NHDR Implementation Guide Release 1.0
0.1.0 - ci-build

NHDR Implementation Guide Release 1.0, published by NHDR. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/UP-Manila-SILab/PhilHealth-NHDR-IG-Review/ and changes regularly. See the Directory of published versions

Resource Profile: PH_Practitioner - Detailed Descriptions

Page standards status: Draft

Definitions for the PH-Practitioner resource profile.

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

0. Practitioner
Definition

A person who is directly involved in the provisioning of healthcare.


A person who is directly or indirectly involved in the provisioning of healthcare.

ShortA person with a formal responsibility in the provisioning of healthcare or related services
Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. Practitioner.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..01
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Practitioner.language
Definition

The base language in which the resource is written.

ShortLanguage of the resource content
Comments

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

Control0..01
BindingThe codes SHOULD be taken from CommonLanguageshttp://hl7.org/fhir/ValueSet/languages|4.0.1
(preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. Practitioner.text
Definition

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

ShortText summary of the resource, for human interpretation
Comments

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

Control0..01
TypeNarrative
Is Modifierfalse
Summaryfalse
Alternate Namesnarrative, html, xhtml, display
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. Practitioner.contained
Definition

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

ShortContained, inline Resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Control0..0*
TypeResource
Is Modifierfalse
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
10. Practitioner.extension
Definition

An Extension


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

ShortExtensionAdditional content defined by implementations
Comments

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

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Practitioner.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 12. Practitioner.extension:sex
    Slice Namesex
    Definition

    Extension to capture the sex of a patient, practitioner, or person.

    ShortSex at birth
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Sex at birth) (Extension Type: code)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    14. Practitioner.extension:nationality
    Slice Namenationality
    Definition

    The nationality of the patient.

    ShortNationality
    Control0..*
    TypeExtension(Patient Nationality) (Complex Extension)
    Is Modifierfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    16. Practitioner.extension:maritalStatus
    Slice NamemaritalStatus
    Definition

    Marital Status

    ShortMarital Status
    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension(Marital Status) (Extension Type: CodeableConcept)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    18. Practitioner.modifierExtension
    Definition

    An Extension


    May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and 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.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    ShortExtensionExtensions that cannot be ignored
    Comments

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

    Control0..0*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
    Summaryfalse
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    20. Practitioner.identifier
    Definition

    An identifier that applies to this person in this role.

    ShortAn identifier for the person as this agent
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..1*
    TypeIdentifier
    Is Modifierfalse
    Summarytrue
    Requirements

    Often, specific identities are assigned for the agent.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    22. Practitioner.address
    Definition

    Address(es) of the practitioner that are not role specific (typically home address). Work addresses are not typically entered in this property as they are usually role dependent.

    ShortAddress(es) of the practitioner that are not role specific (typically home address)
    Comments

    The PractitionerRole does not have an address value on it, as it is expected that the location property be used for this purpose (which has an address).

    Control0..*
    TypeAddress(PH Address)
    Is Modifierfalse
    Summarytrue
    Requirements

    The home/mailing address of the practitioner is often required for employee administration purposes, and also for some rostering services where the start point (practitioners home) can be used in calculations.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    24. Practitioner.address.id
    Definition

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

    ShortUnique id for inter-element referencing
    Control0..01
    Typestring
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    26. Practitioner.address.extension:region
    Slice Nameregion
    Definition

    Code of the region from the standard geographic code.

    ShortRegion code
    Control0..1
    TypeExtension(Region code) (Extension Type: Coding)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    28. Practitioner.address.extension:province
    Slice Nameprovince
    Definition

    Code of the province from the standard geographic code.

    ShortExtension
    Control0..1
    TypeExtension(Province) (Extension Type: Coding)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    30. Practitioner.address.extension:cityMunicipality
    Slice NamecityMunicipality
    Definition

    Code of the city/municipality from the standard geographic code.

    ShortCity Code
    Control0..1
    TypeExtension(City Code) (Extension Type: Coding)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    32. Practitioner.address.extension:barangay
    Slice Namebarangay
    Definition

    Code of the barangay from the standard geographic code.

    ShortBarangay Code
    Control0..1
    TypeExtension(Barangay Code) (Extension Type: Coding)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    34. Practitioner.address.use
    Definition

    The purpose of this address.

    Shorthome | work | temp | old | billing - purpose of this address
    Comments

    Applications can assume that an address is current unless it explicitly says that it is temporary or old.

