RIVO-Noord Zorgviewer Implementation Guide
1.21.0 - CI build

RIVO-Noord Zorgviewer Implementation Guide, published by RIVO-NN HL7NL. This guide is not an authorized publication; it is the continuous build for version 1.21.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/RIVO-Noord/zorgviewer-ig/ and changes regularly. See the Directory of published versions

## Resource Profile: Patient - Detailed Descriptions

Active as of 2025-10-28

Definitions for the Patient resource profile.

- Key Elements Table
- Differential Elements Table
- Snapshot Elements Table

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. This is the base resource type for everything.
Short | PatientBase Resource
Control | 0..*
Alternate Names | SubjectOfCare Client Resident, Patiënt
Invariants | 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.
Short | A 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.
Control | 0..1
Type | uri
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
4. Patient.extension:preferredPharmacy
Slice Name | preferredPharmacy
Definition | Optional Extension Element - found in all resources.
Short | References a patient's preferered pharmacy
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.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(nl-core-preferred-pharmacy) (Extension Type: Reference)
Alternate Names | extensions, user content, Verwijst naar de voorkeursapotheek van de patiënt
Invariants | ele-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 Name | nationality
Definition | The nationality of the patient.
Short | Nationality
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.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(nationality) (Complex Extension)
Alternate Names | extensions, user content, Nationaliteit
Invariants | ele-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 Name | code
Definition | Code representing nationality of patient.
Short | Nationality CodeAdditional Content defined by implementations
Control | 0..1*
Type | Extension
10. Patient.extension:nationality.extension:code.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `code`
12. Patient.extension:nationality.extension:period
Slice Name | period
Definition | Period when nationality was effective.
Short | Nationality PeriodAdditional Content defined by implementations
Control | 0..1*
Type | Extension
14. Patient.extension:nationality.extension:period.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `period`
16. Patient.extension:nationality.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `http://hl7.org/fhir/StructureDefinition/patient-nationality`
18. 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).
Short | Value of extension
Control | 0..01
Type | Choice 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 Value | This primitive element may be present, or absent, or replaced by an extension
20. Patient.extension:legalStatus
Slice Name | legalStatus
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.
Short | legalStatus
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.
Control | 0..2 This element is affected by the following invariants: ele-1
Type | Extension(Patient LegalSatus) (Extension Type: CodeableConcept)
Alternate Names | extensions, user content
Invariants | ele-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()`)
22. Patient.extension:lifeStance
Slice Name | lifeStance
Definition | Optional Extension Element - found in all resources.
Short | Optional Extensions Element
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.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(HCIM LifeStance) (Extension Type: CodeableConcept)
Alternate Names | extensions, user content
Invariants | ele-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()`)
24. 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.
Short | Additional 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.
Control | 0..0*
Type | Extension
Alternate Names | extensions, user content
Slicing | This 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
26. Patient.extension:lifeStance.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `http://nictiz.nl/fhir/StructureDefinition/zib-LifeStance`
28. Patient.extension:lifeStance.value[x]
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).
Short | LifeStanceValue of extension
Control | 10..1
Binding | The codes SHOULD be taken from For codes, see LevensovertuigingCodelijst (preferred to `http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.7.5.1--20171231000000` ) LevensovertuigingCodelijst
Type | CodeableConcept, 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] Note | SeeChoice of Data Typesfor further information about how to use [x]
Alternate Names | Levensovertuiging
30. Patient.extension:lifeStance.value[x].coding
Definition | A reference to a code defined by a terminology system.
Short | Code 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.
Control | 10..1*
Type | Coding
Summary | true
Requirements | Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
32. Patient.extension:lifeStance.value[x].coding.system
Definition | The identification of the code system that defines the meaning of the symbol in the code.
Short | Identity 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.
Control | 10..1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to be unambiguous about the source of the definition of the symbol.
34. Patient.extension:lifeStance.value[x].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).
Short | Symbol in syntax defined by the system
Control | 10..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to refer to a particular code in the system.
36. 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.
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Alternate Names | extensions, user content
38. 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.
Short | PatientIdentificationNumberAn identifier for this patient
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 10..*
Type | Identifier
Summary | true
Requirements | Patients are almost always assigned specific numerical identifiers.
Alternate Names | Identificatienummer
Slicing | This element introduces a set of slices on `Patient.identifier`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ system
40. Patient.identifier:BSN
Slice Name | BSN
Definition | An identifier for this patient.
Short | BSNAn identifier for this patient
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 10..1*
Type | Identifier
Must Support | true
Summary | true
Requirements | Patients are almost always assigned specific numerical identifiers.
Alternate Names | BSN
42. Patient.identifier:BSN.use
Definition | The purpose of this identifier.
Short | usual | 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.
Control | 0..1
Binding | The codes SHALL be taken from IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|3.0.2 (required to `http://hl7.org/fhir/ValueSet/identifier-use` ) Identifies the purpose for this identifier, if known .
Type | code
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
44. Patient.identifier:BSN.system
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Short | The namespace for the identifier value
Control | 10..1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Fixed Value | `http://fhir.nl/fhir/NamingSystem/bsn`
Example | General: http://www.acme.com/identifiers/patient
46. 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.
Short | BSN (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.
Control | 10..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Alternate Names | BSN
Example | General: 123456 Example of a burgerservicenummer: 123456782
48. 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.
Short | Whether 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.
Control | 0..1
Type | boolean
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to be able to mark a patient record as not to be used because it was created in error.
Default Value | `true`
50. Patient.name
Definition | A human's name with the ability to identify parts and usage. A name associated with the individual.
Short | NameInformationA name associated with the patient
Comments | Dutch names require that certain name parts are separately communicable. For this reason, extensions are added onto the base HumanName element to mark the meaning of each part. A Dutch HumanName is still a proper FHIR HumanName; however, there might be an incompatibilty with the default FHIR mechanism for communicating given names. See the compatibility note below for more information. The extension elements cover birth name (NL: eigennaam / geslachtsnaam) and partner/spouse name. Both may have a prefix (NL: voorvoegsel). When a person marries, he or she may keep their own name, assume the partner name, append the partner name to their own name, or the other way around. Incompatibility note: It has come to light that this specification deviates from the way that the HumanName datatype is normally used. This will be fixed in a future release. However, current implementations should be aware of the special considerations regarding the use of this specification. The issue at hand is the way alternative representations of a name, like initials or a nickname, are communicated. Normally this is done using multiple HumanName instances, which are differentiated using the `.use` element. However, this specification allows for including all alternative representations in the same HumanName instance, with the expectation that the extensions provide enough information for receiving systems to differentiate them. However, this means that contrary to the normal usage of this datatype, repetitions of `.given` names cannot be concatenated to get the full list of given names; the list might be a mix of full names, nicknames and initials. Since multiple implementations are based on this specification, sending systems are advised (but not required) to keep the approach with one HumanName instance, while receiving systems should be able to handle this one-instance approach. More specifically: Sending and receiving systems SHOULD always use the specified extensions when using this datatype. Sending systems are encouraged to populate the `.text` element to unambigiously communicate the person's name. Sending systems are encouraged to send either the full given names or the initials, but not both. This alleviates the duplication of names in `.given`. When a sending system uses the current one-instance approach for communicating multiple representations, `.use` MAY NOT be populated. After all, it is not possible to select a single `.use` when the instance contains different representations. When a receiving system interprets the instance as the single-instance-multiple-representations approach, the `.given` names marked as initials SHOULD be interpreted as alternatives to the full given names. Note the underlying HCIM expects both the list of full names and list of initials to be a single string; there's no match for an initial to a full name. The instance SHOULD be regarded as using this approach when: They encounter a single instance And the `.use` element is absent And all the name parts are differentiated using the specified extensions In any other circumstance, receiving systems SHOULD interpret the usage as the normal use. Example: miss Irma XXXHelleman marries mister de Haas and assumes the name Irma XXXHelleman-de Haas: `.family` = "XXX_Helleman-de Haas" `.given` = "Irma" (with `.given:iso21090EnQualifier` = BR) `.family:humannameOwnName` = "XXX_Helleman" `.family:humannamePartnerPrefix` = "de " `.family:humannamePartnerName` = "Haas" 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.
Control | 10..* This element is affected by the following invariants: ele-1
Type | HumanName(nl-core-humanname)
Must Support | true
Summary | true
Requirements | Need to be able to track the patient by multiple names. Examples are your official name and a partner name.
Alternate Names | Naamgegevens
Example | Structured HumanName (preferred above unstructured): { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/humanname-assembly-order", "valueCode" : "NL4" }], "text" : "Irma XXX_Helleman-de Haas", "family" : "XXX_Helleman-de Haas", "_family" : { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/humanname-own-name", "valueString" : "XXX_Helleman" }, { "url" : "http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix", "valueString" : "de" }, { "url" : "http://hl7.org/fhir/StructureDefinition/humanname-partner-name", "valueString" : "Haas" }] }, "given" : ["Irma"], "_given" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier", "valueCode" : "CL" }] }] } Unstructured HumanName: { "text" : "Irma XXX_Helleman-de Haas" }
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() | (children().count() > id.count())`) nl-core-humanname-1: if you specify a prefix for an own name then an own name is also expected (`name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-prefix').empty().not() implies name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-name').empty().not()`) nl-core-humanname-2: if you specify a voorvoegsel for a partner name then a partner name is also expected (`name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix').empty().not() implies name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-name').empty().not()`) zv-pat-1: Either Patient.name.given and/or Patient.name.family and/or Patient.name.text SHALL be present. (`(family.exists() or given.exists() or text.exists())`) zv-pat-2: To be usable for a wide range of internationally available applications, the Patient.name.text SHOULD be present. (`text.exists()`)
52. Patient.name.extension:humannameAssemblyOrder
Slice Name | humannameAssemblyOrder
Definition | A code that represents the preferred display order of the components of this human name.
