Introduction

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

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

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

• Patient Name

• Address that is more specific than a state

  • First 3 digits of Zipcodes can be included if the population of all zipcodes starting with the same 3 digits are > 20000 people and the last 2 digits should be masked with "00", in all other cases, the zipcodes have to be masked to 00000.
• All dates should not have a precision of more than the year. This means month and day cannot be included.
• Demographics including birthdate, deceased indicator
• Patient contact details such as telephone numbers, fax, email, URLs,
• Patient personal identifiers such as SSN, Drivers License,
• Business identifiers such as MRNs, certificate numbers, Account numbers
• Biometrics such as fingerprints, photos

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

Age Computation

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

Id Generation

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

Date Truncation

The Data Submitter has to truncate the following dates to only have a precision of year

• deceased[x] when the data type used is dateTime.

Usage of Data Absent Reason Extension

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

Race and Ethnicity Additional Constraints

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

Birth Sex vs Sex

Healthcenters are enouraged to use the uds-plus-sex-extension to capture the sex of the patient. This is in alignment with the CMS Sex codes and the UDS Manual. However, this change was implemented recently and in order to allow Healthcenters and their vendors who have already tested the 2024 reporting changes the uds-plus-birthsex-extension can be used to convey sex in the patient profile. The uds-plus-birthsex-extension is also enhanced to allow the SNOMED sex codes in addition to the HL7 AdministrativeGender codes that were previously allowed. The cardinality is relaxed from 1..1 to 0..1 but one of either uds-plus-sex or uds-plus-birthsex-extension should be present.

Birth Sex/Sex Null Flavors

NullFlavors are allowed to be sent for this reporting cycle even though they are not in the valueset. The NullFlavor support will be removed in future versions of the IG.

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

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Patient		0..*	Patient	De-Identified UDS Plus Patient
Patient.id	S This element must be supported. Σ This element is included in summaries.	0..1	id	The de-identified patient identifier created by the health center to send data to HRSA.
Patient.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Patient.Slices for extension		3..*	Extension	Extension Slice: Unordered, Open by value:url
Patient.Slices for extension.extension:uds-plus-race	S This element must be supported.	1..1	(Complex)	Indicates the race of the Patient. URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-race profiled by http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-race-extension
Patient.Slices for extension.extension:uds-plus-ethnicty	S This element must be supported.	1..1	(Complex)	Indicates the ethnicity of the Patient. URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity profiled by http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-ethnicity-extension
Patient.Slices for extension.extension:uds-plus-birthsex	S This element must be supported.	0..1	code	Indicates the Birth sex of the Patient. URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-birthsex-extension Binding: Uds Plus Sex Codes (extensible): The set of codes to be used for UDS+ reporting.
Patient.Slices for extension.extension:uds-plus-sex	S This element must be supported.	0..1	code	Indicates the sex of the Patient. URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-sex-extension Binding: https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1021.121/expansion/ (extensible): The set of sex codes to be used for UDS+ reporting.
Patient.Slices for extension.extension:uds-plus-age-extension	S This element must be supported.	1..1	Quantity	Age of the Patient computed using birthDate and the reporting period reference URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-age-extension
Patient.Slices for extension.extension:uds-plus-agriculture-worker-status	S This element must be supported.	0..1	code	Agriculture Status of the patient URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/udsplus-agriculture-worker-status Binding: Uds Plus Agriculture Worker Status Codes (extensible)
Patient.Slices for extension.extension:uds-plus-housing-status	S This element must be supported.	0..1	code	Housing Status of the patient URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-housing-status-extension Binding: Uds Plus Housing Status Codes (extensible)
Patient.Slices for extension.extension:uds-plus-veteran-status	S This element must be supported.	0..1	boolean	Veteran Status of the patient URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-veteran-status-extension
Patient.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
Patient.active	?! This element is a modifier element. Σ This element is included in summaries.	0..1	boolean	Whether this patient's record is in active use
Patient.deceased[x]	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries. C	0..1		Indicates if the Patient is deceased, it can be either a Boolean or a Date with a precision of year only. Constraints: uds-plus-pat-1, uds-plus-pat-1a, uds-plus-pat-1b
Patient.deceased[x].deceasedDateTime			dateTime S This target must be supported.
Patient.deceased[x].deceasedBoolean			boolean S This target must be supported.
Patient.address	S This element must be supported. Σ This element is included in summaries.	1..1	Address	Included only to support zip code
Patient.address.extension		0..0		Extension cannot be included in Address Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Patient.address.use	?! This element is a modifier element. Σ This element is included in summaries.	0..1	code	home | work | temp | old | billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
Patient.address.postalCode	S This element must be supported. Σ This element is included in summaries. C	1..1	string	ZipCode must be included in the profile Constraints: uds-plus-patient-1 Example General: 9132
Patient.address.postalCode.Slices for extension				Content/Rules for all slices
Patient.address.postalCode.Slices for extension.extension:dataAbsentReason	S This element must be supported.	0..1	(Complex)	Reason why the data is not present URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
Patient.address.postalCode.Slices for extension.extension:dataAbsentReason.extension		0..0		Extension Slice: Unordered, Open by value:url
Patient.address.postalCode.Slices for extension.extension:dataAbsentReason.url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/data-absent-reason"
Patient.address.postalCode.Slices for extension.extension:dataAbsentReason.value[x]	S This element must be supported.	1..1	code	Value of extension Binding: DataAbsentReason (required): Used to specify why the normally expected content of the data element is missing.
Patient.address.period	Σ This element is included in summaries.	0..1	Period	Address period cannot be included in the profile Example General: {"start":"2010-03-23","end":"2010-07-01"}
Patient.communication		0..*	BackboneElement	A language which may be used to communicate with the patient about his or her health
Patient.communication.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Patient.communication.language	S This element must be supported.	1..1	CodeableConcept	Language must be included in the profile Binding: Language codes with language and optionally a region modifier (extensible): The set of languages that the patient uses
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Patient.address.use	Base	required	AddressUse	📍4.0.1	FHIR Std.
Patient.address.postalCode.​extension:dataAbsentReason.​value[x]	Base	required	DataAbsentReason	📍4.0.1	FHIR Std.
Patient.communication.​language	Base	extensible	Language codes with language and optionally a region modifier	📦6.1.0	US Core v6.1
Patient.link.type	Base	required	LinkType	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Patient	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Patient	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Patient	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Patient	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Patient	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
uds-plus-pat-1	error	Patient.deceased[x]	All dateTime data elements should be truncated to a year only for de-identified resources.	$this is dateTime implies $this.toString().length() = 4
uds-plus-pat-1a	error	Patient.deceased[x]	All dateTime data elements should have valid year > 1900	$this is dateTime implies $this.toString() >= '1900'
uds-plus-pat-1b	error	Patient.deceased[x]	All dateTime data elements should have valid year < 2030	$this is dateTime implies $this.toString() <= '2030'
uds-plus-patient-1	error	Patient.address.postalCode	De-identified Zipcodes can contain first 3 digits followed by 00 in the last two digits or have to be masked with 00000. If the extended ZipCode format is used the resulting format should be #####-####.	$this.matches('^[0-9]{3}[0]{2}(-[0-9]{4})?$')