    Control0..01
    BindingThe codes SHALL be taken from AddressUsehttp://hl7.org/fhir/ValueSet/address-use|4.0.1
    (required to http://hl7.org/fhir/ValueSet/address-use|4.0.1)

    The use of an address.

    Typecode
    Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

    Allows an appropriate address to be chosen from a list of many.

    ExampleGeneral: home
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    36. Practitioner.address.type
    Definition

    Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both.

    Shortpostal | physical | both
    Comments

    The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource).


    The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource).

    Control0..01
    BindingThe codes SHALL be taken from AddressTypehttp://hl7.org/fhir/ValueSet/address-type|4.0.1
    (required to http://hl7.org/fhir/ValueSet/address-type|4.0.1)

    The type of an address (physical / postal).

    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    ExampleGeneral: both
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    38. Practitioner.address.text
    Definition

    Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts.

    ShortText representation of the address
    Comments

    Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

    Control0..01
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

    A renderable, unencoded form.

    ExampleGeneral: 137 Nowhere Street, Erewhon 9132
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    40. Practitioner.address.city
    Definition

    The name of the city, town, suburb, village or other community or delivery center.

    ShortName of city, town etc.
    Control0..01
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Alternate NamesMunicpality
    ExampleGeneral: Erewhon
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    42. Practitioner.address.state
    Definition

    Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes).

    ShortSub-unit of country (abbreviations ok)
    Control0..01
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Alternate NamesProvince, Territory
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    44. Practitioner.address.country
    Definition

    Country - a nation as commonly understood or generally accepted.

    ShortCountry (e.g. can be ISO 3166 2 or 3 letter code)
    Comments

    ISO 3166 3 letter codes can be used in place of a human readable country name.

    Control0..01
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    46. Practitioner.address.period
    Definition

    Time period when address was/is in use.

    ShortTime period when address was/is in use
    Control0..01
    TypePeriod
    Is Modifierfalse
    Summarytrue
    Requirements

    Allows addresses to be placed in historical context.

    ExampleGeneral: { "start" : "2010-03-23", "end" : "2010-07-01" }
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    48. Practitioner.gender
    Definition

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

    Shortmale | female | other | unknown
    Control0..01
    BindingThe codes SHALL be taken from AdministrativeGenderhttp://hl7.org/fhir/ValueSet/administrative-gender|4.0.1
    (required to http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1)

    The gender of a person used for administrative purposes.

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

    Needed to address the person correctly.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    50. Practitioner.birthDate
    Definition

    The date of birth for the practitioner.

    ShortThe date on which the practitioner was born
    Control0..01
    Typedate
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

    Needed for identification.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    52. Practitioner.photo
    Definition

    Image of the person.

    ShortImage of the person
    Control0..0*
    TypeAttachment
    Is Modifierfalse
    Summaryfalse
    Requirements

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

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    54. Practitioner.qualification
    Definition

    The official certifications, training, and licenses that authorize or otherwise pertain to the provision of care by the practitioner. For example, a medical license issued by a medical board authorizing the practitioner to practice medicine within a certian locality.

    ShortCertification, licenses, or training pertaining to the provision of care
    Control0..0*
    TypeBackboneElement
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    58. Practitioner.communication
    Definition

    A language the practitioner can use in patient communication.

    ShortA language the practitioner can use in patient communication
    Comments

    The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.

    Control0..0*
    BindingThe codes SHOULD be taken from CommonLanguageshttp://hl7.org/fhir/ValueSet/languages|4.0.1
    (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

    A human language.

    Additional BindingsPurpose
    AllLanguagesMax Binding
    TypeCodeableConcept
    Is Modifierfalse
    Summaryfalse
    Requirements

    Knowing which language a practitioner speaks can help in facilitating communication with patients.

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

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

    0. Practitioner
    Definition

    A person who is directly involved in the provisioning of healthcare.

