CH Health Dossier (R4)
1.0.0-preview - draft Switzerland flag

CH Health Dossier (R4), published by eHealth Suisse. This guide is not an authorized publication; it is the continuous build for version 1.0.0-preview built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/ehealthsuisse/ch-health-dossier/ and changes regularly. See the Directory of published versions

Resource Profile: CHPDQmPatient - Detailed Descriptions

Active as of 2026-08-20

Definitions for the ch-pdqm-patient resource profile.

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

0. Patient
Definition

The CH Core Patient is based upon the core FHIR Patient Resource and designed to meet the applicable patient demographic data elements in Switzerland. See also https://www.bfs.admin.ch/bfs/de/home/register/personenregister/registerharmonisierung/nomenklaturen.html for further information


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

ShortCH Core PatientInformation about an individual or animal receiving health care services
Control0..*
Is Modifierfalse
Summaryfalse
Alternate NamesSubjectOfCare Client Resident
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())
ch-pat-1: If one ore more human names are provided, at least one human name should have a family and a given name. (name.where(family.exists() and given.exists()).count()>0 or name.empty())
ch-pat-2: gender 'unknown' is currently not used in Switzerland in eCH and the EPR (gender.empty() or gender!='unknown')
2. Patient.implicitRules
Definition

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

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..1
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. Patient.extension:placeOfBirth
Slice NameplaceOfBirth
Definition

The registered place of birth of the patient.

ShortPlace of birth for patient according to eCH-0011
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(Place of Birth according to eCH-0011) (Extension Type: Address(Address for Place of Birth))
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())
6. Patient.extension:placeOfOrigin
Slice NameplaceOfOrigin
Definition

The registered place of origin of the patient.

ShortPlace of origin(s) of the patient
Control0..*
This element is affected by the following invariants: ele-1
TypeExtension(Place of Origin according to eCH-0011) (Extension Type: Address)
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())
8. Patient.extension:citizenship
Slice Namecitizenship
Definition

The patient's legal status as citizen of a country.

ShortNation(s) where the patient claims citizenship
Control0..*
This element is affected by the following invariants: ele-1
TypeExtension(Patient Citizenship) (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())
ch-pat-3: ISO Country Alpha-2 or ISO Country Alpha-3 code (((extension.where(url='code').value.coding.code.length()=2) and extension.where(url='code').value.coding.code.memberOf('http://hl7.org/fhir/ValueSet/iso3166-1-2')) or ((extension.where(url='code').value.coding.code.length() = 3) and extension.where(url='code').value.coding.code.memberOf('http://hl7.org/fhir/ValueSet/iso3166-1-3')))
10. Patient.extension:religion
Slice Namereligion
Definition

The patient's professed religious affiliations.

ShortThe patient's professed religious affiliations
Control0..0
This element is affected by the following invariants: ele-1
TypeExtension(Patient Religion) (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())
12. Patient.modifierExtension
Definition

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

ShortExtensions that cannot be ignored
Comments

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

Control0..*
TypeExtension
Is Modifiertrue because 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())
14. Patient.identifier
Definition

An identifier for this patient.

ShortAn identifier for this patient
NoteThis is a business identifier, not a resource identifier (see discussion)
Control10..*
TypeIdentifier
Is Modifierfalse
Summarytrue
Requirements

Patients are almost always assigned specific numerical identifiers.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Patient.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ $this
  • 16. Patient.identifier:EPR-SPID
    Slice NameEPR-SPID
    Definition

    EPR-SPID: The Central Compensation Office (ZAS; CCO) assigns and manages the new patient identification number according to the EPRA (EPR-SPID), which is only linked internally in the CCO with the AHV number. It maintains the UPI identification database (Unique Personal Identifier Database), which the EPR communities may access. The law regulates how the the EPR-SPID can be used. SR 816.111 states (Art. 10 para. 3 EPDV) that communities must ensure that the EPR-SPID number cannot be not stored in document repositories or document registries.


    An identifier for this patient.

    ShortEPR-SPIDAn identifier for this patient
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control10..1*
    TypeIdentifier(EPR-SPID Identifier)
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    Patients are almost always assigned specific numerical identifiers.