This structure is derived from Patient

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Patient		0..*	Patient	De-Identified UDS Plus Patient
Patient.id	S This element must be supported.	0..1	id	The de-identified patient identifier created by the health center to send data to HRSA.
Patient.text		0..0		Cannot include any text in the resource as part of the de-identified data.
Patient.contained		0..0		Cannot include any contained resources in the resource as part of the de-identified data.
Patient.Slices for extension				Content/Rules for all slices
Patient.Slices for extension.extension:uds-plus-race	S This element must be supported.	1..1	(Complex)	Indicates the race of the Patient. URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-race profiled by http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-race-extension
Patient.Slices for extension.extension:uds-plus-ethnicty	S This element must be supported.	1..1	(Complex)	Indicates the ethnicity of the Patient. URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity profiled by http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-ethnicity-extension
Patient.Slices for extension.extension:uds-plus-birthsex	S This element must be supported.	0..1	code	Indicates the Birth sex of the Patient. URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-birthsex-extension Binding: Uds Plus Sex Codes (extensible): The set of codes to be used for UDS+ reporting.
Patient.Slices for extension.extension:uds-plus-sex	S This element must be supported.	0..1	code	Indicates the sex of the Patient. URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-sex-extension Binding: https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1021.121/expansion/ (extensible): The set of sex codes to be used for UDS+ reporting.
Patient.Slices for extension.extension:uds-plus-age-extension	S This element must be supported.	1..1	Quantity	Age of the Patient computed using birthDate and the reporting period reference URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-age-extension
Patient.Slices for extension.extension:uds-plus-agriculture-worker-status	S This element must be supported.	0..1	code	Agriculture Status of the patient URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/udsplus-agriculture-worker-status Binding: Uds Plus Agriculture Worker Status Codes (extensible)
Patient.Slices for extension.extension:uds-plus-housing-status	S This element must be supported.	0..1	code	Housing Status of the patient URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-housing-status-extension Binding: Uds Plus Housing Status Codes (extensible)
Patient.Slices for extension.extension:uds-plus-veteran-status	S This element must be supported.	0..1	boolean	Veteran Status of the patient URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-veteran-status-extension
Patient.identifier		0..0		Cannot include any identifier in the resource as part of the de-identified data.
Patient.name		0..0		Cannot include any name in the resource as part of the de-identified data.
Patient.telecom		0..0		Cannot include any telecom information in the resource as part of the de-identified data.
Patient.birthDate		0..0		Cannot include any date of birth information in the resource as part of the de-identified data.
Patient.deceased[x]	S This element must be supported. C	0..1		Indicates if the Patient is deceased, it can be either a Boolean or a Date with a precision of year only. Constraints: uds-plus-pat-1, uds-plus-pat-1a, uds-plus-pat-1b
Patient.deceased[x].deceasedDateTime			dateTime S This target must be supported.
Patient.deceased[x].deceasedBoolean			boolean S This target must be supported.
Patient.address	S This element must be supported.	1..1	Address	Included only to support zip code
Patient.address.extension		0..0		Extension cannot be included in Address
Patient.address.text		0..0		Text cannot be included in the profile
Patient.address.line		0..0		Street names cannot be included in the profile
Patient.address.postalCode	S This element must be supported. C	1..1	string	ZipCode must be included in the profile Constraints: uds-plus-patient-1
Patient.address.postalCode.Slices for extension				Content/Rules for all slices
Patient.address.postalCode.Slices for extension.extension:dataAbsentReason	S This element must be supported.	0..1	(Complex)	Reason why the data is not present URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
Patient.address.postalCode.Slices for extension.extension:dataAbsentReason.value[x]	S This element must be supported.	1..1	code	Value of extension
Patient.address.period		0..1	Period	Address period cannot be included in the profile
Patient.maritalStatus		0..0		Cannot include information not required for UDS+
Patient.multipleBirth[x]		0..0		Cannot include information not required for UDS+
Patient.photo		0..0		Cannot include information not required for UDS+
Patient.contact		0..0		Cannot include information not required for UDS+
Patient.communication
Patient.communication.language	S This element must be supported.	1..1	CodeableConcept	Language must be included in the profile Binding: Language codes with language and optionally a region modifier (extensible): The set of languages that the patient uses
Patient.generalPractitioner		0..0		Cannot include information not required for UDS+
Patient.managingOrganization		0..0		Cannot include information not required for UDS+
Patient.link		0..0		Cannot include information not required for UDS+
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Patient.communication.​language	Base	extensible	Language codes with language and optionally a region modifier	📦6.1.0	US Core v6.1