Short | Preferred display order of name parts
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.
Control | 0..1 This element is affected by the following invariants: ele-1
Binding | The codes SHALL be taken from HumanNameAssemblyOrder (required to `http://hl7.org/fhir/ValueSet/name-assembly-order` ) Human Name Assembly Order
Type | Extension(assembly-order) (Extension Type: code)
Alternate Names | extensions, user content, Voorkeursvolgorde van de naamdelen.
Invariants | ele-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()`)
54. Patient.name.extension:humannameAssemblyOrder.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `http://hl7.org/fhir/StructureDefinition/humanname-assembly-order`
56. Patient.name.extension:humannameAssemblyOrder.valueCode:valueCode
Slice Name | valueCode
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).
Short | Value of extension
Control | 0..1
Binding | The codes SHALL be taken from For codes, see HumanNameAssemblyOrder (required to `http://hl7.org/fhir/ValueSet/name-assembly-order` ) A code that represents the preferred display order of the components of a human name
Type | code, 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 Value | This primitive element may be present, or absent, or replaced by an extension
58. Patient.name.use
Definition | Identifies the purpose for this name.
Short | usual | 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.
Control | 0..1
Binding | The codes SHALL be taken from NameUse http://hl7.org/fhir/ValueSet/name-use|3.0.2 (required to `http://hl7.org/fhir/ValueSet/name-use` ) The use of a human name
Type | code
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Allows the appropriate name for a particular context of use to be selected from among a set of names.
60. Patient.gender
Definition | Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes.
Short | Gendermale | 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.
Control | 0..1
Binding | The codes SHALL be taken from AdministrativeGender http://hl7.org/fhir/ValueSet/administrative-gender|3.0.2 (required to `http://hl7.org/fhir/ValueSet/administrative-gender` ) The gender of a person used for administrative purposes.
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Needed for identification of the individual, in combination with (at least) name and birth date. Gender of individual drives many clinical processes.
Alternate Names | Geslacht
62. Patient.gender.extension:GeslachtCodelijst
Slice Name | GeslachtCodelijst
Definition | Patient’s administrative gender.
Short | Gender
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.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(HCIM extension code-specification) (Extension Type: CodeableConcept)
Alternate Names | extensions, user content, Bevat 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
Invariants | ele-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()`)
64. 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.
Short | Additional 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.
Control | 0..0*
Type | Extension
Alternate Names | extensions, user content
Slicing | This 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
66. Patient.gender.extension:GeslachtCodelijst.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `http://nictiz.nl/fhir/StructureDefinition/code-specification`
68. 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).
Short | Value of extension
Control | 10..1
Binding | Unless not suitable, these codes SHALL be taken from For codes, see GeslachtCodelijst (extensible to `http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.0.1.1--20171231000000` ) GeslachtCodelijst
Type | CodeableConcept, 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] Note | SeeChoice of Data Typesfor further information about how to use [x]
70. Patient.birthDate
Definition | The date of birth for the individual.
Short | Patients 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).
Control | 0..1
Type | date
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Age of the individual drives many clinical processes.
Alternate Names | Geboortedatum
72. Patient.deceased[x]
Definition | Indicates if the individual is deceased or not.
Short | DeathIndicator/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.
Control | 0..1
Type | Choice of: boolean, dateTime
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | true
Requirements | The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.
Alternate Names | Overlijdensindicator/DatumOverlijden
74. Patient.address
Definition | This datatype defines a common basis for expressing all addresses around the world, but adds extensions to express Dutch addresses specifically, according to the HCIM AddressInformation (v1.0, 2017). A Dutch Address still is a proper FHIR Address, which means that systems that cannot interpret the extensions will still be able to render and work with this datatype. To have true compatibility an implementer SHOULD use the core Address parts as intended. To have addresses work for Dutch context, the implementer SHOULD in addition use the extension elements. Separate address parts The first addition is that Dutch addresses make certain address parts separately communicable. These parts are required for use in true Dutch systems when dealing with Dutch addresses, but may not have value for international systems when information gets sent abroad. Custom address types The second addition is that the HCIM defines its own ValueSet for address types, which can only be partially expressed using the FHIR Address datatype and requires a mapping to multiple elements. The table below explains how the HCIM concepts are mapped to the various FHIR elements (see the ConceptMaps <http://nictiz.nl/fhir/ConceptMap/AdresSoortCodelijst-to-AddressUse> and <http://nictiz.nl/fhir/ConceptMap/AdresSoortCodelijst-to-AddressType> as well). The HCIM code itself should also be included using the AddressType extension. | HCIM |`.ext:AddressType` | `.ext:official` | `.use` | `.type` | |-----------------------------------|:------------------:|:---------------:|:------:|:----------:| | Postal Address/Postadres | PST | | | postal | | Primary Home/Officieel adres | HP | true | home | | | Visit Address/Woon-/verblijfadres | PHYS | | home | physical | | Temporary Address/Tijdelijk adres | TMP | | temp | | | Work Place/Werkadres | WP | | work | | | Vacation Home/Vakantie adres | HV | | temp | | If Address.type is both then this is to be understood as a dual purpose address (postal and physical). Systems that support importing it like this are encouraged to do so, otherwise they may need to import this as two separate addresses. NOTE: FHIR core defines the AD-use extension to further specify the postal address type. However, the ValueSet used in that extension doesn't completely match the HCIM ValueSet. Therefore, a custom extension has been made. This doesn't preclude the use of the AD-use extension. Addresses for the individual.
Short | AddressInformationAddresses for the individual
Comments | Note: address is for postal addresses, not physical locations. Patient may have multiple addresses with different uses or applicable periods.
Control | 0..* This element is affected by the following invariants: ele-1, nl-streetname-if-official-and-other-line-parts
Type | Address(nl-core-address)
Summary | true
Requirements | May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.
Alternate Names | AdresInformatie, Adresgegevens
Example | Example of a Vacation Home address: { "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-AddressInformation-AddressType", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/v3/AddressUse", "code" : "HV", "display" : "Vakantie adres" }] } }], "use" : "temp", "line" : ["Binnenkant 12A Hoog"], "_line" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName", "valueString" : "Binnenkant" }, { "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber", "valueString" : "12" }, { "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-buildingNumberSuffix", "valueString" : "A" }, { "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-unitID", "valueString" : "Hoog" }] }], "city" : "Amsterdam", "state" : "NH", "postalCode" : "1000AA", "country" : "NLD" } Example of a Primary Home address: { "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-AddressInformation-AddressType", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/v3/AddressUse", "code" : "HP", "display" : "Officieel adres" }] } }, { "url" : "http://fhir.nl/fhir/StructureDefinition/nl-core-address-official", "valueBoolean" : true }], "use" : "home", "line" : ["Binnenkant to 10"], "_line" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName", "valueString" : "Binnenkant" }, { "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator", "valueString" : "to" }, { "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber", "valueString" : "10" }] }], "city" : "Amsterdam", "state" : "NH", "postalCode" : "1001AA", "country" : "NLD" }
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() | (children().count() > id.count())`) nl-streetname-if-official-and-other-line-parts: Address.streetName in an official address SHALL have a value if one of houseNumber|buildingNumberSuffix|additionalLocator has a value (`(extension.where(url = 'http://fhir.nl/fhir/StructureDefinition/nl-core-address-official').where(value = true)).empty() or (line.extension.where(url = 'http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName').empty().not() and (line.extension.where(url='http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber').empty().not() or line.extension.where(url='http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-buildingNumberSuffix').empty().not() or line.extension.where(url='http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator').empty().not()))`)
76. Patient.animal
Definition | This patient is known to be an animal.
Short | This 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).
Control | 0..1
Type | BackboneElement
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Summary | true
Requirements | Many clinical systems are extended to care for animal patients as well as human.
Invariants | ele-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()))
78. 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.
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Summary | true
Alternate Names | extensions, user content, modifiers
80. Patient.animal.species
Definition | Identifies the high level taxonomic categorization of the kind of animal.
Short | E.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.).
Control | 1..1
Binding | For example codes, see AnimalSpecies http://hl7.org/fhir/ValueSet/animal-species|3.0.2 (example to `http://hl7.org/fhir/ValueSet/animal-species` ) The species of an animal.
Type | CodeableConcept
Summary | true
Requirements | Need to know what kind of animal.
82. Patient.generalPractitioner
Definition | Patient's nominated care provider.
Short | GeneralPractitionerPatient'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.
Control | 0..1*
Type | Reference(nl-core-organization, nl-core-practitioner, Organization, Practitioner)
Alternate Names | careProvider, Huisarts
84. Patient.generalPractitioner.extension:practitionerRole
Slice Name | practitionerRole
Definition | Optional Extension Element - found in all resources.
Short | Optional Extensions Element
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.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(PractitionerRole Reference) (Extension Type: Reference)
Alternate Names | extensions, user content
Invariants | ele-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()`)
86. Patient.managingOrganization
Definition | Organization that is the custodian of the patient record.
Short | Organization 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).
Control | 0..1
Type | Reference(Organization)
Must Support | true
Summary | true
Requirements | Need to know who recognizes this patient record, manages and updates it.
88. Patient.link
Definition | Link to another patient resource that concerns the same actual patient.
Short | Link 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'.
Control | 0..*
Type | BackboneElement
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Summary | true
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.
Invariants | ele-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()))
90. 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.
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Summary | true
Alternate Names | extensions, user content, modifiers
92. Patient.link.other
Definition | The other patient resource that the link refers to.
Short | The 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.