    Pattern Value{
      "system" : "urn:oid:2.16.756.5.30.1.127.3.10.3"
    }
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    18. Patient.identifier:AHVN13
    Slice NameAHVN13
    Definition

    The AHVN13 / NAVS13 - (abbreviation for new thirteen-digit Social Security number) - is an administrative identifier for natural persons in Switzerland. It is issued, announced and administered by the Central Compensation Office. It is available to all organisations and communities for which there is a legal basis.


    An identifier for this patient.

    ShortAHVN13 / NAVS13 of the patient (13 digits starting with 756, no separation points)An identifier for this patient
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..*
    TypeIdentifier(AHVN13 / NAVS13 Identifier)
    Is Modifierfalse
    Summarytrue
    Requirements

    Patients are almost always assigned specific numerical identifiers.

    Pattern Value{
      "system" : "urn:oid:2.16.756.5.32"
    }
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    20. Patient.identifier:LocalPid
    Slice NameLocalPid
    Definition

    An identifier for this patient.

    ShortLocal patient identifier(s)An identifier for this patient
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..*
    TypeIdentifier
    Is Modifierfalse
    Summarytrue
    Requirements

    Patients are almost always assigned specific numerical identifiers.

    Pattern Value{
      "type" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
          "code" : "MR"
        }]
      }
    }
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    22. Patient.identifier:LocalPid.use
    Definition

    The purpose of this identifier.

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

    Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

    Control0..1
    BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
    (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

    Identifies the purpose for this identifier, if known .

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

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

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    24. Patient.identifier:LocalPid.system
    Definition

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

    ShortThe namespace for the identifier value
    Comments

    Identifier.system is always case sensitive.

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

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

    ExampleGeneral: http://www.acme.com/identifiers/patient
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    26. Patient.identifier:LocalPid.value
    Definition

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

    ShortThe value that is unique
    Comments

    If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

    Control10..1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    ExampleGeneral: 123456
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    28. Patient.identifier:insuranceCardNumber
    Slice NameinsuranceCardNumber
    Definition

    Cardnumber Swiss insurance card v1


    An identifier for this patient.

    ShortInsurance card number of the patient (20 digits)An identifier for this patient
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..*
    TypeIdentifier(Insurance Card Number (Identifier))
    Is Modifierfalse
    Summarytrue
    Requirements

    Patients are almost always assigned specific numerical identifiers.

    Pattern Value{
      "system" : "urn:oid:2.16.756.5.30.1.123.100.1.1.1"
    }
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    30. Patient.active
    Definition

    Whether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules.

    It is often used to filter patient lists to exclude inactive patients

    Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death.

    ShortWhether this patient's record is in active use
    Comments

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

    Control0..1
    Typeboolean
    Is Modifiertrue because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

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

    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()))
    32. Patient.name
    Definition

    A name associated with the individual.

    ShortA name associated with the patient
    Comments

    A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.

    Control10..*
    TypeHumanName(Human Name)
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

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

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    SlicingThis element introduces a set of slices on Patient.name. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • profile @ $this
    • 34. Patient.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..1
      BindingThe codes SHALL be taken from NameUsehttp://hl7.org/fhir/ValueSet/name-use|4.0.1
      (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()))
      36. Patient.name.family
      Definition

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

      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()))
      38. Patient.name.family.extension:ech11name
      Slice Nameech11name
      Definition

      Extension for eCH-0011 - namedatatype

      ShortExtension
      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(Name) (Extension Type: Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta)
      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())
      40. Patient.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()))
      42. Patient.name.given.extension:ech11firstname
      Slice Nameech11firstname
      Definition

      eCH-0011: Extension to define first name type

      ShortExtension
      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(First Name) (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())
      44. Patient.name:HumanName
      Slice NameHumanName
      Definition

      A name associated with the individual.

      ShortA name associated with the patient
      Comments

      A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.

      Control10..*
      TypeHumanName(CH EPR FHIR HumanName)
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      46. Patient.name:HumanName.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..1
      BindingThe codes SHALL be taken from NameUsehttp://hl7.org/fhir/ValueSet/name-use|4.0.1
      (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()))
      48. Patient.name:BirthName
      Slice NameBirthName
      Definition

      A name associated with the individual.

      ShortThe birthname of the patientA name associated with the patient
      Comments

      The birthname is added with the ISO 21090 qualifier https://www.hl7.org/fhir/extension-iso21090-en-qualifier.html BR


      A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.