Constraints

Id	Grade	Path(s)	Description	Expression
uds-plus-pat-1	error	Patient.deceased[x]	All dateTime data elements should be truncated to a year only for de-identified resources.	$this is dateTime implies $this.toString().length() = 4
uds-plus-pat-1a	error	Patient.deceased[x]	All dateTime data elements should have valid year > 1900	$this is dateTime implies $this.toString() >= '1900'
uds-plus-pat-1b	error	Patient.deceased[x]	All dateTime data elements should have valid year < 2030	$this is dateTime implies $this.toString() <= '2030'
uds-plus-patient-1	error	Patient.address.postalCode	De-identified Zipcodes can contain first 3 digits followed by 00 in the last two digits or have to be masked with 00000. If the extended ZipCode format is used the resulting format should be #####-####.	$this.matches('^[0-9]{3}[0]{2}(-[0-9]{4})?$')

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Patient		0..*	Patient	De-Identified UDS Plus Patient
Patient.id	S This element must be supported. Σ This element is included in summaries.	0..1	id	The de-identified patient identifier created by the health center to send data to HRSA.
Patient.meta	Σ This element is included in summaries.	0..1	Meta	Metadata about the resource
Patient.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Patient.language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
Patient.Slices for extension		3..*	Extension	Extension Slice: Unordered, Open by value:url
Patient.Slices for extension.extension:uds-plus-race	S This element must be supported.	1..1	(Complex)	Indicates the race of the Patient. URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-race profiled by http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-race-extension
Patient.Slices for extension.extension:uds-plus-ethnicty	S This element must be supported.	1..1	(Complex)	Indicates the ethnicity of the Patient. URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity profiled by http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-ethnicity-extension
Patient.Slices for extension.extension:uds-plus-birthsex	S This element must be supported.	0..1	code	Indicates the Birth sex of the Patient. URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-birthsex-extension Binding: Uds Plus Sex Codes (extensible): The set of codes to be used for UDS+ reporting.
Patient.Slices for extension.extension:uds-plus-sex	S This element must be supported.	0..1	code	Indicates the sex of the Patient. URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-sex-extension Binding: https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1021.121/expansion/ (extensible): The set of sex codes to be used for UDS+ reporting.
Patient.Slices for extension.extension:uds-plus-age-extension	S This element must be supported.	1..1	Quantity	Age of the Patient computed using birthDate and the reporting period reference URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-age-extension
Patient.Slices for extension.extension:uds-plus-agriculture-worker-status	S This element must be supported.	0..1	code	Agriculture Status of the patient URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/udsplus-agriculture-worker-status Binding: Uds Plus Agriculture Worker Status Codes (extensible)
Patient.Slices for extension.extension:uds-plus-housing-status	S This element must be supported.	0..1	code	Housing Status of the patient URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-housing-status-extension Binding: Uds Plus Housing Status Codes (extensible)
Patient.Slices for extension.extension:uds-plus-veteran-status	S This element must be supported.	0..1	boolean	Veteran Status of the patient URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-veteran-status-extension
Patient.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
Patient.active	?! This element is a modifier element. Σ This element is included in summaries.	0..1	boolean	Whether this patient's record is in active use
Patient.gender	Σ This element is included in summaries.	0..1	code	male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
Patient.deceased[x]	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries. C	0..1		Indicates if the Patient is deceased, it can be either a Boolean or a Date with a precision of year only. Constraints: uds-plus-pat-1, uds-plus-pat-1a, uds-plus-pat-1b
Patient.deceased[x].deceasedDateTime			dateTime S This target must be supported.
Patient.deceased[x].deceasedBoolean			boolean S This target must be supported.
Patient.address	S This element must be supported. Σ This element is included in summaries.	1..1	Address	Included only to support zip code
Patient.address.id		0..1	string	Unique id for inter-element referencing
Patient.address.extension		0..0		Extension cannot be included in Address Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Patient.address.use	?! This element is a modifier element. Σ This element is included in summaries.	0..1	code	home | work | temp | old | billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