Control | 1..1
Type | Reference(Patient, RelatedPerson)
Summary | true
94. Patient.link.type
Definition | The type of link between this patient resource and another patient resource.
Short | replaced-by | replaces | refer | seealso - type of link
Control | 1..1
Binding | The codes SHALL be taken from LinkType http://hl7.org/fhir/ValueSet/link-type|3.0.2 (required to `http://hl7.org/fhir/ValueSet/link-type` ) The type of link between this patient resource and another patient resource.
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true

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

0. Patient
2. Patient.identifier:BSN
Slice Name | BSN
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 1..?
Must Support | true
4. Patient.name
Control | 1..?
Must Support | true
Invariants | zv-pat-1: Either Patient.name.given and/or Patient.name.family and/or Patient.name.text SHALL be present. (`(family.exists() or given.exists() or text.exists())`) zv-pat-2: To be usable for a wide range of internationally available applications, the Patient.name.text SHOULD be present. (`text.exists()`)
6. Patient.gender
Must Support | true
8. Patient.birthDate
Must Support | true
10. Patient.deceased[x]
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Must Support | true
12. Patient.managingOrganization
Must Support | true

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.
Short | Patient
Control | 0..*
Alternate Names | SubjectOfCare Client Resident, Patiënt
Invariants | 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.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Short | Logical 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.
Control | 0..1
Type | id
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
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.
Short | Metadata about the resource
Control | 0..1
Type | Meta
Summary | true
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.
Short | A 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.
Control | 0..1
Type | uri
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
8. Patient.language
Definition | The base language in which the resource is written.
Short | Language 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).
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from Common Languages (extensible to `http://hl7.org/fhir/ValueSet/languages` ) A human language.
Additional Bindings | Purpose
All Languages | Max Binding
Type | code
Primitive Value | This 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.
Short | Text 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.
Control | 0..1 This element is affected by the following invariants: dom-1
Type | Narrative
Alternate Names | narrative, 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.
Short | Contained, 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.
Control | 0..*
Type | Resource
Alternate Names | inline resources, anonymous resources, contained resources
14. Patient.extension
Definition | Changed: May be used to represent additional information that is not part of the basic definition of the resource. 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.
Short | Changed:Additional Content defined by implementations
Comments | Added: 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This 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 Name | preferredPharmacy
Definition | Optional Extension Element - found in all resources.
Short | References a patient's preferered pharmacy
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.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(nl-core-preferred-pharmacy) (Extension Type: Reference)
Alternate Names | extensions, user content, Verwijst naar de voorkeursapotheek van de patiënt
Invariants | ele-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 Name | nationality
Definition | The nationality of the patient.
Short | Nationality
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.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(nationality) (Complex Extension)
Alternate Names | extensions, user content, Nationaliteit
Invariants | ele-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.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This 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 Name | code
Definition | Code representing nationality of patient.
Short | Nationality Code
Control | 0..1
Type | Extension
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.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This 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.
Short | identifies 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.
Control | 1..1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `code`
32. Patient.extension:nationality.extension:code.valueCodeableConcept
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).
Short | Value of extension
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from NationaliteitCodelijst (extensible to `http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.7.6.3--20171231000000` ) Indicates the country of citizenship.
Type | CodeableConcept
34. Patient.extension:nationality.extension:period
Slice Name | period
Definition | Period when nationality was effective.
Short | Nationality Period
Control | 0..1
Type | Extension
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.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This 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.
Short | identifies 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.
Control | 1..1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `period`
42. Patient.extension:nationality.extension:period.valuePeriod
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).
Short | Value of extension
Control | 0..1
Type | Period
44. Patient.extension:nationality.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `http://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).
Short | Value of extension
Control | 0..0
Type | Choice 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 Value | This primitive element may be present, or absent, or replaced by an extension
48. Patient.extension:legalStatus
Slice Name | legalStatus
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.
Short | legalStatus
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.
Control | 0..2 This element is affected by the following invariants: ele-1
Type | Extension(Patient LegalSatus) (Extension Type: CodeableConcept)
Alternate Names | extensions, user content
Invariants | ele-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:lifeStance
Slice Name | lifeStance
Definition | Optional Extension Element - found in all resources.
Short | Optional Extensions Element
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.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(HCIM LifeStance) (Extension Type: CodeableConcept)
Alternate Names | extensions, user content
Invariants | ele-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()`)
52. 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.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
54. 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.
Short | Additional 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.
Control | 0..0
Type | Extension
Alternate Names | extensions, user content
Slicing | This 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
56. Patient.extension:lifeStance.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `http://nictiz.nl/fhir/StructureDefinition/zib-LifeStance`
58. Patient.extension:lifeStance.value[x]
Definition | Patient’s life stance and/or religion.
Short | LifeStance
Control | 1..1
Binding | The codes SHOULD be taken from LevensovertuigingCodelijst (preferred to `http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.7.5.1--20171231000000` ) LevensovertuigingCodelijst
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Alternate Names | Levensovertuiging
60. Patient.extension:lifeStance.value[x].id
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
62. Patient.extension:lifeStance.value[x].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.
Short | Additional 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This 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:lifeStance.value[x].coding
Definition | A reference to a code defined by a terminology system.
Short | Code 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.
Control | 1..1
Type | Coding
Summary | true
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:lifeStance.value[x].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.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
68. Patient.extension:lifeStance.value[x].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.
Short | Additional 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This 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:lifeStance.value[x].coding.system
Definition | The identification of the code system that defines the meaning of the symbol in the code.
Short | Identity 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.
Control | 1..1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to be unambiguous about the source of the definition of the symbol.
72. Patient.extension:lifeStance.value[x].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.
Short | Version 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.
Note | This is a business version Id, not a resource version Id (see discussion)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
74. Patient.extension:lifeStance.value[x].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).
Short | Symbol in syntax defined by the system
Control | 1..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to refer to a particular code in the system.
76. Patient.extension:lifeStance.value[x].coding.display
Definition | A representation of the meaning of the code in the system, following the rules of the system.
Short | Representation defined by the system
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
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:lifeStance.value[x].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).
Short | If 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.
Control | 0..1
Type | boolean
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
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:lifeStance.value[x].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.
Short | Plain text representation of the concept
Comments | Very often the text is the same as a displayName of one of the codings.
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
82. 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.
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Alternate Names | extensions, user content
84. 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).
Short | PatientIdentificationNumber
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 1..*
Type | Identifier
Summary | true
Requirements | Patients are almost always assigned specific numerical identifiers.
Alternate Names | Identificatienummer
Slicing | This element introduces a set of slices on `Patient.identifier`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ system
86. Patient.identifier:BSN
Slice Name | BSN
Definition | An identifier for this patient.
Short | BSN
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 1..1
Type | Identifier
Must Support | true
Summary | true
Requirements | Patients are almost always assigned specific numerical identifiers.
Alternate Names | BSN
88. 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.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
90. 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This 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
92. Patient.identifier:BSN.use
Definition | The purpose of this identifier.
Short | usual | 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.
Control | 0..1
Binding | The codes SHALL be taken from IdentifierUse (required to `http://hl7.org/fhir/ValueSet/identifier-use` ) Identifies the purpose for this identifier, if known .
Type | code
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
94. 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.
Short | Description 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.
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from Identifier Type Codes (extensible to `http://hl7.org/fhir/ValueSet/identifier-type` ) A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Type | CodeableConcept
Summary | true
Requirements | Allows users to make use of identifiers when the identifier system is not known.
96. Patient.identifier:BSN.system
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Short | The namespace for the identifier value
Control | 1..1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Fixed Value | `http://fhir.nl/fhir/NamingSystem/bsn`
Example | General: http://www.acme.com/identifiers/patient
98. Patient.identifier:BSN.value
Definition | Burgerservicenummer is the Dutch person identification number which is also allowed for use in healthcare.
Short | BSN (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.
Control | 1..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Alternate Names | BSN
Example | General: 123456 Example of a burgerservicenummer: 123456782
100. Patient.identifier:BSN.period
Definition | Time period during which identifier is/was valid for use.
Short | Time period when id is/was valid for use
Control | 0..1
Type | Period
Summary | true
102. Patient.identifier:BSN.assigner
Definition | Organization that issued/manages the identifier.
Short | Organization 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.
Control | 0..1
Type | Reference(Organization)
Summary | true
104. 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.
Short | Whether 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.
Control | 0..1
Type | boolean
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to be able to mark a patient record as not to be used because it was created in error.
Default Value | `true`
106. Patient.name
Definition | Changed: A human's name with the ability to identify parts and usage.
