comments

                    The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                    Control1..1
                    Typeuri
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Fixed Valuecode
                    32. Patient.extension:nationality.extension:code.valueCodeableConcept:valueCodeableConcept
                    Slice NamevalueCodeableConcept
                    Definition

                    Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                    ShortValue of extension
                    Control0..1
                    BindingUnless not suitable, these codes SHALL be taken from NationaliteitCodelijst (2017-12-31T00:00:00)
                    (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.7.6.3--20171231000000|2017-12-31T00:00:00)

                    Indicates the country of citizenship.

                    TypeCodeableConcept
                    34. Patient.extension:nationality.extension:period
                    Slice Nameperiod
                    Definition

                    An Extension

                    ShortExtension
                    Control0..1
                    TypeExtension
                    36. Patient.extension:nationality.extension:period.id
                    Definition

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

                    Shortxml:id (or equivalent in JSON)
                    Control0..1
                    Typestring
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    38. Patient.extension:nationality.extension:period.extension
                    Definition

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

                    ShortAdditional Content defined by implementations
                    Comments

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

                    Control0..*
                    TypeExtension
                    Alternate Namesextensions, user content
                    SlicingThis element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 40. Patient.extension:nationality.extension:period.url
                      Definition

                      Source of the definition for the extension code - a logical name or a URL.

                      Shortidentifies the meaning of the extension
                      Comments

                      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                      Control1..1
                      Typeuri
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Fixed Valueperiod
                      42. Patient.extension:nationality.extension:period.valuePeriod:valuePeriod
                      Slice NamevaluePeriod
                      Definition

                      Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                      ShortValue of extension
                      Control0..1
                      TypePeriod
                      44. Patient.extension:nationality.url
                      Definition

                      Source of the definition for the extension code - a logical name or a URL.

                      Shortidentifies the meaning of the extension
                      Comments

                      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                      Control1..1
                      Typeuri
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Fixed Valuehttp://hl7.org/fhir/StructureDefinition/patient-nationality
                      46. Patient.extension:nationality.value[x]
                      Definition

                      Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                      ShortValue of extension
                      Control0..0
                      TypeChoice of: base64Binary, boolean, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, Meta
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      48. Patient.extension:legalStatus
                      Slice NamelegalStatus
                      Definition

                      The legal situation that applies to the patient during the intervention. The code of the legal status is based on the Vektis/AZR code list COD232-VEKT Legal Status.

                      ShortlegalStatus
                      Comments

                      The concept LegalStatus of the HCIM FreedomRestrictingMeasures plays an important role in the context of mental healthcare (GGZ). This concept will become an independent HCIM with the next release of HCIM (2018 release).

                      The LegalStatus concept and associated ValueSet will be split in two concepts: legal status and representative. These concepts are currently captured in one ValueSet. It is possible to have a legal status AND a representative. Therefore, we allow this extension to have a cardinality of 0..2.

                      Control0..2
                      This element is affected by the following invariants: ele-1
                      TypeExtension(Patient LegalStatus) (Extension Type: CodeableConcept)
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      50. Patient.extension:legalStatus.id
                      Definition

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

                      Shortxml:id (or equivalent in JSON)
                      Control0..1
                      Typestring
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      XML FormatIn the XML format, this property is represented as an attribute.
                      52. Patient.extension:legalStatus.extension
                      Definition

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

                      ShortAdditional Content defined by implementations
                      Comments

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

                      Control0..*
                      TypeExtension
                      Alternate Namesextensions, user content
                      SlicingThis element introduces a set of slices on Patient.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 54. Patient.extension:legalStatus.url
                        Definition

                        Source of the definition for the extension code - a logical name or a URL.

                        Shortidentifies the meaning of the extension
                        Comments

                        The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                        Control1..1
                        Typeuri
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/zib-patient-legalstatus
                        56. Patient.extension:legalStatus.value[x]
                        Definition

                        Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                        ShortValue of extension
                        Control0..1
                        TypeCodeableConcept
                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                        SlicingThis element introduces a set of slices on Patient.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                        • type @ $this
                        • 58. Patient.extension:legalStatus.value[x]:valueCodeableConcept
                          Slice NamevalueCodeableConcept
                          Definition

                          The legal situation that applies to the patient during the intervention. The code of the legal status is based on the Vektis/AZR code list COD232-VEKT Legal Status.

                          ShortLegalStatus
                          Control1..1
                          BindingUnless not suitable, these codes SHALL be taken from JuridischeStatusCodelijst (2017-12-31T00:00:00)
                          (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.14.3.2--20171231000000|2017-12-31T00:00:00)
                          TypeCodeableConcept
                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                          Alternate NamesJuridischeStatus
                          60. Patient.extension:legalStatus.value[x]:valueCodeableConcept.id
                          Definition

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

                          Shortxml:id (or equivalent in JSON)
                          Control0..1
                          Typestring
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          XML FormatIn the XML format, this property is represented as an attribute.
                          62. Patient.extension:legalStatus.value[x]:valueCodeableConcept.extension
                          Definition

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

                          ShortAdditional Content defined by implementations
                          Comments

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

                          Control0..*
                          TypeExtension
                          Alternate Namesextensions, user content
                          SlicingThis element introduces a set of slices on Patient.extension.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 64. Patient.extension:legalStatus.value[x]:valueCodeableConcept.coding
                            Definition

                            A reference to a code defined by a terminology system.

                            ShortCode defined by a terminology system
                            Comments

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

                            Control1..*
                            TypeCoding
                            Summarytrue
                            Requirements

                            Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                            66. Patient.extension:legalStatus.value[x]:valueCodeableConcept.coding.id
                            Definition

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

                            Shortxml:id (or equivalent in JSON)
                            Control0..1
                            Typestring
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            XML FormatIn the XML format, this property is represented as an attribute.
                            68. Patient.extension:legalStatus.value[x]:valueCodeableConcept.coding.extension
                            Definition

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

                            ShortAdditional Content defined by implementations
                            Comments

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

                            Control0..*
                            TypeExtension
                            Alternate Namesextensions, user content
                            SlicingThis element introduces a set of slices on Patient.extension.value[x].coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 70. Patient.extension:legalStatus.value[x]:valueCodeableConcept.coding.system
                              Definition

                              The identification of the code system that defines the meaning of the symbol in the code.

                              ShortIdentity of the terminology system
                              Comments

                              The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

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

                              Need to be unambiguous about the source of the definition of the symbol.

                              72. Patient.extension:legalStatus.value[x]:valueCodeableConcept.coding.version
                              Definition

                              The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                              ShortVersion of the system - if relevant
                              Comments

                              Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                              NoteThis is a business version Id, not a resource version Id (see discussion)
                              Control0..1
                              Typestring
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              74. Patient.extension:legalStatus.value[x]:valueCodeableConcept.coding.code
                              Definition

                              A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                              ShortSymbol in syntax defined by the system
                              Control1..1
                              Typecode
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Requirements

                              Need to refer to a particular code in the system.

                              76. Patient.extension:legalStatus.value[x]:valueCodeableConcept.coding.display
                              Definition

                              A representation of the meaning of the code in the system, following the rules of the system.

                              ShortRepresentation defined by the system
                              Control0..1
                              Typestring
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Requirements

                              Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                              78. Patient.extension:legalStatus.value[x]:valueCodeableConcept.coding.userSelected
                              Definition

                              Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

                              ShortIf this coding was chosen directly by the user
                              Comments

                              Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

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

                              This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                              80. Patient.extension:legalStatus.value[x]:valueCodeableConcept.text
                              Definition

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

                              ShortPlain text representation of the concept
                              Comments

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

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

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

                              82. Patient.extension:lifeStance
                              Slice NamelifeStance
                              Definition

                              Optional Extension Element - found in all resources.

                              ShortOptional Extensions Element
                              Control0..*
                              This element is affected by the following invariants: ele-1
                              TypeExtension(HCIM LifeStance) (Extension Type: CodeableConcept)
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              84. Patient.extension:lifeStance.id
                              Definition

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

                              Shortxml:id (or equivalent in JSON)
                              Control0..1
                              Typestring
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              XML FormatIn the XML format, this property is represented as an attribute.
                              86. Patient.extension:lifeStance.extension
                              Definition

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

                              ShortAdditional Content defined by implementations
                              Comments

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

                              Control0..*
                              TypeExtension
                              Alternate Namesextensions, user content
                              SlicingThis element introduces a set of slices on Patient.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 88. Patient.extension:lifeStance.url
                                Definition

                                Source of the definition for the extension code - a logical name or a URL.

                                Shortidentifies the meaning of the extension
                                Comments

                                The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                Control1..1
                                Typeuri
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/zib-LifeStance
                                90. Patient.extension:lifeStance.value[x]
                                Definition

                                Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                ShortValue of extension
                                Control1..1
                                TypeCodeableConcept
                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                SlicingThis element introduces a set of slices on Patient.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                • type @ $this
                                • 92. Patient.extension:lifeStance.value[x]:valueCodeableConcept
                                  Slice NamevalueCodeableConcept
                                  Definition

                                  Patient’s life stance and/or religion.

                                  ShortLifeStance
                                  Control1..1
                                  BindingThe codes SHOULD be taken from LevensovertuigingCodelijst (2017-12-31T00:00:00)
                                  (preferred to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.7.5.1--20171231000000|2017-12-31T00:00:00)

                                  LevensovertuigingCodelijst

                                  TypeCodeableConcept
                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                  Alternate NamesLevensovertuiging
                                  94. Patient.extension:lifeStance.value[x]:valueCodeableConcept.id
                                  Definition

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

                                  Shortxml:id (or equivalent in JSON)
                                  Control0..1
                                  Typestring
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  96. Patient.extension:lifeStance.value[x]:valueCodeableConcept.extension
                                  Definition

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

                                  ShortAdditional Content defined by implementations
                                  Comments

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

                                  Control0..*
                                  TypeExtension
                                  Alternate Namesextensions, user content
                                  SlicingThis element introduces a set of slices on Patient.extension.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 98. Patient.extension:lifeStance.value[x]:valueCodeableConcept.coding
                                    Definition

                                    A reference to a code defined by a terminology system.