Patient.address.type	Σ This element is included in summaries.	0..1	code	postal | physical | both Binding: AddressType (required): The type of an address (physical / postal). Example General: both
Patient.address.city	Σ This element is included in summaries.	0..1	string	Name of city, town etc. Example General: Erewhon
Patient.address.district	Σ This element is included in summaries.	0..1	string	District name (aka county) Example General: Madison
Patient.address.state	Σ This element is included in summaries.	0..1	string	Sub-unit of country (abbreviations ok)
Patient.address.postalCode	S This element must be supported. Σ This element is included in summaries. C	1..1	string	ZipCode must be included in the profile Constraints: uds-plus-patient-1 Example General: 9132
Patient.address.postalCode.id		0..1	string	xml:id (or equivalent in JSON)
Patient.address.postalCode.Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
Patient.address.postalCode.Slices for extension.extension:dataAbsentReason	S This element must be supported.	0..1	(Complex)	Reason why the data is not present URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
Patient.address.postalCode.Slices for extension.extension:dataAbsentReason.id		0..1	string	Unique id for inter-element referencing
Patient.address.postalCode.Slices for extension.extension:dataAbsentReason.extension		0..0		Extension Slice: Unordered, Open by value:url
Patient.address.postalCode.Slices for extension.extension:dataAbsentReason.url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/data-absent-reason"
Patient.address.postalCode.Slices for extension.extension:dataAbsentReason.value[x]	S This element must be supported.	1..1	code	Value of extension Binding: DataAbsentReason (required): Used to specify why the normally expected content of the data element is missing.
Patient.address.postalCode.value		0..1	string	Primitive value for string Max Length:1048576
Patient.address.country	Σ This element is included in summaries.	0..1	string	Country (e.g. can be ISO 3166 2 or 3 letter code)
Patient.address.period	Σ This element is included in summaries.	0..1	Period	Address period cannot be included in the profile Example General: {"start":"2010-03-23","end":"2010-07-01"}
Patient.communication		0..*	BackboneElement	A language which may be used to communicate with the patient about his or her health
Patient.communication.id		0..1	string	Unique id for inter-element referencing
Patient.communication.extension		0..*	Extension	Additional content defined by implementations
Patient.communication.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Patient.communication.language	S This element must be supported.	1..1	CodeableConcept	Language must be included in the profile Binding: Language codes with language and optionally a region modifier (extensible): The set of languages that the patient uses
Patient.communication.preferred		0..1	boolean	Language preference indicator
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Patient.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Patient.gender	Base	required	AdministrativeGender	📍4.0.1	FHIR Std.
Patient.address.use	Base	required	AddressUse	📍4.0.1	FHIR Std.
Patient.address.type	Base	required	AddressType	📍4.0.1	FHIR Std.
Patient.address.postalCode.​extension:dataAbsentReason.​value[x]	Base	required	DataAbsentReason	📍4.0.1	FHIR Std.
Patient.contact.relationship	Base	extensible	Patient Contact Relationship	📍4.0.1	FHIR Std.
Patient.contact.gender	Base	required	AdministrativeGender	📍4.0.1	FHIR Std.
Patient.communication.​language	Base	extensible	Language codes with language and optionally a region modifier	📦6.1.0	US Core v6.1
Patient.link.type	Base	required	LinkType	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Patient	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Patient	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Patient	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Patient	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Patient	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
uds-plus-pat-1	error	Patient.deceased[x]	All dateTime data elements should be truncated to a year only for de-identified resources.	$this is dateTime implies $this.toString().length() = 4
uds-plus-pat-1a	error	Patient.deceased[x]	All dateTime data elements should have valid year > 1900	$this is dateTime implies $this.toString() >= '1900'
uds-plus-pat-1b	error	Patient.deceased[x]	All dateTime data elements should have valid year < 2030	$this is dateTime implies $this.toString() <= '2030'
uds-plus-patient-1	error	Patient.address.postalCode	De-identified Zipcodes can contain first 3 digits followed by 00 in the last two digits or have to be masked with 00000. If the extended ZipCode format is used the resulting format should be #####-####.	$this.matches('^[0-9]{3}[0]{2}(-[0-9]{4})?$')