Short | NameInformation
Comments | Changed: Dutch names require that certain name parts are separately communicable. For this reason, extensions are added onto the base HumanName element to mark the meaning of each part. A Dutch HumanName is still a proper FHIR HumanName; however, there might be an incompatibilty with the default FHIR mechanism for communicating given names. See the compatibility note below for more information. The extension elements cover birth name (NL: eigennaam / geslachtsnaam) and partner/spouse name. Both may have a prefix (NL: voorvoegsel). When a person marries, he or she may keep their own name, assume the partner name, append the partner name to their own name, or the other way around. Incompatibility note: It has come to light that this specification deviates from the way that the HumanName datatype is normally used. This will be fixed in a future release. However, current implementations should be aware of the special considerations regarding the use of this specification. The issue at hand is the way alternative representations of a name, like initials or a nickname, are communicated. Normally this is done using multiple HumanName instances, which are differentiated using the `.use` element. However, this specification allows for including all alternative representations in the same HumanName instance, with the expectation that the extensions provide enough information for receiving systems to differentiate them. However, this means that contrary to the normal usage of this datatype, repetitions of `.given` names cannot be concatenated to get the full list of given names; the list might be a mix of full names, nicknames and initials. Since multiple implementations are based on this specification, sending systems are advised (but not required) to keep the approach with one HumanName instance, while receiving systems should be able to handle this one-instance approach. More specifically: Sending and receiving systems SHOULD always use the specified extensions when using this datatype. Sending systems are encouraged to populate the `.text` element to unambigiously communicate the person's name. Sending systems are encouraged to send either the full given names or the initials, but not both. This alleviates the duplication of names in `.given`. When a sending system uses the current one-instance approach for communicating multiple representations, `.use` MAY NOT be populated. After all, it is not possible to select a single `.use` when the instance contains different representations. When a receiving system interprets the instance as the single-instance-multiple-representations approach, the `.given` names marked as initials SHOULD be interpreted as alternatives to the full given names. Note the underlying HCIM expects both the list of full names and list of initials to be a single string; there's no match for an initial to a full name. The instance SHOULD be regarded as using this approach when: They encounter a single instance And the `.use` element is absent And all the name parts are differentiated using the specified extensions In any other circumstance, receiving systems SHOULD interpret the usage as the normal use. Example: miss Irma XXXHelleman marries mister de Haas and assumes the name Irma XXXHelleman-de Haas: `.family` = "XXX_Helleman-de Haas" `.given` = "Irma" (with `.given:iso21090EnQualifier` = BR) `.family:humannameOwnName` = "XXX_Helleman" `.family:humannamePartnerPrefix` = "de " `.family:humannamePartnerName` = "Haas"
Control | 1..* This element is affected by the following invariants: ele-1
Type | HumanName(nl-core-humanname)
Must Support | true
Summary | true
Requirements | Need to be able to track the patient by multiple names. Examples are your official name and a partner name.
Alternate Names | Naamgegevens
Example | Structured HumanName (preferred above unstructured): { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/humanname-assembly-order", "valueCode" : "NL4" }], "text" : "Irma XXX_Helleman-de Haas", "family" : "XXX_Helleman-de Haas", "_family" : { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/humanname-own-name", "valueString" : "XXX_Helleman" }, { "url" : "http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix", "valueString" : "de" }, { "url" : "http://hl7.org/fhir/StructureDefinition/humanname-partner-name", "valueString" : "Haas" }] }, "given" : ["Irma"], "_given" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier", "valueCode" : "CL" }] }] } Unstructured HumanName: { "text" : "Irma XXX_Helleman-de Haas" }
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() | (children().count() > id.count())`) nl-core-humanname-1: if you specify a prefix for an own name then an own name is also expected (`name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-prefix').empty().not() implies name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-name').empty().not()`) nl-core-humanname-2: if you specify a voorvoegsel for a partner name then a partner name is also expected (`name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix').empty().not() implies name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-name').empty().not()`) zv-pat-1: Either Patient.name.given and/or Patient.name.family and/or Patient.name.text SHALL be present. (`(family.exists() or given.exists() or text.exists())`) zv-pat-2: To be usable for a wide range of internationally available applications, the Patient.name.text SHOULD be present. (`text.exists()`)
108. 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.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
110. Patient.name.extension
Definition | Changed: 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.
Short | Changed:Additional Content defined by implementations
Comments | Added: 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This 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
112. Patient.name.extension:humannameAssemblyOrder
Slice Name | humannameAssemblyOrder
Definition | A code that represents the preferred display order of the components of this human name.
Short | Preferred display order of name parts
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.
Control | 0..1 This element is affected by the following invariants: ele-1
Binding | The codes SHALL be taken from HumanNameAssemblyOrder (required to `http://hl7.org/fhir/ValueSet/name-assembly-order` ) Human Name Assembly Order
Type | Extension(assembly-order) (Extension Type: code)
Alternate Names | extensions, user content, Voorkeursvolgorde van de naamdelen.
Invariants | ele-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()`)
114. 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.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
116. 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This 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
118. Patient.name.extension:humannameAssemblyOrder.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `http://hl7.org/fhir/StructureDefinition/humanname-assembly-order`
120. Patient.name.extension:humannameAssemblyOrder.valueCode:valueCode
Slice Name | valueCode
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).
Short | Value of extension
Control | 0..1
Binding | The codes SHALL be taken from HumanNameAssemblyOrder (required to `http://hl7.org/fhir/ValueSet/name-assembly-order` ) A code that represents the preferred display order of the components of a human name
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
122. Patient.name.use
Definition | Identifies the purpose for this name.
Short | usual | 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.
Control | 0..1
Binding | The codes SHALL be taken from NameUse (required to `http://hl7.org/fhir/ValueSet/name-use` ) The use of a human name
Type | code
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Allows the appropriate name for a particular context of use to be selected from among a set of names.
124. Patient.name.text
Definition | A full text representation of the name.
Short | Text representation of the full name
Comments | Can provide both a text representation and structured parts.
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | A renderable, unencoded form.
126. 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.
Short | Surname
Comments | Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Alternate Names | surname, Achternaam
128. Patient.name.family.id
Definition | unique id for the element within a resource (for internal references)
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
130. Patient.name.family.extension
Definition | Changed: May be used to represent additional information that is not part of the basic definition of the resource. 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.
Short | Changed:Additional Content defined by implementations
Comments | Added: 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This 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
132. Patient.name.family.extension:humannameOwnPrefix
Slice Name | humannameOwnPrefix
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.
Short | PrefixOwnName
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.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(own-prefix) (Extension Type: string)
Alternate Names | extensions, user content, VoorvoegselGeslachtsnaam
Invariants | ele-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()`)
134. 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.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
136. 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This 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
138. Patient.name.family.extension:humannameOwnPrefix.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `http://hl7.org/fhir/StructureDefinition/humanname-own-prefix`
140. Patient.name.family.extension:humannameOwnPrefix.valueString:valueString
Slice Name | valueString
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).
Short | Value of extension
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
142. Patient.name.family.extension:humannameOwnName
Slice Name | humannameOwnName
Definition | The person’s official last name.
Short | OwnName
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".
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(own-name) (Extension Type: string)
Alternate Names | extensions, user content, Geslachtsnaam
Invariants | ele-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()`)
144. 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.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
146. 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This 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
148. Patient.name.family.extension:humannameOwnName.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `http://hl7.org/fhir/StructureDefinition/humanname-own-name`
150. Patient.name.family.extension:humannameOwnName.valueString:valueString
Slice Name | valueString
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).
Short | Value of extension
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
152. Patient.name.family.extension:humannamePartnerPrefix
Slice Name | humannamePartnerPrefix
Definition | Voorvoegsel derived from person's partner's surname inclusive of the space between the prefix and the surname, if applicable.
Short | PrefixSurname
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.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(partner-prefix) (Extension Type: string)
Alternate Names | extensions, user content, VoorvoegselGeslachtsnaamPartner
Invariants | ele-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()`)
154. 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.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
156. 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This 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
158. Patient.name.family.extension:humannamePartnerPrefix.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix`
160. Patient.name.family.extension:humannamePartnerPrefix.valueString:valueString
Slice Name | valueString
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).
Short | Value of extension
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
162. Patient.name.family.extension:humannamePartnerName
Slice Name | humannamePartnerName
Definition | Partner’s official last name.
Short | LastNamePartner
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".
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(partner-name) (Extension Type: string)
Alternate Names | extensions, user content, GeslachtsnaamPartner
Invariants | ele-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()`)
164. 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.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
166. 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This 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
168. Patient.name.family.extension:humannamePartnerName.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `http://hl7.org/fhir/StructureDefinition/humanname-partner-name`
170. Patient.name.family.extension:humannamePartnerName.valueString:valueString
Slice Name | valueString
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).
Short | Value of extension
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
172. Patient.name.family.value
Definition | The actual value
Short | Primitive value for string
Control | 0..1
Type | string
XML Format | In the XML format, this property is represented as an attribute.
Max Length: | 1048576
174. 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.
Short | Given
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!
Control | 0..*
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Alternate Names | first name, middle name, Voornamen, Initialen, Roepnaam
176. Patient.name.given.id
Definition | unique id for the element within a resource (for internal references)
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
178. Patient.name.given.extension
Definition | Changed: May be used to represent additional information that is not part of the basic definition of the resource. 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.
Short | Changed:Additional Content defined by implementations
Comments | Added: 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This 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
180. Patient.name.given.extension:iso21090EnQualifier
Slice Name | iso21090EnQualifier
Definition | A set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type.
Short | LS | 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.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(EN-qualifier) (Extension Type: code)
Is Modifier | false
Alternate Names | extensions, user content
Invariants | ele-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()`)
182. 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.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
184. 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This 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
186. Patient.name.given.extension:iso21090EnQualifier.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier`
188. Patient.name.given.extension:iso21090EnQualifier.valueCode:valueCode
Slice Name | valueCode
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).
Short | Value of extension
Control | 0..1
Binding | The codes SHALL be taken from EntityNamePartQualifier (required to `http://hl7.org/fhir/ValueSet/name-part-qualifier` ) A set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
190. Patient.name.given.value
Definition | The actual value
Short | Primitive value for string
Control | 0..1
Type | string
XML Format | In the XML format, this property is represented as an attribute.
Max Length: | 1048576
192. 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.
Short | Parts that come before the name
Control | 0..*
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
194. 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.
Short | Parts that come after the name
Control | 0..*
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
196. Patient.name.period
Definition | Indicates the period of time when this name was valid for the named person.
Short | Time period when name was/is in use
Control | 0..1
Type | Period
Summary | true
Requirements | Allows names to be placed in historical context.
198. Patient.telecom
Definition | A contact detail for the individual. Note that there is no support for multiple use values like 'mobile business'.
Short | Changed:ContactInformation
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).