                                    ShortCode defined by a terminology system
                                    Comments

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

                                    Control1..1
                                    TypeCoding
                                    Summarytrue
                                    Requirements

                                    Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                    100. Patient.extension:lifeStance.value[x]:valueCodeableConcept.coding.id
                                    Definition

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

                                    Shortxml:id (or equivalent in JSON)
                                    Control0..1
                                    Typestring
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    102. Patient.extension:lifeStance.value[x]:valueCodeableConcept.coding.extension
                                    Definition

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

                                    ShortAdditional Content defined by implementations
                                    Comments

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

                                    Control0..*
                                    TypeExtension
                                    Alternate Namesextensions, user content
                                    SlicingThis element introduces a set of slices on Patient.extension.value[x].coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 104. Patient.extension:lifeStance.value[x]:valueCodeableConcept.coding.system
                                      Definition

                                      The identification of the code system that defines the meaning of the symbol in the code.

                                      ShortIdentity of the terminology system
                                      Comments

                                      The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

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

                                      Need to be unambiguous about the source of the definition of the symbol.

                                      106. Patient.extension:lifeStance.value[x]:valueCodeableConcept.coding.version
                                      Definition

                                      The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                      ShortVersion of the system - if relevant
                                      Comments

                                      Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                      NoteThis is a business version Id, not a resource version Id (see discussion)
                                      Control0..1
                                      Typestring
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      108. Patient.extension:lifeStance.value[x]:valueCodeableConcept.coding.code
                                      Definition

                                      A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                      ShortSymbol in syntax defined by the system
                                      Control1..1
                                      Typecode
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Requirements

                                      Need to refer to a particular code in the system.

                                      110. Patient.extension:lifeStance.value[x]:valueCodeableConcept.coding.display
                                      Definition

                                      A representation of the meaning of the code in the system, following the rules of the system.

                                      ShortRepresentation defined by the system
                                      Control0..1
                                      Typestring
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Requirements

                                      Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                      112. Patient.extension:lifeStance.value[x]:valueCodeableConcept.coding.userSelected
                                      Definition

                                      Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

                                      ShortIf this coding was chosen directly by the user
                                      Comments

                                      Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

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

                                      This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                                      114. Patient.extension:lifeStance.value[x]:valueCodeableConcept.text
                                      Definition

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

                                      ShortPlain text representation of the concept
                                      Comments

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

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

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

                                      116. Patient.extension:legallyCapableMedicalTreatmentDecisions
                                      Slice NamelegallyCapableMedicalTreatmentDecisions
                                      Definition

                                      An extension to indicate the patient's legal capability regarding medical treatment decisions, and to provide a comment on this capability.

                                      Shortext LegallyCapable regarding medical treatment decisions
                                      Control0..1
                                      This element is affected by the following invariants: ACP-Patient-1
                                      TypeExtension(ext LegallyCapable regarding medical treatment decisions) (Complex Extension)
                                      118. Patient.extension:legallyCapableMedicalTreatmentDecisions.id
                                      Definition

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

                                      Shortxml:id (or equivalent in JSON)
                                      Control0..1
                                      Typestring
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      120. Patient.extension:legallyCapableMedicalTreatmentDecisions.extension
                                      Definition

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

                                      ShortAdditional Content defined by implementations
                                      Comments

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

                                      Control0..*
                                      TypeExtension
                                      Alternate Namesextensions, user content
                                      SlicingThis element introduces a set of slices on Patient.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 122. Patient.extension:legallyCapableMedicalTreatmentDecisions.extension:legallyCapable
                                        Slice NamelegallyCapable
                                        Definition

                                        An Extension

                                        ShortExtension
                                        Control0..1
                                        TypeExtension
                                        124. Patient.extension:legallyCapableMedicalTreatmentDecisions.extension:legallyCapable.id
                                        Definition

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

                                        Shortxml:id (or equivalent in JSON)
                                        Control0..1
                                        Typestring
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        126. Patient.extension:legallyCapableMedicalTreatmentDecisions.extension:legallyCapable.extension
                                        Definition

                                        An Extension

                                        ShortExtension
                                        Control0..0
                                        TypeExtension
                                        SlicingThis element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • value @ url
                                        • 128. Patient.extension:legallyCapableMedicalTreatmentDecisions.extension:legallyCapable.url
                                          Definition

                                          Source of the definition for the extension code - a logical name or a URL.

                                          Shortidentifies the meaning of the extension
                                          Comments

                                          The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                          Control1..1
                                          Typeuri
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          Fixed ValuelegallyCapable
                                          130. Patient.extension:legallyCapableMedicalTreatmentDecisions.extension:legallyCapable.value[x]
                                          Definition

                                          Indicates the patient's legal capacity (LegallyCapable) regarding medical treatment decisions.

                                          ShortLegallyCapable
                                          Control0..1
                                          Typeboolean
                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Alternate NamesWilsbekwaam
                                          132. Patient.extension:legallyCapableMedicalTreatmentDecisions.extension:legallyCapableComment
                                          Slice NamelegallyCapableComment
                                          Definition

                                          An Extension

                                          ShortExtension
                                          Control0..1
                                          TypeExtension
                                          134. Patient.extension:legallyCapableMedicalTreatmentDecisions.extension:legallyCapableComment.id
                                          Definition

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

                                          Shortxml:id (or equivalent in JSON)
                                          Control0..1
                                          Typestring
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          136. Patient.extension:legallyCapableMedicalTreatmentDecisions.extension:legallyCapableComment.extension
                                          Definition

                                          An Extension

                                          ShortExtension
                                          Control0..0
                                          TypeExtension
                                          SlicingThis element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                          • value @ url
                                          • 138. Patient.extension:legallyCapableMedicalTreatmentDecisions.extension:legallyCapableComment.url
                                            Definition

                                            Source of the definition for the extension code - a logical name or a URL.

                                            Shortidentifies the meaning of the extension
                                            Comments

                                            The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                            Control1..1
                                            Typeuri
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            Fixed ValuelegallyCapableComment
                                            140. Patient.extension:legallyCapableMedicalTreatmentDecisions.extension:legallyCapableComment.value[x]
                                            Definition

                                            A comment regarding the patient's legal capacity regarding medical treatment decisions.

                                            ShortLegallyCapableComment
                                            Control0..1
                                            Typestring
                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Alternate NamesWilsbekwaamToelichting
                                            142. Patient.extension:legallyCapableMedicalTreatmentDecisions.url
                                            Definition

                                            Source of the definition for the extension code - a logical name or a URL.

                                            Shortidentifies the meaning of the extension
                                            Comments

                                            The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                            Control1..1
                                            Typeuri
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            Fixed Valuehttps://api.iknl.nl/docs/pzp/stu3/StructureDefinition/ext-LegallyCapable-MedicalTreatmentDecisions
                                            144. Patient.extension:legallyCapableMedicalTreatmentDecisions.value[x]
                                            Definition

                                            Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                            ShortValue of extension
                                            Control0..0
                                            TypeChoice of: base64Binary, boolean, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, Meta
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            146. 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. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                            ShortExtensions that cannot be ignored
                                            Comments

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

                                            Control0..*
                                            TypeExtension
                                            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                            Alternate Namesextensions, user content
                                            148. Patient.identifier
                                            Definition

                                            The Burgerservicenummer or BSN, as one of the possible patient identification numbers, should at least be sent unless there is a reason not to. Reasons for not sending the burgerservicenummer include but are not limited to, research and apps without a contract for processing data (Dutch: bewerkingsovereenkomst).

                                            ShortPatientIdentificationNumber
                                            NoteThis is a business identifier, not a resource identifier (see discussion)
                                            Control0..*
                                            TypeIdentifier
                                            Summarytrue
                                            Requirements

                                            Patients are almost always assigned specific numerical identifiers.

                                            Alternate NamesIdentificatienummer
                                            SlicingThis element introduces a set of slices on Patient.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • value @ system
                                            • 150. Patient.identifier:BSN
                                              Slice NameBSN
                                              Definition

                                              An identifier for this patient.

                                              ShortBSN
                                              NoteThis is a business identifier, not a resource identifier (see discussion)
                                              Control0..1
                                              TypeIdentifier
                                              Summarytrue
                                              Requirements

                                              Patients are almost always assigned specific numerical identifiers.

                                              Alternate NamesBSN
                                              152. Patient.identifier:BSN.id
                                              Definition

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

                                              Shortxml:id (or equivalent in JSON)
                                              Control0..1
                                              Typestring
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              154. Patient.identifier:BSN.extension
                                              Definition

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

                                              ShortAdditional Content defined by implementations
                                              Comments

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

                                              Control0..*
                                              TypeExtension
                                              Alternate Namesextensions, user content
                                              SlicingThis element introduces a set of slices on Patient.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • value @ url
                                              • 156. Patient.identifier:BSN.use
                                                Definition

                                                The purpose of this identifier.

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

                                                This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                                                Control0..1
                                                BindingThe codes SHALL be taken from IdentifierUse
                                                (required to http://hl7.org/fhir/ValueSet/identifier-use|3.0.2)

                                                Identifies the purpose for this identifier, if known .

                                                Typecode
                                                Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Summarytrue
                                                Requirements

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

                                                158. Patient.identifier:BSN.type
                                                Definition

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

                                                ShortDescription of identifier
                                                Comments

                                                This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage.

                                                Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                                                Control0..1
                                                BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                                (extensible to http://hl7.org/fhir/ValueSet/identifier-type|3.0.2)

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

                                                TypeCodeableConcept
                                                Summarytrue
                                                Requirements

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

                                                160. Patient.identifier:BSN.system
                                                Definition

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

                                                ShortThe namespace for the identifier value
                                                Control1..1
                                                Typeuri
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Summarytrue
                                                Requirements

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

                                                Fixed Valuehttp://fhir.nl/fhir/NamingSystem/bsn
                                                ExampleGeneral: http://www.acme.com/identifiers/patient
                                                162. Patient.identifier:BSN.value
                                                Definition

                                                Burgerservicenummer is the Dutch person identification number which is also allowed for use in healthcare.

                                                ShortBSN (Burgerservicenummer (Dutch person identification number))
                                                Comments

                                                The official format according to the 'Logisch Ontwerp BSN 1.4.pdf' is N8..9 and SHALL conform to an 11-proof algorithm. In order to check if the number is 11-proof the number, if N8, SHALL be prefixed with a leading zero. The expected format in FHIR is N9 with leading zero applied to any N8 bsn.

                                                Control1..1
                                                Typestring
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Summarytrue
                                                Alternate NamesBSN
                                                ExampleGeneral: 123456
                                                Example of a burgerservicenummer: 123456782
                                                164. Patient.identifier:BSN.period
                                                Definition

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

                                                ShortTime period when id is/was valid for use
                                                Control0..1
                                                TypePeriod
                                                Summarytrue
                                                166. Patient.identifier:BSN.assigner
                                                Definition

                                                Organization that issued/manages the identifier.