    2. Practitioner.meta
    4. Practitioner.meta.extension:hfRecordedDate
    Slice NamehfRecordedDate
    Control0..1
    TypeExtension(The recorded date indicating when the record was uploaded by the health facility.) (Extension Type: dateTime)
    6. Practitioner.meta.extension:hfLastUpdated
    Slice NamehfLastUpdated
    Control0..*
    TypeExtension(The date indicating when the record was last updated by the health facility.) (Extension Type: dateTime)
    8. Practitioner.meta.lastUpdated
    ShortWhen the resource was uploaded to the NHDR.
    10. Practitioner.implicitRules
    Control0..0
    12. Practitioner.language
    Control0..0
    14. Practitioner.text
    Control0..0
    16. Practitioner.contained
    Control0..0
    18. Practitioner.extension
    SlicingThis element introduces a set of slices on Practitioner.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 20. Practitioner.extension:sex
      Slice Namesex
      Control0..1
      TypeExtension(Sex at birth) (Extension Type: code)
      22. Practitioner.extension:nationality
      Slice Namenationality
      Control0..*
      TypeExtension(Patient Nationality) (Complex Extension)
      24. Practitioner.extension:maritalStatus
      Slice NamemaritalStatus
      Control0..*
      TypeExtension(Marital Status) (Extension Type: CodeableConcept)
      26. Practitioner.modifierExtension
      Control0..0
      28. Practitioner.identifier
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..1
      30. Practitioner.name
      32. Practitioner.name.id
      Control0..0
      34. Practitioner.name.extension
      Control0..0
      36. Practitioner.name.use
      Control0..0
      38. Practitioner.name.text
      Control0..0
      40. Practitioner.name.prefix
      Control0..0
      42. Practitioner.name.period
      Control0..0
      44. Practitioner.telecom
      46. Practitioner.telecom.id
      Control0..0
      48. Practitioner.telecom.extension
      Control0..0
      50. Practitioner.telecom.use
      Control0..0
      52. Practitioner.telecom.rank
      Control0..0
      54. Practitioner.telecom.period
      Control0..0
      56. Practitioner.address
      TypeAddress(PH Address)
      58. Practitioner.address.country
      Control0..0
      60. Practitioner.gender
      Control0..0
      62. Practitioner.birthDate
      Control0..0
      64. Practitioner.photo
      Control0..0
      66. Practitioner.qualification
      Control0..0
      68. Practitioner.communication
      Control0..0

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

      0. Practitioner
      Definition

      A person who is directly involved in the provisioning of healthcare.

      ShortA person with a formal responsibility in the provisioning of healthcare or related services
      Control0..*
      Is Modifierfalse
      Summaryfalse
      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
      dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
      dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      2. Practitioner.id
      Definition

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

      ShortLogical id of this artifact
      Comments

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

      Control0..1
      Typeid
      Is Modifierfalse
      Summarytrue
      4. Practitioner.meta
      Definition

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

      ShortMetadata about the resource
      Control0..1
      TypeMeta
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      6. Practitioner.meta.id
      Definition

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

      ShortUnique id for inter-element referencing
      Control0..1
      Typestring
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      8. Practitioner.meta.extension
      Definition

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

      ShortAdditional content defined by implementations
      Comments

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

      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on Practitioner.meta.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 10. Practitioner.meta.extension:hfRecordedDate
        Slice NamehfRecordedDate
        Definition

        The recorded date indicating when the record was uploaded by the health facility.

        ShortThe recorded date indicating when the record was uploaded by the health facility.
        Control0..1
        TypeExtension(The recorded date indicating when the record was uploaded by the health facility.) (Extension Type: dateTime)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        12. Practitioner.meta.extension:hfLastUpdated
        Slice NamehfLastUpdated
        Definition

        The date indicating when the record was last updated by the health facility.

        ShortThe date indicating when the record was last updated by the health facility.
        Control0..*
        TypeExtension(The date indicating when the record was last updated by the health facility.) (Extension Type: dateTime)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        14. Practitioner.meta.versionId
        Definition

        The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

        ShortVersion specific identifier
        Comments

        The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

        Control0..1
        Typeid
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        16. Practitioner.meta.lastUpdated
        Definition

        When the resource last changed - e.g. when the version changed.

        ShortWhen the resource was uploaded to the NHDR.
        Comments

        This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

        Control0..1
        Typeinstant
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        18. Practitioner.meta.source
        Definition

        A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

        ShortIdentifies where the resource comes from
        Comments

        In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

        This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

        Control0..1
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        20. Practitioner.meta.profile
        Definition

        A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

        ShortProfiles this resource claims to conform to
        Comments

        It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

        Control0..*
        Typecanonical(StructureDefinition)
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        22. Practitioner.meta.security
        Definition

        Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

        ShortSecurity Labels applied to this resource
        Comments

        The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

        Control0..*
        BindingUnless not suitable, these codes SHALL be taken from All Security Labels
        (extensible to http://hl7.org/fhir/ValueSet/security-labels|4.0.1)

        Security Labels from the Healthcare Privacy and Security Classification System.