Control | 0..* This element is affected by the following invariants: ele-1
Type | ContactPoint(nl-core-contactpoint)
Summary | true
Requirements | People have (primary) ways to contact them in some way such as phone, email.
Alternate Names | Contactgegevens
Example | Mobile business phone number. Note: the mobile nature stems from the number being an 06-* number.: { "system" : "phone", "value" : "+31611234567", "use" : "work" } Mobile phone number undetermined private/business. Note: the mobile nature stems from the number being an 06-* number.: { "system" : "phone", "value" : "+31611234567", "use" : "mobile" } Primary Home Land Line: { "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept" : { "coding" : [{ "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1", "code" : "LL", "display" : "Land Line" }] } }], "system" : "phone", "value" : "...", "use" : "home" } Temporary Land Line: { "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept" : { "coding" : [{ "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1", "code" : "LL", "display" : "Land Line" }] } }], "system" : "phone", "value" : "...", "use" : "temp" } Primary Work Land Line: { "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept" : { "coding" : [{ "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1", "code" : "LL", "display" : "Land Line" }] } }], "system" : "phone", "value" : "...", "use" : "work" } Primary Home Fax: { "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept" : { "coding" : [{ "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1", "code" : "FAX", "display" : "Fax" }] } }], "system" : "fax", "value" : "...", "use" : "home" } Temporary Fax: { "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept" : { "coding" : [{ "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1", "code" : "FAX", "display" : "Fax" }] } }], "system" : "fax", "value" : "...", "use" : "temp" } Primary Work Fax: { "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept" : { "coding" : [{ "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1", "code" : "FAX", "display" : "Fax" }] } }], "system" : "fax", "value" : "...", "use" : "work" } Primary Home Mobile Phone: { "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/v3/AddressUse", "code" : "MC", "display" : "Mobile Phone" }] } }], "system" : "phone", "value" : "...", "use" : "home" } Temporary Mobile Phone: { "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/v3/AddressUse", "code" : "MC", "display" : "Mobile Phone" }] } }], "system" : "phone", "value" : "...", "use" : "temp" } Primary Work Mobile Phone: { "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/v3/AddressUse", "code" : "MC", "display" : "Mobile Phone" }] } }], "system" : "phone", "value" : "...", "use" : "work" } Primary Home Pager: { "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/v3/AddressUse", "code" : "PG", "display" : "Pager" }] } }], "system" : "pager", "value" : "...", "use" : "home" } Temporary Pager: { "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/v3/AddressUse", "code" : "PG", "display" : "Pager" }] } }], "system" : "pager", "value" : "...", "use" : "temp" } Primary Work Pager: { "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/v3/AddressUse", "code" : "PG", "display" : "Pager" }] } }], "system" : "pager", "value" : "...", "use" : "work" } Private email address: { "system" : "email", "value" : "giesput@myweb.nl", "use" : "home" } Work email address: { "system" : "email", "value" : "example@workplace.nl", "use" : "work" }
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() | (children().count() > id.count())`) cpt-2: A system is required if a value is provided. (`value.empty() or system.exists()`)
200. Patient.gender
Definition | Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes.
Short | Gender
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.
Control | 0..1
Binding | The codes SHALL be taken from AdministrativeGender (required to `http://hl7.org/fhir/ValueSet/administrative-gender` ) The gender of a person used for administrative purposes.
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Needed for identification of the individual, in combination with (at least) name and birth date. Gender of individual drives many clinical processes.
Alternate Names | Geslacht
202. Patient.gender.id
Definition | unique id for the element within a resource (for internal references)
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
204. Patient.gender.extension
Definition | Changed: May be used to represent additional information that is not part of the basic definition of the resource. 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.
Short | Changed:Additional Content defined by implementations
Comments | Added: 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This 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
206. Patient.gender.extension:GeslachtCodelijst
Slice Name | GeslachtCodelijst
Definition | Patient’s administrative gender.
Short | Gender
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.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(HCIM extension code-specification) (Extension Type: CodeableConcept)
Alternate Names | extensions, user content, Bevat 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
Invariants | ele-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.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.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
210. 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.
Short | Additional 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.
Control | 0..0
Type | Extension
Alternate Names | extensions, user content
Slicing | This 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
212. Patient.gender.extension:GeslachtCodelijst.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `http://nictiz.nl/fhir/StructureDefinition/code-specification`
214. 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).
Short | Value of extension
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from GeslachtCodelijst (extensible to `http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.0.1.1--20171231000000` ) GeslachtCodelijst
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
216. Patient.gender.value
Definition | Primitive value for code
Short | Primitive value for code
Control | 0..1
Type | code
XML Format | In the XML format, this property is represented as an attribute.
218. Patient.birthDate
Definition | The date of birth for the individual.
Short | Patients 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).
Control | 0..1
Type | date
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Age of the individual drives many clinical processes.
Alternate Names | Geboortedatum
220. Patient.deceased[x]
Definition | Indicates if the individual is deceased or not.
Short | DeathIndicator/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.
Control | 0..1
Type | Choice of: boolean, dateTime
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | true
Requirements | The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.
Alternate Names | Overlijdensindicator/DatumOverlijden
222. Patient.address
Definition | Changed: This datatype defines a common basis for expressing all addresses around the world, but adds extensions to express Dutch addresses specifically, according to the HCIM AddressInformation (v1.0, 2017). A Dutch Address still is a proper FHIR Address, which means that systems that cannot interpret the extensions will still be able to render and work with this datatype. To have true compatibility an implementer SHOULD use the core Address parts as intended. To have addresses work for Dutch context, the implementer SHOULD in addition use the extension elements. Separate address parts The first addition is that Dutch addresses make certain address parts separately communicable. These parts are required for use in true Dutch systems when dealing with Dutch addresses, but may not have value for international systems when information gets sent abroad. Custom address types The second addition is that the HCIM defines its own ValueSet for address types, which can only be partially expressed using the FHIR Address datatype and requires a mapping to multiple elements. The table below explains how the HCIM concepts are mapped to the various FHIR elements (see the ConceptMaps <http://nictiz.nl/fhir/ConceptMap/AdresSoortCodelijst-to-AddressUse> and <http://nictiz.nl/fhir/ConceptMap/AdresSoortCodelijst-to-AddressType> as well). The HCIM code itself should also be included using the AddressType extension. | HCIM |`.ext:AddressType` | `.ext:official` | `.use` | `.type` | |-----------------------------------|:------------------:|:---------------:|:------:|:----------:| | Postal Address/Postadres | PST | | | postal | | Primary Home/Officieel adres | HP | true | home | | | Visit Address/Woon-/verblijfadres | PHYS | | home | physical | | Temporary Address/Tijdelijk adres | TMP | | temp | | | Work Place/Werkadres | WP | | work | | | Vacation Home/Vakantie adres | HV | | temp | | If Address.type is both then this is to be understood as a dual purpose address (postal and physical). Systems that support importing it like this are encouraged to do so, otherwise they may need to import this as two separate addresses. NOTE: FHIR core defines the AD-use extension to further specify the postal address type. However, the ValueSet used in that extension doesn't completely match the HCIM ValueSet. Therefore, a custom extension has been made. This doesn't preclude the use of the AD-use extension.
Short | AddressInformation
Comments | Changed: Note: address is for postal addresses, not physical locations.
Control | 0..* This element is affected by the following invariants: ele-1, nl-streetname-if-official-and-other-line-parts
Type | Address(nl-core-address)
Summary | true
Requirements | May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.
Alternate Names | AdresInformatie, Adresgegevens
Example | Example of a Vacation Home address: { "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-AddressInformation-AddressType", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/v3/AddressUse", "code" : "HV", "display" : "Vakantie adres" }] } }], "use" : "temp", "line" : ["Binnenkant 12A Hoog"], "_line" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName", "valueString" : "Binnenkant" }, { "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber", "valueString" : "12" }, { "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-buildingNumberSuffix", "valueString" : "A" }, { "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-unitID", "valueString" : "Hoog" }] }], "city" : "Amsterdam", "state" : "NH", "postalCode" : "1000AA", "country" : "NLD" } Example of a Primary Home address: { "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-AddressInformation-AddressType", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/v3/AddressUse", "code" : "HP", "display" : "Officieel adres" }] } }, { "url" : "http://fhir.nl/fhir/StructureDefinition/nl-core-address-official", "valueBoolean" : true }], "use" : "home", "line" : ["Binnenkant to 10"], "_line" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName", "valueString" : "Binnenkant" }, { "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator", "valueString" : "to" }, { "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber", "valueString" : "10" }] }], "city" : "Amsterdam", "state" : "NH", "postalCode" : "1001AA", "country" : "NLD" }
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() | (children().count() > id.count())`) nl-streetname-if-official-and-other-line-parts: Address.streetName in an official address SHALL have a value if one of houseNumber|buildingNumberSuffix|additionalLocator has a value (`(extension.where(url = 'http://fhir.nl/fhir/StructureDefinition/nl-core-address-official').where(value = true)).empty() or (line.extension.where(url = 'http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName').empty().not() and (line.extension.where(url='http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber').empty().not() or line.extension.where(url='http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-buildingNumberSuffix').empty().not() or line.extension.where(url='http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator').empty().not()))`)
224. 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.
Short | MaritalStatus
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from BurgerlijkeStaatCodelijst (extensible to `http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.7.9.1--20171231000000` ) The domestic partnership status of a person.
Type | CodeableConcept
Requirements | Most, if not all systems capture it.
Alternate Names | BurgerlijkeStaat
226. Patient.multipleBirth[x]
Definition | Indicates whether the patient is part of a multiple (bool) or indicates the actual birth order (integer).
Short | MultipleBirthIndicator
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).