                                                ShortOrganization that issued id (may be just text)
                                                Comments

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

                                                Control0..1
                                                TypeReference(Organization)
                                                Summarytrue
                                                168. Patient.active
                                                Definition

                                                This field determines the status of the 'patient' record in the context of the organization that owns the record. Note that the record is not the medical record, but rather the actual patient 'resource'. Obviously when the patient 'resource' is not active, then by extension his medical record might also be inactive. Patient.active='false' may be used discourage use of the record, but that it is kept beause there is (medical) data attached to it. Another use case is a patient moving to a different GP practice. Patient.active would be 'false' in the system of the previous GP.

                                                ShortWhether this patient's record is in active use
                                                Comments

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

                                                This element is labeled as a modifier because when the patient record is marked as not active it is not expected to be used/referenced without being changed back to active.

                                                Control0..1
                                                Typeboolean
                                                Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Summarytrue
                                                Requirements

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

                                                Default Valuetrue
                                                170. Patient.name
                                                Definition

                                                A name associated with the individual.

                                                ShortNameInformation
                                                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.

                                                Control0..*
                                                TypeHumanName(nl-core-humanname)
                                                Summarytrue
                                                Requirements

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

                                                Alternate NamesNaamgegevens
                                                172. Patient.name.id
                                                Definition

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

                                                Shortxml:id (or equivalent in JSON)
                                                Control0..1
                                                Typestring
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                174. Patient.name.extension
                                                Definition

                                                An Extension

                                                ShortExtension
                                                Control0..*
                                                TypeExtension
                                                SlicingThis element introduces a set of slices on Patient.name.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                • value @ url
                                                • 176. Patient.name.extension:humannameAssemblyOrder
                                                  Slice NamehumannameAssemblyOrder
                                                  Definition

                                                  A code that represents the preferred display order of the components of this human name.

                                                  ShortPreferred display order of name parts
                                                  Control0..1
                                                  TypeExtension(assembly-order) (Extension Type: code)
                                                  178. Patient.name.extension:humannameAssemblyOrder.id
                                                  Definition

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

                                                  Shortxml:id (or equivalent in JSON)
                                                  Control0..1
                                                  Typestring
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  180. Patient.name.extension:humannameAssemblyOrder.extension
                                                  Definition

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

                                                  ShortAdditional Content defined by implementations
                                                  Comments

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

                                                  Control0..*
                                                  TypeExtension
                                                  Alternate Namesextensions, user content
                                                  SlicingThis element introduces a set of slices on Patient.name.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                  • value @ url
                                                  • 182. Patient.name.extension:humannameAssemblyOrder.url
                                                    Definition

                                                    Source of the definition for the extension code - a logical name or a URL.

                                                    Shortidentifies the meaning of the extension
                                                    Comments

                                                    The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                    Control1..1
                                                    Typeuri
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                    Fixed Valuehttp://hl7.org/fhir/StructureDefinition/humanname-assembly-order
                                                    184. Patient.name.extension:humannameAssemblyOrder.valueCode:valueCode
                                                    Slice NamevalueCode
                                                    Definition

                                                    Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                                    ShortValue of extension
                                                    Control0..1
                                                    BindingThe codes SHALL be taken from HumanNameAssemblyOrder
                                                    (required to http://hl7.org/fhir/ValueSet/name-assembly-order|3.0.2)

                                                    A code that represents the preferred display order of the components of a human name

                                                    Typecode
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    186. Patient.name.use
                                                    Definition

                                                    Identifies the purpose for this name.

                                                    Shortusual | official | temp | nickname | anonymous | old | maiden
                                                    Comments

                                                    This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one. Applications can assume that a name is current unless it explicitly says that it is temporary or old.

                                                    Control0..1
                                                    BindingThe codes SHALL be taken from NameUse
                                                    (required to http://hl7.org/fhir/ValueSet/name-use|3.0.2)

                                                    The use of a human name

                                                    Typecode
                                                    Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Summarytrue
                                                    Requirements

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

                                                    188. Patient.name.text
                                                    Definition

                                                    A full text representation of the name.

                                                    ShortText representation of the full name
                                                    Comments

                                                    Can provide both a text representation and structured parts.

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

                                                    A renderable, unencoded form.

                                                    190. Patient.name.family
                                                    Definition

                                                    The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.

                                                    ShortSurname
                                                    Comments

                                                    Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).

                                                    Control0..1
                                                    Typestring
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Summarytrue
                                                    Alternate Namessurname, Achternaam
                                                    192. Patient.name.family.id
                                                    Definition

                                                    unique id for the element within a resource (for internal references)

                                                    Shortxml:id (or equivalent in JSON)
                                                    Control0..1
                                                    Typestring
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                    194. Patient.name.family.extension
                                                    Definition

                                                    An Extension

                                                    ShortExtension
                                                    Control0..*
                                                    TypeExtension
                                                    SlicingThis element introduces a set of slices on Patient.name.family.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                    • value @ url
                                                    • 196. Patient.name.family.extension:humannameOwnPrefix
                                                      Slice NamehumannameOwnPrefix
                                                      Definition

                                                      The prefix portion (e.g. voorvoegsel) of the family name that is derived from the person's own surname, as distinguished from any portion that is derived from the surname of the person's partner or spouse.

                                                      ShortVoorvoegsel derived from person's own surname
                                                      Comments

                                                      An example of a voorvoegsel is the "van" in "Ludwig van Beethoven". Since the voorvoegsel doesn't sort completely alphabetically, it is reasonable to specify it as a separate sub-component.

                                                      Control0..1
                                                      This element is affected by the following invariants: ele-1
                                                      TypeExtension(own-prefix) (Extension Type: string)
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      198. Patient.name.family.extension:humannameOwnPrefix.id
                                                      Definition

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

                                                      Shortxml:id (or equivalent in JSON)
                                                      Control0..1
                                                      Typestring
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                      200. Patient.name.family.extension:humannameOwnPrefix.extension
                                                      Definition

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

                                                      ShortAdditional Content defined by implementations
                                                      Comments

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

                                                      Control0..*
                                                      TypeExtension
                                                      Alternate Namesextensions, user content
                                                      SlicingThis element introduces a set of slices on Patient.name.family.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                      • value @ url
                                                      • 202. Patient.name.family.extension:humannameOwnPrefix.url
                                                        Definition

                                                        Source of the definition for the extension code - a logical name or a URL.

                                                        Shortidentifies the meaning of the extension
                                                        Comments

                                                        The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                        Control1..1
                                                        Typeuri
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        Fixed Valuehttp://hl7.org/fhir/StructureDefinition/humanname-own-prefix
                                                        204. Patient.name.family.extension:humannameOwnPrefix.valueString:valueString
                                                        Slice NamevalueString
                                                        Definition

                                                        Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                                        ShortValue of extension
                                                        Control0..1
                                                        Typestring
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        206. Patient.name.family.extension:humannameOwnName
                                                        Slice NamehumannameOwnName
                                                        Definition

                                                        The portion of the family name that is derived from the person's own surname, as distinguished from any portion that is derived from the surname of the person's partner or spouse.

                                                        ShortPortion derived from person's own surname
                                                        Comments

                                                        If the person's surname has legally changed to become (or incorporate) the surname of the person's partner or spouse, this is the person's surname immediately prior to such change. Often this is the person's "maiden name".

                                                        Control0..1
                                                        This element is affected by the following invariants: ele-1
                                                        TypeExtension(own-name) (Extension Type: string)
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        208. Patient.name.family.extension:humannameOwnName.id
                                                        Definition

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

                                                        Shortxml:id (or equivalent in JSON)
                                                        Control0..1
                                                        Typestring
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        210. Patient.name.family.extension:humannameOwnName.extension
                                                        Definition

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

                                                        ShortAdditional Content defined by implementations
                                                        Comments

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

                                                        Control0..*
                                                        TypeExtension
                                                        Alternate Namesextensions, user content
                                                        SlicingThis element introduces a set of slices on Patient.name.family.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                        • value @ url
                                                        • 212. Patient.name.family.extension:humannameOwnName.url
                                                          Definition

                                                          Source of the definition for the extension code - a logical name or a URL.

                                                          Shortidentifies the meaning of the extension
                                                          Comments

                                                          The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                          Control1..1
                                                          Typeuri
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                          Fixed Valuehttp://hl7.org/fhir/StructureDefinition/humanname-own-name
                                                          214. Patient.name.family.extension:humannameOwnName.valueString:valueString
                                                          Slice NamevalueString
                                                          Definition

                                                          Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                                          ShortValue of extension
                                                          Control0..1
                                                          Typestring
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          216. Patient.name.family.extension:humannamePartnerPrefix
                                                          Slice NamehumannamePartnerPrefix
                                                          Definition

                                                          The prefix portion (e.g. voorvoegsel) of the family name that is derived from the person's partner's surname, as distinguished from any portion that is derived from the surname of the person's own.

                                                          ShortVoorvoegsel derived from person's partner's surname
                                                          Comments

                                                          An example of a voorvoegsel is the "van" in "Ludwig van Beethoven". Since the voorvoegsel doesn't sort completely alphabetically, it is reasonable to identify it as a separate sub-component.

                                                          Control0..1
                                                          This element is affected by the following invariants: ele-1
                                                          TypeExtension(partner-prefix) (Extension Type: string)
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          218. Patient.name.family.extension:humannamePartnerPrefix.id
                                                          Definition

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

                                                          Shortxml:id (or equivalent in JSON)
                                                          Control0..1
                                                          Typestring
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                          220. Patient.name.family.extension:humannamePartnerPrefix.extension
                                                          Definition

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

                                                          ShortAdditional Content defined by implementations
                                                          Comments

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

                                                          Control0..*
                                                          TypeExtension
                                                          Alternate Namesextensions, user content
                                                          SlicingThis element introduces a set of slices on Patient.name.family.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                          • value @ url
                                                          • 222. Patient.name.family.extension:humannamePartnerPrefix.url
                                                            Definition

                                                            Source of the definition for the extension code - a logical name or a URL.

                                                            Shortidentifies the meaning of the extension
                                                            Comments

                                                            The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                            Control1..1
                                                            Typeuri
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            Fixed Valuehttp://hl7.org/fhir/StructureDefinition/humanname-partner-prefix
                                                            224. Patient.name.family.extension:humannamePartnerPrefix.valueString:valueString
                                                            Slice NamevalueString
                                                            Definition

                                                            Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                                            ShortValue of extension
                                                            Control0..1
                                                            Typestring
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            226. Patient.name.family.extension:humannamePartnerName
                                                            Slice NamehumannamePartnerName
                                                            Definition

                                                            The portion of the family name that is derived from the person's partner's surname, as distinguished from any portion that is derived from the surname of the person's own name.