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Patient		0..*	Patient	De-Identified UDS Plus Patient
Patient.id	S This element must be supported. Σ This element is included in summaries.	0..1	id	The de-identified patient identifier created by the health center to send data to HRSA.
Patient.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Patient.Slices for extension		3..*	Extension	Extension Slice: Unordered, Open by value:url
Patient.Slices for extension.extension:uds-plus-race	S This element must be supported.	1..1	(Complex)	Indicates the race of the Patient. URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-race profiled by http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-race-extension
Patient.Slices for extension.extension:uds-plus-ethnicty	S This element must be supported.	1..1	(Complex)	Indicates the ethnicity of the Patient. URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity profiled by http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-ethnicity-extension
Patient.Slices for extension.extension:uds-plus-birthsex	S This element must be supported.	0..1	code	Indicates the Birth sex of the Patient. URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-birthsex-extension Binding: Uds Plus Sex Codes (extensible): The set of codes to be used for UDS+ reporting.
Patient.Slices for extension.extension:uds-plus-sex	S This element must be supported.	0..1	code	Indicates the sex of the Patient. URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-sex-extension Binding: https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1021.121/expansion/ (extensible): The set of sex codes to be used for UDS+ reporting.
Patient.Slices for extension.extension:uds-plus-age-extension	S This element must be supported.	1..1	Quantity	Age of the Patient computed using birthDate and the reporting period reference URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-age-extension
Patient.Slices for extension.extension:uds-plus-agriculture-worker-status	S This element must be supported.	0..1	code	Agriculture Status of the patient URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/udsplus-agriculture-worker-status Binding: Uds Plus Agriculture Worker Status Codes (extensible)
Patient.Slices for extension.extension:uds-plus-housing-status	S This element must be supported.	0..1	code	Housing Status of the patient URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-housing-status-extension Binding: Uds Plus Housing Status Codes (extensible)
Patient.Slices for extension.extension:uds-plus-veteran-status	S This element must be supported.	0..1	boolean	Veteran Status of the patient URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-veteran-status-extension
Patient.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
Patient.active	?! This element is a modifier element. Σ This element is included in summaries.	0..1	boolean	Whether this patient's record is in active use
Patient.deceased[x]	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries. C	0..1		Indicates if the Patient is deceased, it can be either a Boolean or a Date with a precision of year only. Constraints: uds-plus-pat-1, uds-plus-pat-1a, uds-plus-pat-1b
Patient.deceased[x].deceasedDateTime			dateTime S This target must be supported.
Patient.deceased[x].deceasedBoolean			boolean S This target must be supported.
Patient.address	S This element must be supported. Σ This element is included in summaries.	1..1	Address	Included only to support zip code
Patient.address.extension		0..0		Extension cannot be included in Address Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Patient.address.use	?! This element is a modifier element. Σ This element is included in summaries.	0..1	code	home | work | temp | old | billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
Patient.address.postalCode	S This element must be supported. Σ This element is included in summaries. C	1..1	string	ZipCode must be included in the profile Constraints: uds-plus-patient-1 Example General: 9132
Patient.address.postalCode.Slices for extension				Content/Rules for all slices
Patient.address.postalCode.Slices for extension.extension:dataAbsentReason	S This element must be supported.	0..1	(Complex)	Reason why the data is not present URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
Patient.address.postalCode.Slices for extension.extension:dataAbsentReason.extension		0..0		Extension Slice: Unordered, Open by value:url
Patient.address.postalCode.Slices for extension.extension:dataAbsentReason.url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/data-absent-reason"
Patient.address.postalCode.Slices for extension.extension:dataAbsentReason.value[x]	S This element must be supported.	1..1	code	Value of extension Binding: DataAbsentReason (required): Used to specify why the normally expected content of the data element is missing.
Patient.address.period	Σ This element is included in summaries.	0..1	Period	Address period cannot be included in the profile Example General: {"start":"2010-03-23","end":"2010-07-01"}
Patient.communication		0..*	BackboneElement	A language which may be used to communicate with the patient about his or her health
Patient.communication.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Patient.communication.language	S This element must be supported.	1..1	CodeableConcept	Language must be included in the profile Binding: Language codes with language and optionally a region modifier (extensible): The set of languages that the patient uses
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Patient.address.use	Base	required	AddressUse	📍4.0.1	FHIR Std.
Patient.address.postalCode.​extension:dataAbsentReason.​value[x]	Base	required	DataAbsentReason	📍4.0.1	FHIR Std.
Patient.communication.​language	Base	extensible	Language codes with language and optionally a region modifier	📦6.1.0	US Core v6.1
Patient.link.type	Base	required	LinkType	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Patient	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Patient	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Patient	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Patient	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Patient	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
uds-plus-pat-1	error	Patient.deceased[x]	All dateTime data elements should be truncated to a year only for de-identified resources.	$this is dateTime implies $this.toString().length() = 4
uds-plus-pat-1a	error	Patient.deceased[x]	All dateTime data elements should have valid year > 1900	$this is dateTime implies $this.toString() >= '1900'
uds-plus-pat-1b	error	Patient.deceased[x]	All dateTime data elements should have valid year < 2030	$this is dateTime implies $this.toString() <= '2030'
uds-plus-patient-1	error	Patient.address.postalCode	De-identified Zipcodes can contain first 3 digits followed by 00 in the last two digits or have to be masked with 00000. If the extended ZipCode format is used the resulting format should be #####-####.	$this.matches('^[0-9]{3}[0]{2}(-[0-9]{4})?$')