Control | 0..1
Type | Choice of: boolean, integer
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Primitive Value | This 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 Names | Meerlingindicator
228. Patient.photo
Definition | Image of the patient.
Short | Image of the patient
Control | 0..*
Type | Attachment
Requirements | Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too.
230. 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'.
Short | ContactPerson
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.
Control | 0..*
Type | BackboneElement
Requirements | Need to track people you can contact about the patient.
Alternate Names | Contactpersoon
Invariants | ele-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()`)
232. 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.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
234. 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
236. 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.
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Summary | true
Alternate Names | extensions, user content, modifiers
238. Patient.contact.relationship
Definition | The nature of the relationship between the patient and the contact person.
Short | The kind of relationship
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from v2 Contact Role (extensible to `http://hl7.org/fhir/ValueSet/v2-0131` ) The nature of the relationship between a patient and a contact person for that patient.
Type | CodeableConcept
Requirements | Used to determine which contact person is the most relevant to approach, depending on circumstances.
Slicing | This 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
240. Patient.contact.relationship:relationship
Slice Name | relationship
Definition | The nature of the relationship between the patient and the contact person.
Short | Relationship
Control | 0..*
Binding | The codes SHALL be taken from RelatieCodelijst (required to `http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.3.1.1--20171231000000` ) The nature of the relationship between a patient and a contact person for that patient.
Type | CodeableConcept
Requirements | Used to determine which contact person is the most relevant to approach, depending on circumstances.
Alternate Names | Relatie
242. Patient.contact.relationship:role
Slice Name | role
Definition | Expectation is to have at least one of primary contact ('Eerste relatie/contactpersoon') or secondary contact ('Tweede relatie/contactpersoon')
Short | Role
Control | 0..*
Binding | The codes SHALL be taken from RolCodelijst (required to `http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.3.1.2--20171231000000` ) The nature of the relationship between a patient and a contact person for that patient.
Type | CodeableConcept
Requirements | Used to determine which contact person is the most relevant to approach, depending on circumstances.
Alternate Names | Rol
244. Patient.contact.name
Definition | Changed: A human's name with the ability to identify parts and usage.
Short | NameInformation
Comments | Added: Dutch names require that certain name parts are separately communicable. For this reason, extensions are added onto the base HumanName element to mark the meaning of each part. A Dutch HumanName is still a proper FHIR HumanName; however, there might be an incompatibilty with the default FHIR mechanism for communicating given names. See the compatibility note below for more information. The extension elements cover birth name (NL: eigennaam / geslachtsnaam) and partner/spouse name. Both may have a prefix (NL: voorvoegsel). When a person marries, he or she may keep their own name, assume the partner name, append the partner name to their own name, or the other way around. Incompatibility note: It has come to light that this specification deviates from the way that the HumanName datatype is normally used. This will be fixed in a future release. However, current implementations should be aware of the special considerations regarding the use of this specification. The issue at hand is the way alternative representations of a name, like initials or a nickname, are communicated. Normally this is done using multiple HumanName instances, which are differentiated using the `.use` element. However, this specification allows for including all alternative representations in the same HumanName instance, with the expectation that the extensions provide enough information for receiving systems to differentiate them. However, this means that contrary to the normal usage of this datatype, repetitions of `.given` names cannot be concatenated to get the full list of given names; the list might be a mix of full names, nicknames and initials. Since multiple implementations are based on this specification, sending systems are advised (but not required) to keep the approach with one HumanName instance, while receiving systems should be able to handle this one-instance approach. More specifically: Sending and receiving systems SHOULD always use the specified extensions when using this datatype. Sending systems are encouraged to populate the `.text` element to unambigiously communicate the person's name. Sending systems are encouraged to send either the full given names or the initials, but not both. This alleviates the duplication of names in `.given`. When a sending system uses the current one-instance approach for communicating multiple representations, `.use` MAY NOT be populated. After all, it is not possible to select a single `.use` when the instance contains different representations. When a receiving system interprets the instance as the single-instance-multiple-representations approach, the `.given` names marked as initials SHOULD be interpreted as alternatives to the full given names. Note the underlying HCIM expects both the list of full names and list of initials to be a single string; there's no match for an initial to a full name. The instance SHOULD be regarded as using this approach when: They encounter a single instance And the `.use` element is absent And all the name parts are differentiated using the specified extensions In any other circumstance, receiving systems SHOULD interpret the usage as the normal use. Example: miss Irma XXXHelleman marries mister de Haas and assumes the name Irma XXXHelleman-de Haas: `.family` = "XXX_Helleman-de Haas" `.given` = "Irma" (with `.given:iso21090EnQualifier` = BR) `.family:humannameOwnName` = "XXX_Helleman" `.family:humannamePartnerPrefix` = "de " `.family:humannamePartnerName` = "Haas"
Control | 0..1 This element is affected by the following invariants: ele-1
Type | HumanName(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 Names | Naamgegevens
Example | Structured HumanName (preferred above unstructured): { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/humanname-assembly-order", "valueCode" : "NL4" }], "text" : "Irma XXX_Helleman-de Haas", "family" : "XXX_Helleman-de Haas", "_family" : { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/humanname-own-name", "valueString" : "XXX_Helleman" }, { "url" : "http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix", "valueString" : "de" }, { "url" : "http://hl7.org/fhir/StructureDefinition/humanname-partner-name", "valueString" : "Haas" }] }, "given" : ["Irma"], "_given" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier", "valueCode" : "CL" }] }] } Unstructured HumanName: { "text" : "Irma XXX_Helleman-de Haas" }
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() | (children().count() > id.count())`) nl-core-humanname-1: if you specify a prefix for an own name then an own name is also expected (`name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-prefix').empty().not() implies name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-name').empty().not()`) nl-core-humanname-2: if you specify a voorvoegsel for a partner name then a partner name is also expected (`name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix').empty().not() implies name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-name').empty().not()`)
246. 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.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
248. Patient.contact.name.extension
Definition | Changed: 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.
Short | Changed:Additional Content defined by implementations
Comments | Added: 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This 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
250. Patient.contact.name.extension:humannameAssemblyOrder
Slice Name | humannameAssemblyOrder
Definition | A code that represents the preferred display order of the components of this human name.
Short | Preferred display order of name parts
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.
Control | 0..1 This element is affected by the following invariants: ele-1
Binding | The codes SHALL be taken from HumanNameAssemblyOrder (required to `http://hl7.org/fhir/ValueSet/name-assembly-order` ) Human Name Assembly Order
Type | Extension(assembly-order) (Extension Type: code)
Alternate Names | extensions, user content, Voorkeursvolgorde van de naamdelen.
Invariants | ele-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()`)
252. 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.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
254. 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This 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
256. Patient.contact.name.extension:humannameAssemblyOrder.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `http://hl7.org/fhir/StructureDefinition/humanname-assembly-order`
258. Patient.contact.name.extension:humannameAssemblyOrder.valueCode:valueCode
Slice Name | valueCode
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).
Short | Value of extension
Control | 0..1
Binding | The codes SHALL be taken from HumanNameAssemblyOrder (required to `http://hl7.org/fhir/ValueSet/name-assembly-order` ) A code that represents the preferred display order of the components of a human name
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
260. Patient.contact.name.use
Definition | Identifies the purpose for this name.
Short | usual | 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.
Control | 0..1
Binding | The codes SHALL be taken from NameUse (required to `http://hl7.org/fhir/ValueSet/name-use` ) The use of a human name
Type | code
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Allows the appropriate name for a particular context of use to be selected from among a set of names.
262. Patient.contact.name.text
Definition | A full text representation of the name.
Short | Text representation of the full name
Comments | Can provide both a text representation and structured parts.
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | A renderable, unencoded form.
264. 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.
Short | Surname
Comments | Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Alternate Names | surname, Achternaam
266. Patient.contact.name.family.id
Definition | unique id for the element within a resource (for internal references)
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
268. Patient.contact.name.family.extension
Definition | Changed: May be used to represent additional information that is not part of the basic definition of the resource. 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.
Short | Changed:Additional Content defined by implementations
Comments | Added: 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This 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
270. Patient.contact.name.family.extension:humannameOwnPrefix
Slice Name | humannameOwnPrefix
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.
Short | PrefixOwnName
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.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(own-prefix) (Extension Type: string)
Alternate Names | extensions, user content, VoorvoegselGeslachtsnaam
Invariants | ele-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.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.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
274. 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This 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
276. Patient.contact.name.family.extension:humannameOwnPrefix.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `http://hl7.org/fhir/StructureDefinition/humanname-own-prefix`
278. Patient.contact.name.family.extension:humannameOwnPrefix.valueString:valueString
Slice Name | valueString
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).
Short | Value of extension
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
280. Patient.contact.name.family.extension:humannameOwnName
Slice Name | humannameOwnName
Definition | The person’s official last name.
Short | OwnName
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".
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(own-name) (Extension Type: string)
Alternate Names | extensions, user content, Geslachtsnaam
Invariants | ele-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()`)
282. 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.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
284. 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This 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
286. Patient.contact.name.family.extension:humannameOwnName.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `http://hl7.org/fhir/StructureDefinition/humanname-own-name`
288. Patient.contact.name.family.extension:humannameOwnName.valueString:valueString
Slice Name | valueString
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).
Short | Value of extension
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
290. Patient.contact.name.family.extension:humannamePartnerPrefix
Slice Name | humannamePartnerPrefix
Definition | Voorvoegsel derived from person's partner's surname inclusive of the space between the prefix and the surname, if applicable.
Short | PrefixSurname
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.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(partner-prefix) (Extension Type: string)
Alternate Names | extensions, user content, VoorvoegselGeslachtsnaamPartner
Invariants | ele-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()`)
292. 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.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
294. 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This 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
296. Patient.contact.name.family.extension:humannamePartnerPrefix.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix`
298. Patient.contact.name.family.extension:humannamePartnerPrefix.valueString:valueString
Slice Name | valueString
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).