                                                            ShortPortion derived from person's partner's surname
                                                            Comments

                                                            If the person's surname has legally changed to become (or incorporate) the surname of the person's partner or spouse, this is the person's surname immediately prior to such change. Often this is the person's "maiden name".

                                                            Control0..1
                                                            This element is affected by the following invariants: ele-1
                                                            TypeExtension(partner-name) (Extension Type: string)
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            228. Patient.name.family.extension:humannamePartnerName.id
                                                            Definition

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

                                                            Shortxml:id (or equivalent in JSON)
                                                            Control0..1
                                                            Typestring
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            230. Patient.name.family.extension:humannamePartnerName.extension
                                                            Definition

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

                                                            ShortAdditional Content defined by implementations
                                                            Comments

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

                                                            Control0..*
                                                            TypeExtension
                                                            Alternate Namesextensions, user content
                                                            SlicingThis element introduces a set of slices on Patient.name.family.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                            • value @ url
                                                            • 232. Patient.name.family.extension:humannamePartnerName.url
                                                              Definition

                                                              Source of the definition for the extension code - a logical name or a URL.

                                                              Shortidentifies the meaning of the extension
                                                              Comments

                                                              The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                              Control1..1
                                                              Typeuri
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                              Fixed Valuehttp://hl7.org/fhir/StructureDefinition/humanname-partner-name
                                                              234. Patient.name.family.extension:humannamePartnerName.valueString:valueString
                                                              Slice NamevalueString
                                                              Definition

                                                              Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                                              ShortValue of extension
                                                              Control0..1
                                                              Typestring
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              236. Patient.name.family.value
                                                              Definition

                                                              The actual value

                                                              ShortPrimitive value for string
                                                              Control0..1
                                                              Typestring
                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                              Max Length:1048576
                                                              238. Patient.name.given
                                                              Definition

                                                              Note that in order to mark the type of a given name, the FHIR standard extension for ISO 21090 EN Qualifiers is to be used. Examples include call me name (Dutch: roepnaam) and initials. Each initial is expected to be delimited by a dot.

                                                              ShortGiven
                                                              Comments

                                                              Note that in order to mark the type of a given name, the FHIR standard extension for ISO 21090 EN Qualifiers is to be used. Examples include call me name (Dutch: roepnaam) and initials. Each initial is expected to be delimited by a dot. To be conformant to the HCIM for NameInformation, at least the following qualifiers SHALL be supported: BR, IN and CL. The qualifier BR maps to the HCIM concept FirstNames, IN maps to Initials and CL to GivenName.

                                                              Please see the compatibility note on the containing element as well!

                                                              Control0..*
                                                              Typestring
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Summarytrue
                                                              Alternate Namesfirst name, middle name, Voornamen, Initialen, Roepnaam
                                                              240. Patient.name.given.id
                                                              Definition

                                                              unique id for the element within a resource (for internal references)

                                                              Shortxml:id (or equivalent in JSON)
                                                              Control0..1
                                                              Typestring
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                              242. Patient.name.given.extension
                                                              Definition

                                                              An Extension

                                                              ShortExtension
                                                              Control0..*
                                                              TypeExtension
                                                              SlicingThis element introduces a set of slices on Patient.name.given.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                              • value @ url
                                                              • 244. Patient.name.given.extension:iso21090EnQualifier
                                                                Slice Nameiso21090EnQualifier
                                                                Definition

                                                                A set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type.

                                                                ShortLS | AC | NB | PR | HON | BR | AD | SP | MID | CL | IN | VV
                                                                Comments

                                                                Used to indicate additional information about the name part and how it should be used.

                                                                Control0..1
                                                                This element is affected by the following invariants: ele-1
                                                                TypeExtension(EN-qualifier) (Extension Type: code)
                                                                Is Modifierfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                246. Patient.name.given.extension:iso21090EnQualifier.id
                                                                Definition

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

                                                                Shortxml:id (or equivalent in JSON)
                                                                Control0..1
                                                                Typestring
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                248. Patient.name.given.extension:iso21090EnQualifier.extension
                                                                Definition

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

                                                                ShortAdditional Content defined by implementations
                                                                Comments

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

                                                                Control0..*
                                                                TypeExtension
                                                                Alternate Namesextensions, user content
                                                                SlicingThis element introduces a set of slices on Patient.name.given.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                • value @ url
                                                                • 250. Patient.name.given.extension:iso21090EnQualifier.url
                                                                  Definition

                                                                  Source of the definition for the extension code - a logical name or a URL.

                                                                  Shortidentifies the meaning of the extension
                                                                  Comments

                                                                  The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                                  Control1..1
                                                                  Typeuri
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                  Fixed Valuehttp://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier
                                                                  252. Patient.name.given.extension:iso21090EnQualifier.valueCode:valueCode
                                                                  Slice NamevalueCode
                                                                  Definition

                                                                  Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                                                  ShortValue of extension
                                                                  Control0..1
                                                                  BindingThe codes SHALL be taken from EntityNamePartQualifier
                                                                  (required to http://hl7.org/fhir/ValueSet/name-part-qualifier|3.0.2)

                                                                  A set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type

                                                                  Typecode
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  254. Patient.name.given.value
                                                                  Definition

                                                                  The actual value

                                                                  ShortPrimitive value for string
                                                                  Control0..1
                                                                  Typestring
                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                  Max Length:1048576
                                                                  256. Patient.name.prefix
                                                                  Definition

                                                                  Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name.

                                                                  ShortParts that come before the name
                                                                  Control0..*
                                                                  Typestring
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Summarytrue
                                                                  258. Patient.name.suffix
                                                                  Definition

                                                                  Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name.

                                                                  ShortParts that come after the name
                                                                  Control0..*
                                                                  Typestring
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Summarytrue
                                                                  260. Patient.name.period
                                                                  Definition

                                                                  Indicates the period of time when this name was valid for the named person.

                                                                  ShortTime period when name was/is in use
                                                                  Control0..1
                                                                  TypePeriod
                                                                  Summarytrue
                                                                  Requirements

                                                                  Allows names to be placed in historical context.

                                                                  262. Patient.telecom
                                                                  Definition

                                                                  A contact detail for the individual. Note that there is no support for multiple use values like 'mobile business'.

                                                                  ShortA contact detail for the individual
                                                                  Comments

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

                                                                  Control0..*
                                                                  TypeContactPoint(nl-core-contactpoint)
                                                                  Summarytrue
                                                                  Requirements

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

                                                                  264. Patient.gender
                                                                  Definition

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

                                                                  ShortGender
                                                                  Comments

                                                                  The gender may 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 M and F, though the vast majority of systems and contexts only support M and F. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific gender aspect of interest (anatomical, chromosonal, 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, chromosonal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overrideable error, not a "hard" error.

                                                                  Control0..1
                                                                  BindingThe codes SHALL be taken from AdministrativeGender
                                                                  (required to http://hl7.org/fhir/ValueSet/administrative-gender|3.0.2)
                                                                  Typecode
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Summarytrue
                                                                  Requirements

                                                                  Needed for identification of the individual, in combination with (at least) name and birth date. Gender of individual drives many clinical processes.

                                                                  Alternate NamesGeslacht
                                                                  266. Patient.gender.id
                                                                  Definition

                                                                  unique id for the element within a resource (for internal references)

                                                                  Shortxml:id (or equivalent in JSON)
                                                                  Control0..1
                                                                  Typestring
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                  268. Patient.gender.extension
                                                                  Definition

                                                                  An Extension

                                                                  ShortExtension
                                                                  Control0..*
                                                                  TypeExtension
                                                                  SlicingThis element introduces a set of slices on Patient.gender.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                  • value @ url
                                                                  • 270. Patient.gender.extension:GeslachtCodelijst
                                                                    Slice NameGeslachtCodelijst
                                                                    Definition

                                                                    Patient’s administrative gender.

                                                                    ShortGender
                                                                    Control0..1
                                                                    This element is affected by the following invariants: ele-1
                                                                    TypeExtension(HCIM extension code-specification) (Extension Type: CodeableConcept)
                                                                    Alternate NamesBevat de specifieke code conform de zib, bij een FHIR-element die een verplichte koppeling heeft met een bepaalde FHIR waardelijst of een FHIR element die niet gecodeerd is gedefinieerd, terwijl de zib dit wel doet., Geslacht
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                    272. Patient.gender.extension:GeslachtCodelijst.id
                                                                    Definition

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

                                                                    Shortxml:id (or equivalent in JSON)
                                                                    Control0..1
                                                                    Typestring
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                    274. Patient.gender.extension:GeslachtCodelijst.extension
                                                                    Definition

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

                                                                    ShortAdditional Content defined by implementations
                                                                    Comments

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

                                                                    Control0..*
                                                                    TypeExtension
                                                                    Alternate Namesextensions, user content
                                                                    SlicingThis element introduces a set of slices on Patient.gender.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                    • value @ url
                                                                    • 276. Patient.gender.extension:GeslachtCodelijst.url
                                                                      Definition

                                                                      Source of the definition for the extension code - a logical name or a URL.

                                                                      Shortidentifies the meaning of the extension
                                                                      Comments

                                                                      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                                      Control1..1
                                                                      Typeuri
                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                      Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/code-specification
                                                                      278. Patient.gender.extension:GeslachtCodelijst.value[x]
                                                                      Definition

                                                                      Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                                                      ShortValue of extension
                                                                      Control1..1
                                                                      TypeCodeableConcept
                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                      SlicingThis element introduces a set of slices on Patient.gender.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                                      • type @ $this
                                                                      • 280. Patient.gender.extension:GeslachtCodelijst.value[x]:valueCodeableConcept
                                                                        Slice NamevalueCodeableConcept
                                                                        Definition

                                                                        Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                                                        ShortValue of extension
                                                                        Control1..1
                                                                        BindingUnless not suitable, these codes SHALL be taken from GeslachtCodelijst (2017-12-31T00:00:00)
                                                                        (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.0.1.1--20171231000000|2017-12-31T00:00:00)

                                                                        GeslachtCodelijst

                                                                        TypeCodeableConcept
                                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                        282. Patient.gender.value
                                                                        Definition

                                                                        Primitive value for code

                                                                        ShortPrimitive value for code
                                                                        Control0..1
                                                                        Typecode
                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                        284. Patient.birthDate
                                                                        Definition

                                                                        The date of birth for the individual.