Differential View

This structure is derived from Patient

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Patient		0..*	Patient	De-Identified UDS Plus Patient
Patient.id	S This element must be supported.	0..1	id	The de-identified patient identifier created by the health center to send data to HRSA.
Patient.text		0..0		Cannot include any text in the resource as part of the de-identified data.
Patient.contained		0..0		Cannot include any contained resources in the resource as part of the de-identified data.
Patient.Slices for extension				Content/Rules for all slices
Patient.Slices for extension.extension:uds-plus-race	S This element must be supported.	1..1	(Complex)	Indicates the race of the Patient. URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-race profiled by http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-race-extension
Patient.Slices for extension.extension:uds-plus-ethnicty	S This element must be supported.	1..1	(Complex)	Indicates the ethnicity of the Patient. URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity profiled by http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-ethnicity-extension
Patient.Slices for extension.extension:uds-plus-birthsex	S This element must be supported.	0..1	code	Indicates the Birth sex of the Patient. URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-birthsex-extension Binding: Uds Plus Sex Codes (extensible): The set of codes to be used for UDS+ reporting.
Patient.Slices for extension.extension:uds-plus-sex	S This element must be supported.	0..1	code	Indicates the sex of the Patient. URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-sex-extension Binding: https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1021.121/expansion/ (extensible): The set of sex codes to be used for UDS+ reporting.
Patient.Slices for extension.extension:uds-plus-age-extension	S This element must be supported.	1..1	Quantity	Age of the Patient computed using birthDate and the reporting period reference URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-age-extension
Patient.Slices for extension.extension:uds-plus-agriculture-worker-status	S This element must be supported.	0..1	code	Agriculture Status of the patient URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/udsplus-agriculture-worker-status Binding: Uds Plus Agriculture Worker Status Codes (extensible)
Patient.Slices for extension.extension:uds-plus-housing-status	S This element must be supported.	0..1	code	Housing Status of the patient URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-housing-status-extension Binding: Uds Plus Housing Status Codes (extensible)
Patient.Slices for extension.extension:uds-plus-veteran-status	S This element must be supported.	0..1	boolean	Veteran Status of the patient URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-veteran-status-extension
Patient.identifier		0..0		Cannot include any identifier in the resource as part of the de-identified data.
Patient.name		0..0		Cannot include any name in the resource as part of the de-identified data.
Patient.telecom		0..0		Cannot include any telecom information in the resource as part of the de-identified data.
Patient.birthDate		0..0		Cannot include any date of birth information in the resource as part of the de-identified data.
Patient.deceased[x]	S This element must be supported. C	0..1		Indicates if the Patient is deceased, it can be either a Boolean or a Date with a precision of year only. Constraints: uds-plus-pat-1, uds-plus-pat-1a, uds-plus-pat-1b
Patient.deceased[x].deceasedDateTime			dateTime S This target must be supported.
Patient.deceased[x].deceasedBoolean			boolean S This target must be supported.
Patient.address	S This element must be supported.	1..1	Address	Included only to support zip code
Patient.address.extension		0..0		Extension cannot be included in Address
Patient.address.text		0..0		Text cannot be included in the profile
Patient.address.line		0..0		Street names cannot be included in the profile
Patient.address.postalCode	S This element must be supported. C	1..1	string	ZipCode must be included in the profile Constraints: uds-plus-patient-1
Patient.address.postalCode.Slices for extension				Content/Rules for all slices
Patient.address.postalCode.Slices for extension.extension:dataAbsentReason	S This element must be supported.	0..1	(Complex)	Reason why the data is not present URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
Patient.address.postalCode.Slices for extension.extension:dataAbsentReason.value[x]	S This element must be supported.	1..1	code	Value of extension
Patient.address.period		0..1	Period	Address period cannot be included in the profile
Patient.maritalStatus		0..0		Cannot include information not required for UDS+
Patient.multipleBirth[x]		0..0		Cannot include information not required for UDS+
Patient.photo		0..0		Cannot include information not required for UDS+
Patient.contact		0..0		Cannot include information not required for UDS+
Patient.communication
Patient.communication.language	S This element must be supported.	1..1	CodeableConcept	Language must be included in the profile Binding: Language codes with language and optionally a region modifier (extensible): The set of languages that the patient uses
Patient.generalPractitioner		0..0		Cannot include information not required for UDS+
Patient.managingOrganization		0..0		Cannot include information not required for UDS+
Patient.link		0..0		Cannot include information not required for UDS+
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Patient.communication.​language	Base	extensible	Language codes with language and optionally a region modifier	📦6.1.0	US Core v6.1