        TypeCoding
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        24. Practitioner.meta.tag
        Definition

        Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

        ShortTags applied to this resource
        Comments

        The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

        Control0..*
        BindingFor example codes, see CommonTags
        (example to http://hl7.org/fhir/ValueSet/common-tags|4.0.1)

        Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

        TypeCoding
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        26. Practitioner.implicitRules
        Definition

        A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

        ShortA set of rules under which this content was created
        Comments

        Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

        Control0..0
        Typeuri
        Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        28. Practitioner.language
        Definition

        The base language in which the resource is written.

        ShortLanguage of the resource content
        Comments

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

        Control0..0
        BindingThe codes SHOULD be taken from CommonLanguages
        (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

        A human language.

        Additional BindingsPurpose
        AllLanguagesMax Binding
        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        30. Practitioner.text
        Definition

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

        ShortText summary of the resource, for human interpretation
        Comments

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

        Control0..0
        TypeNarrative
        Is Modifierfalse
        Summaryfalse
        Alternate Namesnarrative, html, xhtml, display
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        32. Practitioner.contained
        Definition

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

        ShortContained, inline Resources
        Comments

        This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

        Control0..0
        TypeResource
        Is Modifierfalse
        Summaryfalse
        Alternate Namesinline resources, anonymous resources, contained resources
        34. Practitioner.extension
        Definition

        An Extension

        ShortExtension
        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on Practitioner.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 36. Practitioner.extension:sex
          Slice Namesex
          Definition

          Extension to capture the sex of a patient, practitioner, or person.

          ShortSex at birth
          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(Sex at birth) (Extension Type: code)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          38. Practitioner.extension:nationality
          Slice Namenationality
          Definition

          The nationality of the patient.

          ShortNationality
          Control0..*
          TypeExtension(Patient Nationality) (Complex Extension)
          Is Modifierfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          40. Practitioner.extension:maritalStatus
          Slice NamemaritalStatus
          Definition

          Marital Status

          ShortMarital Status
          Control0..*
          This element is affected by the following invariants: ele-1
          TypeExtension(Marital Status) (Extension Type: CodeableConcept)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          42. Practitioner.modifierExtension
          Definition

          An Extension

          ShortExtension
          Control0..0
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          44. Practitioner.identifier
          Definition

          An identifier that applies to this person in this role.

          ShortAn identifier for the person as this agent
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..1
          TypeIdentifier
          Is Modifierfalse
          Summarytrue
          Requirements

          Often, specific identities are assigned for the agent.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          46. Practitioner.active
          Definition

          Whether this practitioner's record is in active use.

          ShortWhether this practitioner's record is in active use
          Comments

          If the practitioner is not in use by one organization, then it should mark the period on the PractitonerRole with an end date (even if they are active) as they may be active in another role.

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

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

          Meaning if MissingThis resource is generally assumed to be active if no value is provided for the active element
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          48. Practitioner.name
          Definition

          The name(s) associated with the practitioner.

          ShortThe name(s) associated with the practitioner
          Comments

          The selection of the use property should ensure that there is a single usual name specified, and others use the nickname (alias), old, or other values as appropriate.

          In general, select the value to be used in the ResourceReference.display based on this:

          1. There is more than 1 name
          2. Use = usual
          3. Period is current to the date of the usage
          4. Use = official
          5. Other order as decided by internal business rules.
          Control0..*
          TypeHumanName
          Is Modifierfalse
          Summarytrue
          Requirements

          The name(s) that a Practitioner is known by. Where there are multiple, the name that the practitioner is usually known as should be used in the display.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          50. Practitioner.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.

          ShortUnique id for inter-element referencing
          Control0..0
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          52. Practitioner.name.extension
          Definition

          An Extension

          ShortExtension
          Control0..0
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on Practitioner.name.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 54. Practitioner.name.use
            Definition

            Identifies the purpose for this name.

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

            Applications can assume that a name is current unless it explicitly says that it is temporary or old.

            Control0..0
            BindingThe codes SHALL be taken from NameUse
            (required to http://hl7.org/fhir/ValueSet/name-use|4.0.1)

            The use of a human name.

            Typecode
            Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

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

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            56. Practitioner.name.text
            Definition

            Specifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts.

            ShortText representation of the full name
            Comments

            Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

            Control0..0
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            A renderable, unencoded form.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            58. Practitioner.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.