                                                                        ShortPatients date of birth. The date of birth is mandatory for a patient. An incomplete date, e.g. only year or only year + month, is permitted.
                                                                        Comments

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

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

                                                                        Age of the individual drives many clinical processes.

                                                                        Alternate NamesGeboortedatum
                                                                        LOINC Code21112-8
                                                                        286. Patient.deceased[x]
                                                                        Definition

                                                                        Indicates if the individual is deceased or not.

                                                                        ShortDeathIndicator/DateOfDeath
                                                                        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.

                                                                        This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.

                                                                        Control0..1
                                                                        TypeChoice of: boolean, dateTime
                                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                        Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Summarytrue
                                                                        Requirements

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

                                                                        Alternate NamesOverlijdensindicator/DatumOverlijden
                                                                        288. Patient.address
                                                                        Definition

                                                                        Addresses for the individual.

                                                                        ShortAddressInformation
                                                                        Comments

                                                                        Patient may have multiple addresses with different uses or applicable periods.

                                                                        Control0..*
                                                                        TypeAddress(nl-core-address)
                                                                        Summarytrue
                                                                        Requirements

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

                                                                        Alternate NamesAdresgegevens
                                                                        290. Patient.maritalStatus
                                                                        Definition

                                                                        This field contains a patient's most recent marital (civil) status. A person’s marital status according to the terms and definition in the Dutch civil code.

                                                                        ShortMaritalStatus
                                                                        Control0..1
                                                                        BindingUnless not suitable, these codes SHALL be taken from BurgerlijkeStaatCodelijst (2017-12-31T00:00:00)
                                                                        (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.7.9.1--20171231000000|2017-12-31T00:00:00)
                                                                        TypeCodeableConcept
                                                                        Requirements

                                                                        Most, if not all systems capture it.

                                                                        Alternate NamesBurgerlijkeStaat
                                                                        292. Patient.multipleBirth[x]
                                                                        Definition

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

                                                                        ShortMultipleBirthIndicator
                                                                        Comments

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

                                                                        Control0..1
                                                                        TypeChoice of: boolean, integer
                                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Requirements

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

                                                                        Alternate NamesMeerlingindicator
                                                                        294. Patient.photo
                                                                        Definition

                                                                        Image of the patient.

                                                                        ShortImage of the patient
                                                                        Control0..*
                                                                        TypeAttachment
                                                                        Requirements

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

                                                                        296. Patient.contact
                                                                        Definition

                                                                        Contacts are related persons in some way, but not all related persons are contacts. The HCIM ContactPerson is designed to deal with both related persons and contacts. An HCIM ContactPerson who is a contact, is expected to have an NL-CM:3.1.2 Role primary contact ('Eerste relatie/contactpersoon') or secondary contact ('Tweede relatie/contactpersoon'). See Patient.contact.relationship in slice 'role'.

                                                                        ShortContactPerson
                                                                        Comments

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

                                                                        Control0..*
                                                                        TypeBackboneElement
                                                                        Requirements

                                                                        Need to track people you can contact about the patient.

                                                                        Alternate NamesContactpersoon
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (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())
                                                                        298. 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.

                                                                        Shortxml:id (or equivalent in JSON)
                                                                        Control0..1
                                                                        Typestring
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                        300. Patient.contact.extension
                                                                        Definition

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

                                                                        ShortAdditional Content defined by implementations
                                                                        Comments

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

                                                                        Control0..*
                                                                        TypeExtension
                                                                        Alternate Namesextensions, user content
                                                                        302. 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 that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                        ShortExtensions that cannot be ignored
                                                                        Comments

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

                                                                        Control0..*
                                                                        TypeExtension
                                                                        Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                                                        Summarytrue
                                                                        Alternate Namesextensions, user content, modifiers
                                                                        304. Patient.contact.relationship
                                                                        Definition

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

                                                                        ShortThe kind of relationship
                                                                        Control0..*
                                                                        BindingUnless not suitable, these codes SHALL be taken from v2 Contact Role
                                                                        (extensible to http://hl7.org/fhir/ValueSet/v2-0131|2.8.2)

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

                                                                        TypeCodeableConcept
                                                                        Requirements

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

                                                                        SlicingThis element introduces a set of slices on Patient.contact.relationship. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                        • value @ $this
                                                                        • 306. Patient.contact.relationship:relationship
                                                                          Slice Namerelationship
                                                                          Definition

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

                                                                          ShortRelationship
                                                                          Control0..*
                                                                          BindingThe codes SHALL be taken from RelatieCodelijst (2017-12-31T00:00:00)
                                                                          (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.3.1.1--20171231000000|2017-12-31T00:00:00)
                                                                          TypeCodeableConcept
                                                                          Requirements

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

                                                                          Alternate NamesRelatie
                                                                          308. Patient.contact.relationship:role
                                                                          Slice Namerole
                                                                          Definition

                                                                          Expectation is to have at least one of primary contact ('Eerste relatie/contactpersoon') or secondary contact ('Tweede relatie/contactpersoon')

                                                                          ShortRole
                                                                          Control0..*
                                                                          BindingThe codes SHALL be taken from RolCodelijst (2017-12-31T00:00:00)
                                                                          (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.3.1.2--20171231000000|2017-12-31T00:00:00)
                                                                          TypeCodeableConcept
                                                                          Requirements

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

                                                                          Alternate NamesRol
                                                                          310. Patient.contact.name
                                                                          Definition

                                                                          A name associated with the contact person.

                                                                          ShortNameInformation
                                                                          Control0..1
                                                                          TypeHumanName(nl-core-humanname)
                                                                          Requirements

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

                                                                          Alternate NamesNaamgegevens
                                                                          312. Patient.contact.name.id
                                                                          Definition

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

                                                                          Shortxml:id (or equivalent in JSON)
                                                                          Control0..1
                                                                          Typestring
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                          314. Patient.contact.name.extension
                                                                          Definition

                                                                          An Extension

                                                                          ShortExtension
                                                                          Control0..*
                                                                          TypeExtension
                                                                          SlicingThis element introduces a set of slices on Patient.contact.name.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                          • value @ url
                                                                          • 316. Patient.contact.name.extension:humannameAssemblyOrder
                                                                            Slice NamehumannameAssemblyOrder
                                                                            Definition

                                                                            A code that represents the preferred display order of the components of this human name.

                                                                            ShortPreferred display order of name parts
                                                                            Control0..1
                                                                            TypeExtension(assembly-order) (Extension Type: code)
                                                                            318. Patient.contact.name.extension:humannameAssemblyOrder.id
                                                                            Definition

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

                                                                            Shortxml:id (or equivalent in JSON)
                                                                            Control0..1
                                                                            Typestring
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                            320. Patient.contact.name.extension:humannameAssemblyOrder.extension
                                                                            Definition

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

                                                                            ShortAdditional Content defined by implementations
                                                                            Comments

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

                                                                            Control0..*
                                                                            TypeExtension
                                                                            Alternate Namesextensions, user content
                                                                            SlicingThis element introduces a set of slices on Patient.contact.name.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                            • value @ url
                                                                            • 322. Patient.contact.name.extension:humannameAssemblyOrder.url
                                                                              Definition

                                                                              Source of the definition for the extension code - a logical name or a URL.

                                                                              Shortidentifies the meaning of the extension
                                                                              Comments

                                                                              The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                                              Control1..1
                                                                              Typeuri
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                              Fixed Valuehttp://hl7.org/fhir/StructureDefinition/humanname-assembly-order
                                                                              324. Patient.contact.name.extension:humannameAssemblyOrder.valueCode:valueCode
                                                                              Slice NamevalueCode
                                                                              Definition

                                                                              Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                                                              ShortValue of extension
                                                                              Control0..1
                                                                              BindingThe codes SHALL be taken from HumanNameAssemblyOrder
                                                                              (required to http://hl7.org/fhir/ValueSet/name-assembly-order|3.0.2)

                                                                              A code that represents the preferred display order of the components of a human name

                                                                              Typecode
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              326. Patient.contact.name.use
                                                                              Definition

                                                                              Identifies the purpose for this name.

                                                                              Shortusual | official | temp | nickname | anonymous | old | maiden
                                                                              Comments

                                                                              This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one. Applications can assume that a name is current unless it explicitly says that it is temporary or old.

                                                                              Control0..1
                                                                              BindingThe codes SHALL be taken from NameUse
                                                                              (required to http://hl7.org/fhir/ValueSet/name-use|3.0.2)

                                                                              The use of a human name

                                                                              Typecode
                                                                              Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Summarytrue
                                                                              Requirements

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

                                                                              328. Patient.contact.name.text
                                                                              Definition

                                                                              A full text representation of the name.

                                                                              ShortText representation of the full name
                                                                              Comments

                                                                              Can provide both a text representation and structured parts.

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

                                                                              A renderable, unencoded form.

                                                                              330. Patient.contact.name.family
                                                                              Definition

                                                                              The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.

                                                                              ShortSurname
                                                                              Comments

                                                                              Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).

                                                                              Control0..1
                                                                              Typestring
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Summarytrue
                                                                              Alternate Namessurname, Achternaam
                                                                              332. Patient.contact.name.family.id
                                                                              Definition

                                                                              unique id for the element within a resource (for internal references)

                                                                              Shortxml:id (or equivalent in JSON)
                                                                              Control0..1
                                                                              Typestring
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                              334. Patient.contact.name.family.extension
                                                                              Definition

                                                                              An Extension

                                                                              ShortExtension
                                                                              Control0..*
                                                                              TypeExtension
                                                                              SlicingThis element introduces a set of slices on Patient.contact.name.family.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                              • value @ url
                                                                              • 336. Patient.contact.name.family.extension:humannameOwnPrefix
                                                                                Slice NamehumannameOwnPrefix
                                                                                Definition

                                                                                The prefix portion (e.g. voorvoegsel) inclusive of the space between the prefix and the surname, if applicable, of the family name that is derived from the person's own surname, as distinguished from any portion that is derived from the surname of the person's partner or spouse.

                                                                                ShortPrefixOwnName
                                                                                Comments

                                                                                An example of a voorvoegsel is the "van" in "Ludwig van Beethoven". Since the voorvoegsel doesn't sort completely alphabetically, it is reasonable to specify it as a separate sub-component.