      Control0..1*
      TypeHumanName(CH EPR FHIR BirthName)
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      50. Patient.name:BirthName.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..1
      BindingThe codes SHALL be taken from NameUsehttp://hl7.org/fhir/ValueSet/name-use|4.0.1
      (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()))
      52. Patient.telecom
      Definition

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

      ShortA contact detail for the individual
      Comments

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

      Control0..*
      TypeContactPoint
      Is Modifierfalse
      Summarytrue
      Requirements

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      SlicingThis element introduces a set of slices on Patient.telecom. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ system
      • 54. Patient.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
        Control10..1
        This element is affected by the following invariants: cpt-2
        BindingThe codes SHALL be taken from ContactPointSystemhttp://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
        (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()))
        56. Patient.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.

        Control10..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()))
        58. Patient.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..1
        BindingThe codes SHALL be taken from ContactPointUsehttp://hl7.org/fhir/ValueSet/contact-point-use|4.0.1
        (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()))
        60. Patient.telecom:email
        Slice Nameemail
        Definition

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

        ShortA contact detail for the individual
        Comments

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

        Control0..*
        TypeContactPoint(CH Core ContactPoint eCH-0046 Email)
        Is Modifierfalse
        Summarytrue
        Requirements

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

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        62. Patient.telecom:email.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
        Control10..1
        This element is affected by the following invariants: cpt-2
        BindingThe codes SHALL be taken from ContactPointSystemhttp://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
        (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
        Fixed Valueemail
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        64. Patient.telecom:email.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.

        Control10..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()))
        66. Patient.telecom:email.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..1
        BindingThe codes SHALL be taken from ContactPointUsehttp://hl7.org/fhir/ValueSet/contact-point-use|4.0.1
        (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()))
        68. Patient.telecom:email.use.extension:emailCategory
        Slice NameemailCategory
        Definition

        Optional Extension Element - found in all resources.

        ShortOptional Extensions Element
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(eCH-0046 Email Category) (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())
        70. Patient.telecom:phone
        Slice Namephone
        Definition

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

        ShortA contact detail for the individual
        Comments

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

        Control0..*
        TypeContactPoint(CH Core ContactPoint eCH-0046 Phone)
        Is Modifierfalse
        Summarytrue
        Requirements

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

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        72. Patient.telecom:phone.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
        Control10..1
        This element is affected by the following invariants: cpt-2
        BindingThe codes SHALL be taken from ContactPointSystemhttp://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
        (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
        Fixed Valuephone
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        74. Patient.telecom:phone.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.

        Control10..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()))
        76. Patient.telecom:phone.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..1
        BindingThe codes SHALL be taken from ContactPointUsehttp://hl7.org/fhir/ValueSet/contact-point-use|4.0.1
        (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()))
        78. Patient.telecom:phone.use.extension:phoneCategory
        Slice NamephoneCategory
        Definition

        Optional Extension Element - found in all resources.

        ShortOptional Extensions Element
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(eCH-0046 Phone Category) (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())
        80. Patient.telecom:internet
        Slice Nameinternet
        Definition

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

        ShortA contact detail for the individual
        Comments

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

        Control0..*
        TypeContactPoint(CH Core ContactPoint eCH-0046 Internet)
        Is Modifierfalse
        Summarytrue
        Requirements

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

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        82. Patient.telecom:internet.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
        Control10..1
        This element is affected by the following invariants: cpt-2
        BindingThe codes SHALL be taken from ContactPointSystemhttp://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
        (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
        Fixed Valueurl
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        84. Patient.telecom:internet.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.

        Control10..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()))
        86. Patient.telecom:internet.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..1
        BindingThe codes SHALL be taken from ContactPointUsehttp://hl7.org/fhir/ValueSet/contact-point-use|4.0.1
        (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()))
        88. Patient.telecom:internet.use.extension:internetCategory
        Slice NameinternetCategory
        Definition

        Optional Extension Element - found in all resources.

        ShortOptional Extensions Element
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(eCH-0046 Internet Category) (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())
        90. Patient.gender
        Definition

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

        Shortmale | female | other | unknown* (* see warning 'ch-pat-2')
        Comments

        The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex.

        Control0..1
        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 for identification of the individual, in combination with (at least) name and birth date.

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

        The date of birth for the individual.