            ShortFamily name (often called 'Surname')
            Comments

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

            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Alternate Namessurname
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            60. Practitioner.name.given
            Definition

            Given name.

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

            If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first.

            Control0..*
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Alternate Namesfirst name, middle name
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            62. Practitioner.name.prefix
            Definition

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

            ShortParts that come before the name
            Control0..0
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            64. Practitioner.name.suffix
            Definition

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

            ShortParts that come after the name
            Control0..*
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            66. Practitioner.name.period
            Definition

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

            ShortTime period when name was/is in use
            Control0..0
            TypePeriod
            Is Modifierfalse
            Summarytrue
            Requirements

            Allows names to be placed in historical context.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            68. Practitioner.telecom
            Definition

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

            ShortA contact detail for the practitioner (that apply to all roles)
            Comments

            Person may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and to help with identification. These typically will have home numbers, or mobile numbers that are not role specific.

            Control0..*
            TypeContactPoint
            Is Modifierfalse
            Summarytrue
            Requirements

            Need to know how to reach a practitioner independent to any roles the practitioner may have.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            70. Practitioner.telecom.id
            Definition

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

            ShortUnique id for inter-element referencing
            Control0..0
            Typestring
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            72. Practitioner.telecom.extension
            Definition

            An Extension

            ShortExtension
            Control0..0
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on Practitioner.telecom.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 74. Practitioner.telecom.system
              Definition

              Telecommunications form for contact point - what communications system is required to make use of the contact.

              Shortphone | fax | email | pager | url | sms | other
              Control0..1
              This element is affected by the following invariants: cpt-2
              BindingThe codes SHALL be taken from ContactPointSystem
              (required to http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1)

              Telecommunications form for contact point.

              Typecode
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              76. Practitioner.telecom.value
              Definition

              The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

              ShortThe actual contact point details
              Comments

              Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

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

              Need to support legacy numbers that are not in a tightly controlled format.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              78. Practitioner.telecom.use
              Definition

              Identifies the purpose for the contact point.

              Shorthome | work | temp | old | mobile - purpose of this contact point
              Comments

              Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

              Control0..0
              BindingThe codes SHALL be taken from ContactPointUse
              (required to http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1)

              Use of contact point.

              Typecode
              Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              80. Practitioner.telecom.rank
              Definition

              Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.

              ShortSpecify preferred order of use (1 = highest)
              Comments

              Note that rank does not necessarily follow the order in which the contacts are represented in the instance.

              Control0..0
              TypepositiveInt
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              82. Practitioner.telecom.period
              Definition

              Time period when the contact point was/is in use.

              ShortTime period when the contact point was/is in use
              Control0..0
              TypePeriod
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              84. Practitioner.address
              Definition

              Address(es) of the practitioner that are not role specific (typically home address). Work addresses are not typically entered in this property as they are usually role dependent.

              ShortAddress(es) of the practitioner that are not role specific (typically home address)
              Comments

              The PractitionerRole does not have an address value on it, as it is expected that the location property be used for this purpose (which has an address).

              Control0..*
              TypeAddress(PH Address)
              Is Modifierfalse
              Summarytrue
              Requirements

              The home/mailing address of the practitioner is often required for employee administration purposes, and also for some rostering services where the start point (practitioners home) can be used in calculations.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              86. Practitioner.address.id
              Definition

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

              ShortUnique id for inter-element referencing
              Control0..0
              Typestring
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              88. Practitioner.address.extension
              Definition

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

              ShortAdditional content defined by implementations
              Comments

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

              Control0..*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingThis element introduces a set of slices on Practitioner.address.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 90. Practitioner.address.extension:region
                Slice Nameregion
                Definition

                Code of the region from the standard geographic code.

                ShortRegion code
                Control0..1
                TypeExtension(Region code) (Extension Type: Coding)
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                92. Practitioner.address.extension:province
                Slice Nameprovince
                Definition

                Code of the province from the standard geographic code.

                ShortExtension
                Control0..1
                TypeExtension(Province) (Extension Type: Coding)
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                94. Practitioner.address.extension:cityMunicipality
                Slice NamecityMunicipality
                Definition

                Code of the city/municipality from the standard geographic code.

                ShortCity Code
                Control0..1
                TypeExtension(City Code) (Extension Type: Coding)
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                96. Practitioner.address.extension:barangay
                Slice Namebarangay
                Definition

                Code of the barangay from the standard geographic code.