Constraints

Id	Grade	Path(s)	Description	Expression
uds-plus-pat-1	error	Patient.deceased[x]	All dateTime data elements should be truncated to a year only for de-identified resources.	$this is dateTime implies $this.toString().length() = 4
uds-plus-pat-1a	error	Patient.deceased[x]	All dateTime data elements should have valid year > 1900	$this is dateTime implies $this.toString() >= '1900'
uds-plus-pat-1b	error	Patient.deceased[x]	All dateTime data elements should have valid year < 2030	$this is dateTime implies $this.toString() <= '2030'
uds-plus-patient-1	error	Patient.address.postalCode	De-identified Zipcodes can contain first 3 digits followed by 00 in the last two digits or have to be masked with 00000. If the extended ZipCode format is used the resulting format should be #####-####.	$this.matches('^[0-9]{3}[0]{2}(-[0-9]{4})?$')

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Patient		0..*	Patient	De-Identified UDS Plus Patient
Patient.id	S This element must be supported. Σ This element is included in summaries.	0..1	id	The de-identified patient identifier created by the health center to send data to HRSA.
Patient.meta	Σ This element is included in summaries.	0..1	Meta	Metadata about the resource
Patient.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Patient.language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
Patient.Slices for extension		3..*	Extension	Extension Slice: Unordered, Open by value:url
Patient.Slices for extension.extension:uds-plus-race	S This element must be supported.	1..1	(Complex)	Indicates the race of the Patient. URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-race profiled by http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-race-extension
Patient.Slices for extension.extension:uds-plus-ethnicty	S This element must be supported.	1..1	(Complex)	Indicates the ethnicity of the Patient. URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity profiled by http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-ethnicity-extension
Patient.Slices for extension.extension:uds-plus-birthsex	S This element must be supported.	0..1	code	Indicates the Birth sex of the Patient. URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-birthsex-extension Binding: Uds Plus Sex Codes (extensible): The set of codes to be used for UDS+ reporting.
Patient.Slices for extension.extension:uds-plus-sex	S This element must be supported.	0..1	code	Indicates the sex of the Patient. URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-sex-extension Binding: https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1021.121/expansion/ (extensible): The set of sex codes to be used for UDS+ reporting.
Patient.Slices for extension.extension:uds-plus-age-extension	S This element must be supported.	1..1	Quantity	Age of the Patient computed using birthDate and the reporting period reference URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-age-extension
Patient.Slices for extension.extension:uds-plus-agriculture-worker-status	S This element must be supported.	0..1	code	Agriculture Status of the patient URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/udsplus-agriculture-worker-status Binding: Uds Plus Agriculture Worker Status Codes (extensible)
Patient.Slices for extension.extension:uds-plus-housing-status	S This element must be supported.	0..1	code	Housing Status of the patient URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-housing-status-extension Binding: Uds Plus Housing Status Codes (extensible)
Patient.Slices for extension.extension:uds-plus-veteran-status	S This element must be supported.	0..1	boolean	Veteran Status of the patient URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-veteran-status-extension
Patient.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
Patient.active	?! This element is a modifier element. Σ This element is included in summaries.	0..1	boolean	Whether this patient's record is in active use
Patient.gender	Σ This element is included in summaries.	0..1	code	male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
Patient.deceased[x]	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries. C	0..1		Indicates if the Patient is deceased, it can be either a Boolean or a Date with a precision of year only. Constraints: uds-plus-pat-1, uds-plus-pat-1a, uds-plus-pat-1b
Patient.deceased[x].deceasedDateTime			dateTime S This target must be supported.
Patient.deceased[x].deceasedBoolean			boolean S This target must be supported.
Patient.address	S This element must be supported. Σ This element is included in summaries.	1..1	Address	Included only to support zip code
Patient.address.id		0..1	string	Unique id for inter-element referencing
Patient.address.extension		0..0		Extension cannot be included in Address Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Patient.address.use	?! This element is a modifier element. Σ This element is included in summaries.	0..1	code	home | work | temp | old | billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
Patient.address.type	Σ This element is included in summaries.	0..1	code	postal | physical | both Binding: AddressType (required): The type of an address (physical / postal). Example General: both
Patient.address.city	Σ This element is included in summaries.	0..1	string	Name of city, town etc. Example General: Erewhon