Short | Value of extension
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
300. Patient.contact.name.family.extension:humannamePartnerName
Slice Name | humannamePartnerName
Definition | Partner’s official last name.
Short | LastNamePartner
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".
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(partner-name) (Extension Type: string)
Alternate Names | extensions, user content, GeslachtsnaamPartner
Invariants | ele-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()`)
302. 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.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
304. 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This 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
306. Patient.contact.name.family.extension:humannamePartnerName.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `http://hl7.org/fhir/StructureDefinition/humanname-partner-name`
308. Patient.contact.name.family.extension:humannamePartnerName.valueString:valueString
Slice Name | valueString
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).
Short | Value of extension
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
310. Patient.contact.name.family.value
Definition | The actual value
Short | Primitive value for string
Control | 0..1
Type | string
XML Format | In the XML format, this property is represented as an attribute.
Max Length: | 1048576
312. 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.
Short | Given
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!
Control | 0..*
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Alternate Names | first name, middle name, Voornamen, Initialen, Roepnaam
314. Patient.contact.name.given.id
Definition | unique id for the element within a resource (for internal references)
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
316. Patient.contact.name.given.extension
Definition | Changed: May be used to represent additional information that is not part of the basic definition of the resource. 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.
Short | Changed:Additional Content defined by implementations
Comments | Added: 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This 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
318. Patient.contact.name.given.extension:iso21090EnQualifier
Slice Name | iso21090EnQualifier
Definition | A set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type.
Short | LS | 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.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(EN-qualifier) (Extension Type: code)
Is Modifier | false
Alternate Names | extensions, user content
Invariants | ele-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()`)
320. 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.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
322. 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This 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
324. Patient.contact.name.given.extension:iso21090EnQualifier.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier`
326. Patient.contact.name.given.extension:iso21090EnQualifier.valueCode:valueCode
Slice Name | valueCode
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).
Short | Value of extension
Control | 0..1
Binding | The codes SHALL be taken from EntityNamePartQualifier (required to `http://hl7.org/fhir/ValueSet/name-part-qualifier` ) A set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
328. Patient.contact.name.given.value
Definition | The actual value
Short | Primitive value for string
Control | 0..1
Type | string
XML Format | In the XML format, this property is represented as an attribute.
Max Length: | 1048576
330. 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.
Short | Parts that come before the name
Control | 0..*
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
332. 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.
Short | Parts that come after the name
Control | 0..*
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
334. Patient.contact.name.period
Definition | Indicates the period of time when this name was valid for the named person.
Short | Time period when name was/is in use
Control | 0..1
Type | Period
Summary | true
Requirements | Allows names to be placed in historical context.
336. Patient.contact.telecom
Definition | Changed: Contact information includes a person's telephone numbers and email addresses. This datatype defines a common basis for expressing all contact information around the world, but adds extensions to express Dutch contacts specifically, according to the HCIM ContactInformation (v1.0, 2017). A Dutch ContactPoint still is a proper FHIR ContactPoint, which means that systems that cannot interpret the extensions will still be able to render and work with this datatype. The table below explains how the HCIM concepts are mapped to the various FHIR elements. The HCIM code itself should also be included using the TelecomType extension. | HCIM | `.ext:TelecomType` | `.system` | `.use` | |----------------------------------------------------|:------------------:|:---------:|:--------:| | Primary Home Land Line | LL | phone | home | | Temporary Land Line | LL | phone | temp | | Primary Work Land Line | LL | phone | work | | | | | | | Primary Home Fax | FAX | fax | home | | Temporary Fax | FAX | fax | temp | | Primary Work Fax | FAX | fax | work | | | | | | | Primary Home Mobile Phone | MC | phone | home | | Temporary Mobile Phone | MC | phone | temp | | Primary Work Mobile Phone | MC | phone | work | | | | | | | Primary Home Pager | PG | pager | home | | Temporary Pager | PG | pager | temp | | Primary Work Pager | PG | pager | work | | | | | | | Private email address | | email | home | | Work email address | | email | work | | | | | | | Mobile phone number undetermined private/business | | phone | mobile |
Short | Changed:ContactInformation
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
Control | 0..* This element is affected by the following invariants: ele-1
Type | ContactPoint(nl-core-contactpoint)
Requirements | People have (primary) ways to contact them in some way such as phone, email.
Alternate Names | Contactgegevens
Example | Mobile business phone number. Note: the mobile nature stems from the number being an 06-* number.: { "system" : "phone", "value" : "+31611234567", "use" : "work" } Mobile phone number undetermined private/business. Note: the mobile nature stems from the number being an 06-* number.: { "system" : "phone", "value" : "+31611234567", "use" : "mobile" } Primary Home Land Line: { "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept" : { "coding" : [{ "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1", "code" : "LL", "display" : "Land Line" }] } }], "system" : "phone", "value" : "...", "use" : "home" } Temporary Land Line: { "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept" : { "coding" : [{ "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1", "code" : "LL", "display" : "Land Line" }] } }], "system" : "phone", "value" : "...", "use" : "temp" } Primary Work Land Line: { "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept" : { "coding" : [{ "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1", "code" : "LL", "display" : "Land Line" }] } }], "system" : "phone", "value" : "...", "use" : "work" } Primary Home Fax: { "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept" : { "coding" : [{ "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1", "code" : "FAX", "display" : "Fax" }] } }], "system" : "fax", "value" : "...", "use" : "home" } Temporary Fax: { "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept" : { "coding" : [{ "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1", "code" : "FAX", "display" : "Fax" }] } }], "system" : "fax", "value" : "...", "use" : "temp" } Primary Work Fax: { "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept" : { "coding" : [{ "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1", "code" : "FAX", "display" : "Fax" }] } }], "system" : "fax", "value" : "...", "use" : "work" } Primary Home Mobile Phone: { "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/v3/AddressUse", "code" : "MC", "display" : "Mobile Phone" }] } }], "system" : "phone", "value" : "...", "use" : "home" } Temporary Mobile Phone: { "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/v3/AddressUse", "code" : "MC", "display" : "Mobile Phone" }] } }], "system" : "phone", "value" : "...", "use" : "temp" } Primary Work Mobile Phone: { "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/v3/AddressUse", "code" : "MC", "display" : "Mobile Phone" }] } }], "system" : "phone", "value" : "...", "use" : "work" } Primary Home Pager: { "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/v3/AddressUse", "code" : "PG", "display" : "Pager" }] } }], "system" : "pager", "value" : "...", "use" : "home" } Temporary Pager: { "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/v3/AddressUse", "code" : "PG", "display" : "Pager" }] } }], "system" : "pager", "value" : "...", "use" : "temp" } Primary Work Pager: { "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/v3/AddressUse", "code" : "PG", "display" : "Pager" }] } }], "system" : "pager", "value" : "...", "use" : "work" } Private email address: { "system" : "email", "value" : "giesput@myweb.nl", "use" : "home" } Work email address: { "system" : "email", "value" : "example@workplace.nl", "use" : "work" }
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() | (children().count() > id.count())`) cpt-2: A system is required if a value is provided. (`value.empty() or system.exists()`)
338. Patient.contact.address
Definition | Changed: This datatype defines a common basis for expressing all addresses around the world, but adds extensions to express Dutch addresses specifically, according to the HCIM AddressInformation (v1.0, 2017). A Dutch Address still is a proper FHIR Address, which means that systems that cannot interpret the extensions will still be able to render and work with this datatype. To have true compatibility an implementer SHOULD use the core Address parts as intended. To have addresses work for Dutch context, the implementer SHOULD in addition use the extension elements. Separate address parts The first addition is that Dutch addresses make certain address parts separately communicable. These parts are required for use in true Dutch systems when dealing with Dutch addresses, but may not have value for international systems when information gets sent abroad. Custom address types The second addition is that the HCIM defines its own ValueSet for address types, which can only be partially expressed using the FHIR Address datatype and requires a mapping to multiple elements. The table below explains how the HCIM concepts are mapped to the various FHIR elements (see the ConceptMaps <http://nictiz.nl/fhir/ConceptMap/AdresSoortCodelijst-to-AddressUse> and <http://nictiz.nl/fhir/ConceptMap/AdresSoortCodelijst-to-AddressType> as well). The HCIM code itself should also be included using the AddressType extension. | HCIM |`.ext:AddressType` | `.ext:official` | `.use` | `.type` | |-----------------------------------|:------------------:|:---------------:|:------:|:----------:| | Postal Address/Postadres | PST | | | postal | | Primary Home/Officieel adres | HP | true | home | | | Visit Address/Woon-/verblijfadres | PHYS | | home | physical | | Temporary Address/Tijdelijk adres | TMP | | temp | | | Work Place/Werkadres | WP | | work | | | Vacation Home/Vakantie adres | HV | | temp | | If Address.type is both then this is to be understood as a dual purpose address (postal and physical). Systems that support importing it like this are encouraged to do so, otherwise they may need to import this as two separate addresses. NOTE: FHIR core defines the AD-use extension to further specify the postal address type. However, the ValueSet used in that extension doesn't completely match the HCIM ValueSet. Therefore, a custom extension has been made. This doesn't preclude the use of the AD-use extension.
Short | AddressInformation
Comments | Added: Note: address is for postal addresses, not physical locations.
Control | 0..1 This element is affected by the following invariants: ele-1, nl-streetname-if-official-and-other-line-parts
Type | Address(nl-core-address)
Requirements | Need to keep track where the contact person can be contacted per postal mail or visited.