                ShortBarangay Code
                Control0..1
                TypeExtension(Barangay Code) (Extension Type: Coding)
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                98. Practitioner.address.use
                Definition

                The purpose of this address.

                Shorthome | work | temp | old | billing - purpose of this address
                Comments

                Applications can assume that an address is current unless it explicitly says that it is temporary or old.

                Control0..0
                BindingThe codes SHALL be taken from AddressUse
                (required to http://hl7.org/fhir/ValueSet/address-use|4.0.1)

                The use of an address.

                Typecode
                Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                Allows an appropriate address to be chosen from a list of many.

                ExampleGeneral: home
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                100. Practitioner.address.type
                Definition

                Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both.

                Shortpostal | physical | both
                Comments

                The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource).

                Control0..0
                BindingThe codes SHALL be taken from AddressType
                (required to http://hl7.org/fhir/ValueSet/address-type|4.0.1)

                The type of an address (physical / postal).

                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                ExampleGeneral: both
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                102. Practitioner.address.text
                Definition

                Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts.

                ShortText representation of the address
                Comments

                Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

                Control0..0
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                A renderable, unencoded form.

                ExampleGeneral: 137 Nowhere Street, Erewhon 9132
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                104. Practitioner.address.line
                Definition

                This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.

                ShortStreet name, number, direction & P.O. Box etc.
                Control0..*
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                ExampleGeneral: 137 Nowhere Street
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                106. Practitioner.address.city
                Definition

                The name of the city, town, suburb, village or other community or delivery center.

                ShortName of city, town etc.
                Control0..0
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Alternate NamesMunicpality
                ExampleGeneral: Erewhon
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                108. Practitioner.address.district
                Definition

                The name of the administrative area (county).

                ShortDistrict name (aka county)
                Comments

                District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.

                Control0..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Alternate NamesCounty
                ExampleGeneral: Madison
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                110. Practitioner.address.state
                Definition

                Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes).

                ShortSub-unit of country (abbreviations ok)
                Control0..0
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Alternate NamesProvince, Territory
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                112. Practitioner.address.postalCode
                Definition

                A postal code designating a region defined by the postal service.

                ShortPostal code for area
                Control0..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Alternate NamesZip
                ExampleGeneral: 9132
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                114. Practitioner.address.country
                Definition

                Country - a nation as commonly understood or generally accepted.

                ShortCountry (e.g. can be ISO 3166 2 or 3 letter code)
                Comments

                ISO 3166 3 letter codes can be used in place of a human readable country name.

                Control0..0
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                116. Practitioner.address.period
                Definition

                Time period when address was/is in use.

                ShortTime period when address was/is in use
                Control0..0
                TypePeriod
                Is Modifierfalse
                Summarytrue
                Requirements

                Allows addresses to be placed in historical context.

                ExampleGeneral: { "start" : "2010-03-23", "end" : "2010-07-01" }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                118. Practitioner.gender
                Definition

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

                Shortmale | female | other | unknown
                Control0..0
                BindingThe codes SHALL be taken from AdministrativeGender
                (required to http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1)

                The gender of a person used for administrative purposes.

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

                Needed to address the person correctly.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                120. Practitioner.birthDate
                Definition

                The date of birth for the practitioner.

                ShortThe date on which the practitioner was born
                Control0..0
                Typedate
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                Needed for identification.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                122. Practitioner.photo
                Definition

                Image of the person.

                ShortImage of the person
                Control0..0
                TypeAttachment
                Is Modifierfalse
                Summaryfalse
                Requirements

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

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                124. Practitioner.qualification
                Definition

                The official certifications, training, and licenses that authorize or otherwise pertain to the provision of care by the practitioner. For example, a medical license issued by a medical board authorizing the practitioner to practice medicine within a certian locality.

                ShortCertification, licenses, or training pertaining to the provision of care
                Control0..0
                TypeBackboneElement
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                133. Practitioner.communication
                Definition

                A language the practitioner can use in patient communication.

                ShortA language the practitioner can use in patient communication
                Comments

                The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.

                Control0..0
                BindingThe codes SHOULD be taken from CommonLanguages
                (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

                A human language.

                Additional BindingsPurpose
                AllLanguagesMax Binding
                TypeCodeableConcept
                Is Modifierfalse
                Summaryfalse
                Requirements

                Knowing which language a practitioner speaks can help in facilitating communication with patients.

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