                                                                                Control0..1
                                                                                This element is affected by the following invariants: ele-1
                                                                                TypeExtension(own-prefix) (Extension Type: string)
                                                                                Alternate NamesVoorvoegselGeslachtsnaam
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                338. Patient.contact.name.family.extension:humannameOwnPrefix.id
                                                                                Definition

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

                                                                                Shortxml:id (or equivalent in JSON)
                                                                                Control0..1
                                                                                Typestring
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                340. Patient.contact.name.family.extension:humannameOwnPrefix.extension
                                                                                Definition

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

                                                                                ShortAdditional Content defined by implementations
                                                                                Comments

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

                                                                                Control0..*
                                                                                TypeExtension
                                                                                Alternate Namesextensions, user content
                                                                                SlicingThis element introduces a set of slices on Patient.contact.name.family.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                • value @ url
                                                                                • 342. Patient.contact.name.family.extension:humannameOwnPrefix.url
                                                                                  Definition

                                                                                  Source of the definition for the extension code - a logical name or a URL.

                                                                                  Shortidentifies the meaning of the extension
                                                                                  Comments

                                                                                  The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                                                  Control1..1
                                                                                  Typeuri
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                  Fixed Valuehttp://hl7.org/fhir/StructureDefinition/humanname-own-prefix
                                                                                  344. Patient.contact.name.family.extension:humannameOwnPrefix.valueString:valueString
                                                                                  Slice NamevalueString
                                                                                  Definition

                                                                                  Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                                                                  ShortValue of extension
                                                                                  Control0..1
                                                                                  Typestring
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  346. Patient.contact.name.family.extension:humannameOwnName
                                                                                  Slice NamehumannameOwnName
                                                                                  Definition

                                                                                  The person’s official last name.

                                                                                  ShortOwnName
                                                                                  Comments

                                                                                  The portion of the family name that is derived from the person's own surname, as distinguished from any portion that is derived from the surname of the person's partner or spouse. If the person's surname has legally changed to become (or incorporate) the surname of the person's partner or spouse, this is the person's surname immediately prior to such change. Often this is the person's "maiden name".

                                                                                  Control0..1
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  TypeExtension(own-name) (Extension Type: string)
                                                                                  Alternate NamesGeslachtsnaam
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  348. Patient.contact.name.family.extension:humannameOwnName.id
                                                                                  Definition

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

                                                                                  Shortxml:id (or equivalent in JSON)
                                                                                  Control0..1
                                                                                  Typestring
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                  350. Patient.contact.name.family.extension:humannameOwnName.extension
                                                                                  Definition

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

                                                                                  ShortAdditional Content defined by implementations
                                                                                  Comments

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

                                                                                  Control0..*
                                                                                  TypeExtension
                                                                                  Alternate Namesextensions, user content
                                                                                  SlicingThis element introduces a set of slices on Patient.contact.name.family.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                  • value @ url
                                                                                  • 352. Patient.contact.name.family.extension:humannameOwnName.url
                                                                                    Definition

                                                                                    Source of the definition for the extension code - a logical name or a URL.

                                                                                    Shortidentifies the meaning of the extension
                                                                                    Comments

                                                                                    The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                                                    Control1..1
                                                                                    Typeuri
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                    Fixed Valuehttp://hl7.org/fhir/StructureDefinition/humanname-own-name
                                                                                    354. Patient.contact.name.family.extension:humannameOwnName.valueString:valueString
                                                                                    Slice NamevalueString
                                                                                    Definition

                                                                                    Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                                                                    ShortValue of extension
                                                                                    Control0..1
                                                                                    Typestring
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    356. Patient.contact.name.family.extension:humannamePartnerPrefix
                                                                                    Slice NamehumannamePartnerPrefix
                                                                                    Definition

                                                                                    Voorvoegsel derived from person's partner's surname inclusive of the space between the prefix and the surname, if applicable.

                                                                                    ShortPrefixSurname
                                                                                    Comments

                                                                                    An example of a voorvoegsel is the "van" in "Ludwig van Beethoven". Since the voorvoegsel doesn't sort completely alphabetically, it is reasonable to identify it as a separate sub-component.

                                                                                    Control0..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    TypeExtension(partner-prefix) (Extension Type: string)
                                                                                    Alternate NamesVoorvoegselGeslachtsnaamPartner
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                    358. Patient.contact.name.family.extension:humannamePartnerPrefix.id
                                                                                    Definition

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

                                                                                    Shortxml:id (or equivalent in JSON)
                                                                                    Control0..1
                                                                                    Typestring
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                    360. Patient.contact.name.family.extension:humannamePartnerPrefix.extension
                                                                                    Definition

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

                                                                                    ShortAdditional Content defined by implementations
                                                                                    Comments

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

                                                                                    Control0..*
                                                                                    TypeExtension
                                                                                    Alternate Namesextensions, user content
                                                                                    SlicingThis element introduces a set of slices on Patient.contact.name.family.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                    • value @ url
                                                                                    • 362. Patient.contact.name.family.extension:humannamePartnerPrefix.url
                                                                                      Definition

                                                                                      Source of the definition for the extension code - a logical name or a URL.

                                                                                      Shortidentifies the meaning of the extension
                                                                                      Comments

                                                                                      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                                                      Control1..1
                                                                                      Typeuri
                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                      Fixed Valuehttp://hl7.org/fhir/StructureDefinition/humanname-partner-prefix
                                                                                      364. Patient.contact.name.family.extension:humannamePartnerPrefix.valueString:valueString
                                                                                      Slice NamevalueString
                                                                                      Definition

                                                                                      Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                                                                      ShortValue of extension
                                                                                      Control0..1
                                                                                      Typestring
                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                      366. Patient.contact.name.family.extension:humannamePartnerName
                                                                                      Slice NamehumannamePartnerName
                                                                                      Definition

                                                                                      Partner’s official last name.

                                                                                      ShortLastNamePartner
                                                                                      Comments

                                                                                      The portion of the family name that is derived from the person's partner's surname, as distinguished from any portion that is derived from the surname of the person's own name. If the person's surname has legally changed to become (or incorporate) the surname of the person's partner or spouse, this is the person's surname immediately prior to such change. Often this is the person's "maiden name".

                                                                                      Control0..1
                                                                                      This element is affected by the following invariants: ele-1
                                                                                      TypeExtension(partner-name) (Extension Type: string)
                                                                                      Alternate NamesGeslachtsnaamPartner
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                      368. Patient.contact.name.family.extension:humannamePartnerName.id
                                                                                      Definition

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

                                                                                      Shortxml:id (or equivalent in JSON)
                                                                                      Control0..1
                                                                                      Typestring
                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                      370. Patient.contact.name.family.extension:humannamePartnerName.extension
                                                                                      Definition

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

                                                                                      ShortAdditional Content defined by implementations
                                                                                      Comments

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

                                                                                      Control0..*
                                                                                      TypeExtension
                                                                                      Alternate Namesextensions, user content
                                                                                      SlicingThis element introduces a set of slices on Patient.contact.name.family.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                      • value @ url
                                                                                      • 372. Patient.contact.name.family.extension:humannamePartnerName.url
                                                                                        Definition

                                                                                        Source of the definition for the extension code - a logical name or a URL.

                                                                                        Shortidentifies the meaning of the extension
                                                                                        Comments

                                                                                        The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                                                        Control1..1
                                                                                        Typeuri
                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                        Fixed Valuehttp://hl7.org/fhir/StructureDefinition/humanname-partner-name
                                                                                        374. Patient.contact.name.family.extension:humannamePartnerName.valueString:valueString
                                                                                        Slice NamevalueString
                                                                                        Definition

                                                                                        Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                                                                        ShortValue of extension
                                                                                        Control0..1
                                                                                        Typestring
                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                        376. Patient.contact.name.family.value
                                                                                        Definition

                                                                                        The actual value

                                                                                        ShortPrimitive value for string
                                                                                        Control0..1
                                                                                        Typestring
                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                        Max Length:1048576
                                                                                        378. Patient.contact.name.given
                                                                                        Definition

                                                                                        Note that in order to mark the type of a given name, the FHIR standard extension for ISO 21090 EN Qualifiers is to be used. Examples include call me name (Dutch: roepnaam) and initials. Each initial is expected to be delimited by a dot.

                                                                                        ShortGiven
                                                                                        Comments

                                                                                        Note that in order to mark the type of a given name, the FHIR standard extension for ISO 21090 EN Qualifiers is to be used. Examples include call me name (Dutch: roepnaam) and initials. Each initial is expected to be delimited by a dot. To be conformant to the HCIM for NameInformation, at least the following qualifiers SHALL be supported: BR, IN and CL. The qualifier BR maps to the HCIM concept FirstNames, IN maps to Initials and CL to GivenName.

                                                                                        Please see the compatibility note on the containing element as well!

                                                                                        Control0..*
                                                                                        Typestring
                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                        Summarytrue
                                                                                        Alternate Namesfirst name, middle name, Voornamen, Initialen, Roepnaam
                                                                                        380. Patient.contact.name.given.id
                                                                                        Definition

                                                                                        unique id for the element within a resource (for internal references)

                                                                                        Shortxml:id (or equivalent in JSON)
                                                                                        Control0..1
                                                                                        Typestring
                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                        382. Patient.contact.name.given.extension
                                                                                        Definition

                                                                                        An Extension

                                                                                        ShortExtension
                                                                                        Control0..*
                                                                                        TypeExtension
                                                                                        SlicingThis element introduces a set of slices on Patient.contact.name.given.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                        • value @ url
                                                                                        • 384. Patient.contact.name.given.extension:iso21090EnQualifier
                                                                                          Slice Nameiso21090EnQualifier
                                                                                          Definition

                                                                                          A set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type.

                                                                                          ShortLS | AC | NB | PR | HON | BR | AD | SP | MID | CL | IN | VV
                                                                                          Comments

                                                                                          Used to indicate additional information about the name part and how it should be used.

                                                                                          Control0..1
                                                                                          This element is affected by the following invariants: ele-1
                                                                                          TypeExtension(EN-qualifier) (Extension Type: code)
                                                                                          Is Modifierfalse
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                          386. Patient.contact.name.given.extension:iso21090EnQualifier.id
                                                                                          Definition

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

                                                                                          Shortxml:id (or equivalent in JSON)
                                                                                          Control0..1
                                                                                          Typestring
                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                                          388. Patient.contact.name.given.extension:iso21090EnQualifier.extension
                                                                                          Definition

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

                                                                                          ShortAdditional Content defined by implementations
                                                                                          Comments

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

                                                                                          Control0..*
                                                                                          TypeExtension
                                                                                          Alternate Namesextensions, user content
                                                                                          SlicingThis element introduces a set of slices on Patient.contact.name.given.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                          • value @ url
                                                                                          • 390. Patient.contact.name.given.extension:iso21090EnQualifier.url
                                                                                            Definition

                                                                                            Source of the definition for the extension code - a logical name or a URL.