Alternate Names | AdresInformatie, Adresgegevens
Example | Example of a Vacation Home address: { "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-AddressInformation-AddressType", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/v3/AddressUse", "code" : "HV", "display" : "Vakantie adres" }] } }], "use" : "temp", "line" : ["Binnenkant 12A Hoog"], "_line" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName", "valueString" : "Binnenkant" }, { "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber", "valueString" : "12" }, { "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-buildingNumberSuffix", "valueString" : "A" }, { "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-unitID", "valueString" : "Hoog" }] }], "city" : "Amsterdam", "state" : "NH", "postalCode" : "1000AA", "country" : "NLD" } Example of a Primary Home address: { "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-AddressInformation-AddressType", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/v3/AddressUse", "code" : "HP", "display" : "Officieel adres" }] } }, { "url" : "http://fhir.nl/fhir/StructureDefinition/nl-core-address-official", "valueBoolean" : true }], "use" : "home", "line" : ["Binnenkant to 10"], "_line" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName", "valueString" : "Binnenkant" }, { "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator", "valueString" : "to" }, { "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber", "valueString" : "10" }] }], "city" : "Amsterdam", "state" : "NH", "postalCode" : "1001AA", "country" : "NLD" }
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() | (children().count() > id.count())`) nl-streetname-if-official-and-other-line-parts: Address.streetName in an official address SHALL have a value if one of houseNumber|buildingNumberSuffix|additionalLocator has a value (`(extension.where(url = 'http://fhir.nl/fhir/StructureDefinition/nl-core-address-official').where(value = true)).empty() or (line.extension.where(url = 'http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName').empty().not() and (line.extension.where(url='http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber').empty().not() or line.extension.where(url='http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-buildingNumberSuffix').empty().not() or line.extension.where(url='http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator').empty().not()))`)
340. Patient.contact.gender
Definition | Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes.
Short | male | female | other | unknown
Control | 0..1
Binding | The codes SHALL be taken from AdministrativeGender (required to `http://hl7.org/fhir/ValueSet/administrative-gender` ) The gender of a person used for administrative purposes.
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Requirements | Needed to address the person correctly.
342. Patient.contact.organization
Definition | Organization on behalf of which the contact is acting or for which the contact is working.
Short | Organization that is associated with the contact
Control | 0..1 This element is affected by the following invariants: pat-1
Type | Reference(Organization)
Requirements | For guardians or business related contacts, the organization is relevant.
344. Patient.contact.period
Definition | The period during which this contact person or organization is valid to be contacted relating to this patient.
Short | The period during which this contact person or organization is valid to be contacted relating to this patient
Control | 0..1
Type | Period
346. Patient.animal
Definition | This patient is known to be an animal.
Short | This 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).
Control | 0..1
Type | BackboneElement
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Summary | true
Requirements | Many clinical systems are extended to care for animal patients as well as human.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() | (children().count() > id.count())`)
348. 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.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
350. 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
352. 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.
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Summary | true
Alternate Names | extensions, user content, modifiers
354. Patient.animal.species
Definition | Identifies the high level taxonomic categorization of the kind of animal.
Short | E.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.).
Control | 1..1
Binding | For example codes, see AnimalSpecies (example to `http://hl7.org/fhir/ValueSet/animal-species` ) The species of an animal.
Type | CodeableConcept
Summary | true
Requirements | Need to know what kind of animal.
356. Patient.animal.breed
Definition | Identifies the detailed categorization of the kind of animal.
Short | E.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.
Control | 0..1
Binding | For example codes, see AnimalBreeds (example to `http://hl7.org/fhir/ValueSet/animal-breeds` ) The breed of an animal.
Type | CodeableConcept
Summary | true
Requirements | May need to know the specific kind within the species.
358. Patient.animal.genderStatus
Definition | Indicates the current state of the animal's reproductive organs.
Short | E.g. Neutered, Intact
Control | 0..1
Binding | For example codes, see GenderStatus (example to `http://hl7.org/fhir/ValueSet/animal-genderstatus` ) The state of the animal's reproductive organs.
Type | CodeableConcept
Summary | true
Requirements | Gender status can affect housing and animal behavior.
360. Patient.communication
Definition | Languages which may be used to communicate with the patient about his or her health.
Short | A 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.
Control | 0..*
Type | BackboneElement
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 Names | Taalvaardigheid
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() | (children().count() > id.count())`)
362. 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.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
364. Patient.communication.extension
Definition | Changed: 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.
Short | Changed:Additional Content defined by implementations
Comments | Added: 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This 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
366. Patient.communication.extension:languageProficiency
Slice Name | languageProficiency
Definition | Proficiency level of the communication.
Short | Proficiency 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)
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(proficiency) (Complex Extension)
Alternate Names | extensions, user content
Invariants | ele-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.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.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
370. Patient.communication.extension:languageProficiency.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.
Short | Additional 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.
Control | 2..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This 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
372. Patient.communication.extension:languageProficiency.extension:type
Slice Name | type
Definition | What type of communication for the proficiency (spoken, written, etc.).
Short | The proficiency type of the communication
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.
Control | 1..1
Type | Extension
Alternate Names | extensions, user content
374. 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.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
376. 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.
Short | Additional 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.
Control | 0..0
Type | Extension
Alternate Names | extensions, user content
Slicing | This 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
378. Patient.communication.extension:languageProficiency.extension:type.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `type`
380. Patient.communication.extension:languageProficiency.extension:type.valueCoding:valueCoding
Slice Name | valueCoding
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).
Short | Value of extension
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from LanguageAbilityMode (extensible to `http://hl7.org/fhir/ValueSet/v3-LanguageAbilityMode` ) The proficiency type for the communication.
Type | Coding
382. Patient.communication.extension:languageProficiency.extension:level
Slice Name | level
Definition | How well the patient can communicate this communication (good, poor, etc.).
Short | The proficiency level of the communication
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.
Control | 1..1
Type | Extension
Alternate Names | extensions, user content
384. 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.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
386. 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.
Short | Additional 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.
Control | 0..0
Type | Extension
Alternate Names | extensions, user content
Slicing | This 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
388. Patient.communication.extension:languageProficiency.extension:level.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `level`
390. Patient.communication.extension:languageProficiency.extension:level.valueCoding:valueCoding
Slice Name | valueCoding
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).
Short | Value of extension
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from LanguageAbilityProficiency (extensible to `http://hl7.org/fhir/ValueSet/v3-LanguageAbilityProficiency` ) The proficiency level for the communication.
Type | Coding
392. Patient.communication.extension:languageProficiency.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `http://nictiz.nl/fhir/StructureDefinition/patient-proficiency`
394. 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).
Short | Value of extension
Control | 0..0
Type | Choice 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 Value | This primitive element may be present, or absent, or replaced by an extension
396. Patient.communication.extension:comment
Slice Name | comment
Definition | Optional Extension Element - found in all resources.
Short | Comment
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.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(Comment) (Extension Type: string)
Alternate Names | extensions, user content, Toelichting
Invariants | ele-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()`)
398. 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.
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Summary | true
Alternate Names | extensions, user content, modifiers
400. 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.
Short | CommunicationLanguage
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.
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from Common Languages (extensible to `http://hl7.org/fhir/ValueSet/languages` ) A human language.
Additional Bindings | Purpose
All Languages | Max Binding
Type | CodeableConcept
Requirements | Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.
Alternate Names | CommunicatieTaal
402. Patient.communication.preferred
Definition | Indicates whether or not the patient prefers this language (over other languages he masters up a certain level).
Short | Language preference indicator
Comments | This language is specifically identified for communicating healthcare information.
Control | 0..1
Type | boolean
Primitive Value | This 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.
404. Patient.generalPractitioner
Definition | Patient's nominated care provider.
Short | GeneralPractitioner
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.
Control | 0..1
Type | Reference(nl-core-organization, nl-core-practitioner)
Alternate Names | careProvider, Huisarts
406. 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.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
408. Patient.generalPractitioner.extension
Definition | Changed: 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.
Short | Changed:Additional Content defined by implementations
Comments | Added: 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This 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
410. Patient.generalPractitioner.extension:practitionerRole
Slice Name | practitionerRole
Definition | Optional Extension Element - found in all resources.
Short | Optional Extensions Element
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.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(PractitionerRole Reference) (Extension Type: Reference)
Alternate Names | extensions, user content
Invariants | ele-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()`)
412. 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.
Short | Literal 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.
Control | 0..1 This element is affected by the following invariants: ref-1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
414. 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.
Short | Logical 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.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1
Type | Identifier
Summary | true
416. Patient.generalPractitioner.display
Definition | Plain text narrative that identifies the resource in addition to the resource reference.
Short | Text 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.
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
418. Patient.managingOrganization
Definition | Organization that is the custodian of the patient record.
Short | Organization 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).
Control | 0..1
Type | Reference(Organization)
Must Support | true
Summary | true
Requirements | Need to know who recognizes this patient record, manages and updates it.
420. Patient.link
Definition | Link to another patient resource that concerns the same actual patient.
Short | Link 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'.
Control | 0..*
Type | BackboneElement
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Summary | true
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.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() | (children().count() > id.count())`)
422. 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.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
424. 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
426. 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.
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Summary | true
Alternate Names | extensions, user content, modifiers
428. Patient.link.other
Definition | The other patient resource that the link refers to.
Short | The 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.
Control | 1..1
Type | Reference(Patient, RelatedPerson)
Summary | true
430. Patient.link.type
Definition | The type of link between this patient resource and another patient resource.
Short | replaced-by | replaces | refer | seealso - type of link
Control | 1..1
Binding | The codes SHALL be taken from LinkType (required to `http://hl7.org/fhir/ValueSet/link-type` ) The type of link between this patient resource and another patient resource.
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true