Patient.address.district	Σ This element is included in summaries.	0..1	string	District name (aka county) Example General: Madison
Patient.address.state	Σ This element is included in summaries.	0..1	string	Sub-unit of country (abbreviations ok)
Patient.address.postalCode	S This element must be supported. Σ This element is included in summaries. C	1..1	string	ZipCode must be included in the profile Constraints: uds-plus-patient-1 Example General: 9132
Patient.address.postalCode.id		0..1	string	xml:id (or equivalent in JSON)
Patient.address.postalCode.Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
Patient.address.postalCode.Slices for extension.extension:dataAbsentReason	S This element must be supported.	0..1	(Complex)	Reason why the data is not present URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
Patient.address.postalCode.Slices for extension.extension:dataAbsentReason.id		0..1	string	Unique id for inter-element referencing
Patient.address.postalCode.Slices for extension.extension:dataAbsentReason.extension		0..0		Extension Slice: Unordered, Open by value:url
Patient.address.postalCode.Slices for extension.extension:dataAbsentReason.url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/data-absent-reason"
Patient.address.postalCode.Slices for extension.extension:dataAbsentReason.value[x]	S This element must be supported.	1..1	code	Value of extension Binding: DataAbsentReason (required): Used to specify why the normally expected content of the data element is missing.
Patient.address.postalCode.value		0..1	string	Primitive value for string Max Length:1048576
Patient.address.country	Σ This element is included in summaries.	0..1	string	Country (e.g. can be ISO 3166 2 or 3 letter code)
Patient.address.period	Σ This element is included in summaries.	0..1	Period	Address period cannot be included in the profile Example General: {"start":"2010-03-23","end":"2010-07-01"}
Patient.communication		0..*	BackboneElement	A language which may be used to communicate with the patient about his or her health
Patient.communication.id		0..1	string	Unique id for inter-element referencing
Patient.communication.extension		0..*	Extension	Additional content defined by implementations
Patient.communication.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Patient.communication.language	S This element must be supported.	1..1	CodeableConcept	Language must be included in the profile Binding: Language codes with language and optionally a region modifier (extensible): The set of languages that the patient uses
Patient.communication.preferred		0..1	boolean	Language preference indicator
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Patient.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Patient.gender	Base	required	AdministrativeGender	📍4.0.1	FHIR Std.
Patient.address.use	Base	required	AddressUse	📍4.0.1	FHIR Std.
Patient.address.type	Base	required	AddressType	📍4.0.1	FHIR Std.
Patient.address.postalCode.​extension:dataAbsentReason.​value[x]	Base	required	DataAbsentReason	📍4.0.1	FHIR Std.
Patient.contact.relationship	Base	extensible	Patient Contact Relationship	📍4.0.1	FHIR Std.
Patient.contact.gender	Base	required	AdministrativeGender	📍4.0.1	FHIR Std.
Patient.communication.​language	Base	extensible	Language codes with language and optionally a region modifier	📦6.1.0	US Core v6.1
Patient.link.type	Base	required	LinkType	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Patient	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Patient	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Patient	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Patient	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Patient	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
uds-plus-pat-1	error	Patient.deceased[x]	All dateTime data elements should be truncated to a year only for de-identified resources.	$this is dateTime implies $this.toString().length() = 4
uds-plus-pat-1a	error	Patient.deceased[x]	All dateTime data elements should have valid year > 1900	$this is dateTime implies $this.toString() >= '1900'
uds-plus-pat-1b	error	Patient.deceased[x]	All dateTime data elements should have valid year < 2030	$this is dateTime implies $this.toString() <= '2030'
uds-plus-patient-1	error	Patient.address.postalCode	De-identified Zipcodes can contain first 3 digits followed by 00 in the last two digits or have to be masked with 00000. If the extended ZipCode format is used the resulting format should be #####-####.	$this.matches('^[0-9]{3}[0]{2}(-[0-9]{4})?$')

This structure is derived from Patient

Summary

Mandatory: 5 elements(2 nested mandatory elements)
Must-Support: 15 elements
Prohibited: 16 elements

Extensions

This structure refers to these extensions:

• http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-race-extension
• http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-ethnicity-extension
• http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-birthsex-extension
• http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-sex-extension
• http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-age-extension
• http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/udsplus-agriculture-worker-status
• http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-housing-status-extension
• http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-veteran-status-extension
• http://hl7.org/fhir/StructureDefinition/data-absent-reason|4.0.1

Maturity: 2