                                                                                            Shortidentifies the meaning of the extension
                                                                                            Comments

                                                                                            The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                                                            Control1..1
                                                                                            Typeuri
                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                                            Fixed Valuehttp://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier
                                                                                            392. Patient.contact.name.given.extension:iso21090EnQualifier.valueCode:valueCode
                                                                                            Slice NamevalueCode
                                                                                            Definition

                                                                                            Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                                                                            ShortValue of extension
                                                                                            Control0..1
                                                                                            BindingThe codes SHALL be taken from EntityNamePartQualifier
                                                                                            (required to http://hl7.org/fhir/ValueSet/name-part-qualifier|3.0.2)

                                                                                            A set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type

                                                                                            Typecode
                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                            394. Patient.contact.name.given.value
                                                                                            Definition

                                                                                            The actual value

                                                                                            ShortPrimitive value for string
                                                                                            Control0..1
                                                                                            Typestring
                                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                                            Max Length:1048576
                                                                                            396. Patient.contact.name.prefix
                                                                                            Definition

                                                                                            Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name.

                                                                                            ShortParts that come before the name
                                                                                            Control0..*
                                                                                            Typestring
                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                            Summarytrue
                                                                                            398. Patient.contact.name.suffix
                                                                                            Definition

                                                                                            Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name.

                                                                                            ShortParts that come after the name
                                                                                            Control0..*
                                                                                            Typestring
                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                            Summarytrue
                                                                                            400. Patient.contact.name.period
                                                                                            Definition

                                                                                            Indicates the period of time when this name was valid for the named person.

                                                                                            ShortTime period when name was/is in use
                                                                                            Control0..1
                                                                                            TypePeriod
                                                                                            Summarytrue
                                                                                            Requirements

                                                                                            Allows names to be placed in historical context.

                                                                                            402. Patient.contact.telecom
                                                                                            Definition

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

                                                                                            ShortA contact detail for the person
                                                                                            Comments

                                                                                            Telecommunication data details (phone/email) is physically modeled in the HCIM Patient, which is why the telecommunication mappings appear to be coming from the HCIM Patient instead of the HCIM ContactPerson

                                                                                            Control0..*
                                                                                            TypeContactPoint(nl-core-contactpoint)
                                                                                            Requirements

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

                                                                                            404. Patient.contact.address
                                                                                            Definition

                                                                                            Address for the contact person.

                                                                                            ShortAddressInformation
                                                                                            Control0..1
                                                                                            TypeAddress(nl-core-address)
                                                                                            Requirements

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

                                                                                            Alternate NamesAdresgegevens
                                                                                            406. Patient.contact.gender
                                                                                            Definition

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

                                                                                            Shortmale | female | other | unknown
                                                                                            Control0..1
                                                                                            BindingThe codes SHALL be taken from AdministrativeGender
                                                                                            (required to http://hl7.org/fhir/ValueSet/administrative-gender|3.0.2)

                                                                                            The gender of a person used for administrative purposes.

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

                                                                                            Needed to address the person correctly.

                                                                                            408. Patient.contact.organization
                                                                                            Definition

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

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

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

                                                                                            410. Patient.contact.period
                                                                                            Definition

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

                                                                                            ShortThe period during which this contact person or organization is valid to be contacted relating to this patient
                                                                                            Control0..1
                                                                                            TypePeriod
                                                                                            412. Patient.animal
                                                                                            Definition

                                                                                            This patient is known to be an animal.

                                                                                            ShortThis patient is known to be an animal (non-human)
                                                                                            Comments

                                                                                            The animal element is labeled "Is Modifier" since patients may be non-human. Systems SHALL either handle patient details appropriately (e.g. inform users patient is not human) or reject declared animal records. The absense of the animal element does not imply that the patient is a human. If a system requires such a positive assertion that the patient is human, an extension will be required. (Do not use a species of homo-sapiens in animal species, as this would incorrectly infer that the patient is an animal).

                                                                                            Control0..1
                                                                                            TypeBackboneElement
                                                                                            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                                                                            Summarytrue
                                                                                            Requirements

                                                                                            Many clinical systems are extended to care for animal patients as well as human.

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

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

                                                                                            Shortxml:id (or equivalent in JSON)
                                                                                            Control0..1
                                                                                            Typestring
                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                                            416. Patient.animal.extension
                                                                                            Definition

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

                                                                                            ShortAdditional Content defined by implementations
                                                                                            Comments

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

                                                                                            Control0..*
                                                                                            TypeExtension
                                                                                            Alternate Namesextensions, user content
                                                                                            418. Patient.animal.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 that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                            ShortExtensions that cannot be ignored
                                                                                            Comments

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

                                                                                            Control0..*
                                                                                            TypeExtension
                                                                                            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                                                                            Summarytrue
                                                                                            Alternate Namesextensions, user content, modifiers
                                                                                            420. Patient.animal.species
                                                                                            Definition

                                                                                            Identifies the high level taxonomic categorization of the kind of animal.

                                                                                            ShortE.g. Dog, Cow
                                                                                            Comments

                                                                                            If the patient is non-human, at least a species SHALL be specified. Species SHALL be a widely recognised taxonomic classification. It may or may not be Linnaean taxonomy and may or may not be at the level of species. If the level is finer than species--such as a breed code--the code system used SHALL allow inference of the species. (The common example is that the word "Hereford" does not allow inference of the species Bos taurus, because there is a Hereford pig breed, but the SNOMED CT code for "Hereford Cattle Breed" does.).

                                                                                            Control1..1
                                                                                            BindingFor example codes, see AnimalSpecies
                                                                                            (example to http://hl7.org/fhir/ValueSet/animal-species|3.0.2)

                                                                                            The species of an animal.

                                                                                            TypeCodeableConcept
                                                                                            Summarytrue
                                                                                            Requirements

                                                                                            Need to know what kind of animal.

                                                                                            422. Patient.animal.breed
                                                                                            Definition

                                                                                            Identifies the detailed categorization of the kind of animal.

                                                                                            ShortE.g. Poodle, Angus
                                                                                            Comments

                                                                                            Breed MAY be used to provide further taxonomic or non-taxonomic classification. It may involve local or proprietary designation--such as commercial strain--and/or additional information such as production type.

                                                                                            Control0..1
                                                                                            BindingFor example codes, see AnimalBreeds
                                                                                            (example to http://hl7.org/fhir/ValueSet/animal-breeds|3.0.2)

                                                                                            The breed of an animal.

                                                                                            TypeCodeableConcept
                                                                                            Summarytrue
                                                                                            Requirements

                                                                                            May need to know the specific kind within the species.

                                                                                            424. Patient.animal.genderStatus
                                                                                            Definition

                                                                                            Indicates the current state of the animal's reproductive organs.

                                                                                            ShortE.g. Neutered, Intact
                                                                                            Control0..1
                                                                                            BindingFor example codes, see GenderStatus
                                                                                            (example to http://hl7.org/fhir/ValueSet/animal-genderstatus|3.0.2)

                                                                                            The state of the animal's reproductive organs.

                                                                                            TypeCodeableConcept
                                                                                            Summarytrue
                                                                                            Requirements

                                                                                            Gender status can affect housing and animal behavior.

                                                                                            426. Patient.communication
                                                                                            Definition

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

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

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

                                                                                            Control0..*
                                                                                            TypeBackboneElement
                                                                                            Requirements

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

                                                                                            Alternate NamesTaalvaardigheid
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                                                                            428. 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.

                                                                                            Shortxml:id (or equivalent in JSON)
                                                                                            Control0..1
                                                                                            Typestring
                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                                            430. Patient.communication.extension
                                                                                            Definition

                                                                                            An Extension

                                                                                            ShortExtension
                                                                                            Control0..*
                                                                                            TypeExtension
                                                                                            SlicingThis element introduces a set of slices on Patient.communication.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                            • value @ url
                                                                                            • 432. Patient.communication.extension:languageProficiency
                                                                                              Slice NamelanguageProficiency
                                                                                              Definition

                                                                                              Proficiency level of the communication.

                                                                                              ShortProficiency level of the communication
                                                                                              Comments

                                                                                              The HCIM concepts LanguageControlListening, LanguageControlReading, LanguageControlSpeaking are captuperd using a mocked offical HL7 core extension from the R4 FHIR specification. Each of these three concepts is encoded as a copy of the extension, typed using the code in the type slice according to the following mapping: * LanguaneControlListening maps to code 'RSP' (Received spoken) * LanguageControlReading maps to code 'RWR' (Received written) * LanguageControlSpeaking maps to code 'ESP' (Expressed spoken)

                                                                                              Control0..*
                                                                                              This element is affected by the following invariants: ele-1
                                                                                              TypeExtension(proficiency) (Complex Extension)
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                              434. Patient.communication.extension:languageProficiency.id
                                                                                              Definition

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

                                                                                              Shortxml:id (or equivalent in JSON)
                                                                                              Control0..1
                                                                                              Typestring
                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                                              436. Patient.communication.extension:languageProficiency.extension
                                                                                              Definition

                                                                                              An Extension

                                                                                              ShortExtension
                                                                                              Control2..*
                                                                                              TypeExtension
                                                                                              SlicingThis element introduces a set of slices on Patient.communication.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                              • value @ url
                                                                                              • 438. Patient.communication.extension:languageProficiency.extension:type
                                                                                                Slice Nametype
                                                                                                Definition

                                                                                                An Extension

                                                                                                ShortExtension
                                                                                                Control1..1
                                                                                                TypeExtension
                                                                                                440. Patient.communication.extension:languageProficiency.extension: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.

                                                                                                Shortxml:id (or equivalent in JSON)
                                                                                                Control0..1
                                                                                                Typestring
                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                442. Patient.communication.extension:languageProficiency.extension:type.extension
                                                                                                Definition

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

                                                                                                ShortAdditional Content defined by implementations
                                                                                                Comments

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

                                                                                                Control0..*
                                                                                                TypeExtension
                                                                                                Alternate Namesextensions, user content
                                                                                                SlicingThis element introduces a set of slices on Patient.communication.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                • value @ url
                                                                                                • 444. Patient.communication.extension:languageProficiency.extension:type.url
                                                                                                  Definition

                                                                                                  Source of the definition for the extension code - a logical name or a URL.

                                                                                                  Shortidentifies the meaning of the extension
                                                                                                  Comments

                                                                                                  The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                                                                  Control1..1
                                                                                                  Typeuri
                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                  Fixed Valuetype
                                                                                                  446. Patient.communication.extension:languageProficiency.extension:type.value[x]
                                                                                                  Definition

                                                                                                  Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                                                                                  ShortValue of extension
                                                                                                  Control1..1
                                                                                                  TypeCoding
                                                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                  SlicingThis element introduces a set of slices on Patient.communication.extension.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                                                                  • type @ $this
                                                                                                  • 448. Patient.communication.extension:languageProficiency.extension:type.value[x]:valueCoding
                                                                                                    Slice NamevalueCoding
                                                                                                    Definition

                                                                                                    Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                                                                                    ShortValue of extension
                                                                                                    Control1..1
                                                                                                    BindingUnless not suitable, these codes SHALL be taken from LanguageAbilityMode|2016-11-11
                                                                                                    (extensible to http://hl7.org/fhir/ValueSet/v3-LanguageAbilityMode|2016-11-11)
                                                                                                    TypeCoding
                                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                    450. Patient.communication.extension:languageProficiency.extension:level
                                                                                                    Slice Namelevel
                                                                                                    Definition

                                                                                                    An Extension

                                                                                                    ShortExtension
                                                                                                    Control1..1
                                                                                                    TypeExtension
                                                                                                    452. Patient.communication.extension:languageProficiency.extension:level.id
                                                                                                    Definition

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

                                                                                                    Shortxml:id (or equivalent in JSON)
                                                                                                    Control0..1
                                                                                                    Typestring
                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                    454. Patient.communication.extension:languageProficiency.extension:level.extension
                                                                                                    Definition

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

                                                                                                    ShortAdditional Content defined by implementations
                                                                                                    Comments

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

                                                                                                    Control0..*
                                                                                                    TypeExtension
                                                                                                    Alternate Namesextensions, user content
                                                                                                    SlicingThis element introduces a set of slices on Patient.communication.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                    • value @ url
                                                                                                    • 456. Patient.communication.extension:languageProficiency.extension:level.url
                                                                                                      Definition

                                                                                                      Source of the definition for the extension code - a logical name or a URL.

                                                                                                      Shortidentifies the meaning of the extension
                                                                                                      Comments

                                                                                                      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                                                                      Control1..1
                                                                                                      Typeuri
                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                      Fixed Valuelevel
                                                                                                      458. Patient.communication.extension:languageProficiency.extension:level.value[x]
                                                                                                      Definition

                                                                                                      Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                                                                                      ShortValue of extension
                                                                                                      Control1..1
                                                                                                      TypeCoding
                                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                      SlicingThis element introduces a set of slices on Patient.communication.extension.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                                                                      • type @ $this
                                                                                                      • 460. Patient.communication.extension:languageProficiency.extension:level.value[x]:valueCoding
                                                                                                        Slice NamevalueCoding
                                                                                                        Definition

                                                                                                        Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                                                                                        ShortValue of extension
                                                                                                        Control1..1
                                                                                                        BindingUnless not suitable, these codes SHALL be taken from LanguageAbilityProficiency|2016-11-11
                                                                                                        (extensible to http://hl7.org/fhir/ValueSet/v3-LanguageAbilityProficiency|2016-11-11)
                                                                                                        TypeCoding
                                                                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                        462. Patient.communication.extension:languageProficiency.url
                                                                                                        Definition

                                                                                                        Source of the definition for the extension code - a logical name or a URL.

                                                                                                        Shortidentifies the meaning of the extension
                                                                                                        Comments

                                                                                                        The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                                                                        Control1..1
                                                                                                        Typeuri
                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                        Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/patient-proficiency
                                                                                                        464. Patient.communication.extension:languageProficiency.value[x]
                                                                                                        Definition

                                                                                                        Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                                                                                        ShortValue of extension
                                                                                                        Control0..0
                                                                                                        TypeChoice of: base64Binary, boolean, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, Meta
                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                        466. Patient.communication.extension:comment
                                                                                                        Slice Namecomment
                                                                                                        Definition

                                                                                                        An Extension

                                                                                                        ShortComment
                                                                                                        Control0..*
                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                        TypeExtension(Comment) (Extension Type: string)
                                                                                                        Alternate NamesToelichting
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                        468. 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 that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                        ShortExtensions that cannot be ignored
                                                                                                        Comments

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

                                                                                                        Control0..*
                                                                                                        TypeExtension
                                                                                                        Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                                                                                        Summarytrue
                                                                                                        Alternate Namesextensions, user content, modifiers
                                                                                                        470. Patient.communication.language
                                                                                                        Definition

                                                                                                        The language of communication.

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

                                                                                                        ShortCommunicationLanguage
                                                                                                        Comments

                                                                                                        The FHIR value set http://hl7.org/fhir/valueset-languages.html is used instead of the HCIM value set CommunicationLanguageCodelist. The FHIR value set uses the code system urn:ietf:bcp:47 which includes the ISO-639-2 alpha code system used by the HCIM value set.

                                                                                                        Control1..1
                                                                                                        BindingUnless not suitable, these codes SHALL be taken from Common Languages
                                                                                                        (extensible to http://hl7.org/fhir/ValueSet/languages|3.0.2)

                                                                                                        A human language.

                                                                                                        Additional BindingsPurpose
                                                                                                        All LanguagesMax Binding
                                                                                                        TypeCodeableConcept
                                                                                                        Requirements

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

                                                                                                        Alternate NamesCommunicatieTaal
                                                                                                        472. Patient.communication.preferred
                                                                                                        Definition

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

                                                                                                        ShortLanguage preference indicator
                                                                                                        Comments

                                                                                                        This language is specifically identified for communicating healthcare information.

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

                                                                                                        474. Patient.generalPractitioner
                                                                                                        Definition

                                                                                                        Patient's nominated care provider.

                                                                                                        ShortGeneralPractitioner
                                                                                                        Comments

                                                                                                        This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disablity 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.

                                                                                                        Control0..1
                                                                                                        TypeReference(nl-core-organization, nl-core-practitioner)
                                                                                                        Alternate NamescareProvider, Huisarts
                                                                                                        476. Patient.generalPractitioner.id
                                                                                                        Definition

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

                                                                                                        Shortxml:id (or equivalent in JSON)
                                                                                                        Control0..1
                                                                                                        Typestring
                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                        478. Patient.generalPractitioner.extension
                                                                                                        Definition

                                                                                                        An Extension

                                                                                                        ShortExtension
                                                                                                        Control0..*
                                                                                                        TypeExtension
                                                                                                        SlicingThis element introduces a set of slices on Patient.generalPractitioner.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                        • value @ url
                                                                                                        • 480. Patient.generalPractitioner.extension:practitionerRole
                                                                                                          Slice NamepractitionerRole
                                                                                                          Definition

                                                                                                          Optional Extension Element - found in all resources.

                                                                                                          ShortOptional Extensions Element
                                                                                                          Control0..1
                                                                                                          TypeExtension(PractitionerRole Reference) (Extension Type: Reference)
                                                                                                          482. Patient.generalPractitioner.reference
                                                                                                          Definition

                                                                                                          A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                                                          ShortLiteral reference, Relative, internal or absolute URL
                                                                                                          Comments

                                                                                                          Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                                                          Control0..1
                                                                                                          This element is affected by the following invariants: ref-1
                                                                                                          Typestring
                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                          Summarytrue
                                                                                                          484. Patient.generalPractitioner.identifier
                                                                                                          Definition

                                                                                                          An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                                                          ShortLogical reference, when literal reference is not known
                                                                                                          Comments

                                                                                                          When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                                                          When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                                                          Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                                                          NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                                                          Control0..1
                                                                                                          TypeIdentifier
                                                                                                          Summarytrue
                                                                                                          486. Patient.generalPractitioner.display
                                                                                                          Definition

                                                                                                          Plain text narrative that identifies the resource in addition to the resource reference.

                                                                                                          ShortText alternative for the resource
                                                                                                          Comments

                                                                                                          This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                                                          Control0..1
                                                                                                          Typestring
                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                          Summarytrue
                                                                                                          488. Patient.managingOrganization
                                                                                                          Definition

                                                                                                          Organization that is the custodian of the patient record.

                                                                                                          ShortOrganization that is the custodian of the patient record
                                                                                                          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).

                                                                                                          Control0..1
                                                                                                          TypeReference(Organization)
                                                                                                          Summarytrue
                                                                                                          Requirements

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

                                                                                                          490. Patient.link
                                                                                                          Definition

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

                                                                                                          ShortLink to another patient resource that concerns the same actual person
                                                                                                          Comments

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

                                                                                                          This element is labelled as a modifier because it may not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'.

                                                                                                          Control0..*
                                                                                                          TypeBackboneElement
                                                                                                          Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                                                                                          Summarytrue
                                                                                                          Requirements

                                                                                                          There are multiple usecases:

                                                                                                          • Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and * Distribution of patient information across multiple servers.
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                                                                                          492. 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.

                                                                                                          Shortxml:id (or equivalent in JSON)
                                                                                                          Control0..1
                                                                                                          Typestring
                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                          494. Patient.link.extension
                                                                                                          Definition

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

                                                                                                          ShortAdditional Content defined by implementations
                                                                                                          Comments

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

                                                                                                          Control0..*
                                                                                                          TypeExtension
                                                                                                          Alternate Namesextensions, user content
                                                                                                          496. 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 that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                          ShortExtensions that cannot be ignored
                                                                                                          Comments

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

                                                                                                          Control0..*
                                                                                                          TypeExtension
                                                                                                          Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                                                                                          Summarytrue
                                                                                                          Alternate Namesextensions, user content, modifiers
                                                                                                          498. Patient.link.other
                                                                                                          Definition

                                                                                                          The other patient resource that the link refers to.

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

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

                                                                                                          Control1..1
                                                                                                          TypeReference(Patient, RelatedPerson)
                                                                                                          Summarytrue
                                                                                                          500. Patient.link.type
                                                                                                          Definition

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

                                                                                                          Shortreplaced-by | replaces | refer | seealso - type of link
                                                                                                          Control1..1
                                                                                                          BindingThe codes SHALL be taken from LinkType
                                                                                                          (required to http://hl7.org/fhir/ValueSet/link-type|3.0.2)

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

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