        ShortThe date of birth for the individual
        Comments

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

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

        Age of the individual drives many clinical processes.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        LOINC Code21112-8
        94. Patient.deceased[x]
        Definition

        Indicates if the individual is deceased or not.

        ShortIndicates if the individual is deceased or not
        Comments

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

        Control0..1
        TypeChoice of: boolean, dateTime
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifiertrue because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

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

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        SlicingThis element introduces a set of slices on Patient.deceased[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • type @ $this
        • 96. Patient.deceased[x]:deceasedDateTime
          Slice NamedeceasedDateTime
          Definition

          Indicates if the individual is deceased or not.

          ShortIndicates if the individual is deceased or not
          Comments

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

          Control0..1
          TypedateTime, boolean
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifiertrue because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

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

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

          A contact party (e.g. guardian, partner, friend) for the patient.

          ShortA contact party (e.g. guardian, partner, friend) for the patient
          Comments

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

          Control0..*
          TypeBackboneElement
          Is Modifierfalse
          Summaryfalse
          Requirements

          Need to track people you can contact about the patient.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          pat-1: SHALL at least contain a contact's details or a reference to an organization (name.exists() or telecom.exists() or address.exists() or organization.exists())
          pat-1: SHALL at least contain a contact's details or a reference to an organization (name.exists() or telecom.exists() or address.exists() or organization.exists())
          SlicingThis element introduces a set of slices on Patient.contact. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ relationship
          • 100. Patient.contact.modifierExtension
            Definition

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

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

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

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            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, modifiers
            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())
            102. Patient.contact:contact
            Slice Namecontact
            Definition

            A contact party (e.g. guardian, partner, friend) for the patient.

            ShortContact data if it is not the address of the patientA contact party (e.g. guardian, partner, friend) for the patient
            Comments

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

            Control0..1*
            TypeBackboneElement
            Is Modifierfalse
            Summaryfalse
            Requirements

            Need to track people you can contact about the patient.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            pat-1: SHALL at least contain a contact's details or a reference to an organization (name.exists() or telecom.exists() or address.exists() or organization.exists())
            pat-1: SHALL at least contain a contact's details or a reference to an organization (name.exists() or telecom.exists() or address.exists() or organization.exists())
            104. Patient.contact:contact.modifierExtension
            Definition

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

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

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

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            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, modifiers
            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())
            106. Patient.contact:contact.relationship
            Definition

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

            ShortThe kind of relationship
            Control10..1*
            BindingUnless not suitable, these codes SHALL be taken from PatientContactRelationshiphttp://hl7.org/fhir/ValueSet/patient-contactrelationship|4.0.1
            (extensible to http://hl7.org/fhir/ValueSet/patient-contactrelationship|4.0.1)

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

            TypeCodeableConcept
            Is Modifierfalse
            Summaryfalse
            Requirements

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

            Pattern Value{
              "coding" : [{
                "system" : "http://fhir.ch/ig/ch-core/CodeSystem/ech-11",
                "code" : "contactData"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            108. Patient.contact:contact.telecom
            Definition

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

            ShortA contact detail for the person
            Comments

            Contact may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification.

            Control0..0*
            TypeContactPoint
            Is Modifierfalse
            Summaryfalse
            Requirements

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

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

            Address for the contact person.

            ShortAddress for the contact person
            Control10..1
            TypeAddress(CH Core Postal Address)
            Is Modifierfalse
            Summaryfalse
            Requirements

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

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            112. Patient.contact:nameOfParent
            Slice NamenameOfParent
            Definition

            A contact party (e.g. guardian, partner, friend) for the patient.

            ShortName of parentA contact party (e.g. guardian, partner, friend) for the patient
            Comments

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

            Control0..*
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            Need to track people you can contact about the patient.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            pat-1: SHALL at least contain a contact's details or a reference to an organization (name.exists() or telecom.exists() or address.exists() or organization.exists())
            pat-1: SHALL at least contain a contact's details or a reference to an organization (name.exists() or telecom.exists() or address.exists() or organization.exists())
            114. Patient.contact:nameOfParent.modifierExtension
            Definition

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

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

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

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            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, modifiers
            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())
            116. Patient.contact:nameOfParent.relationship
            Definition

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

            ShortThe kind of relationship
            Control10..1*
            BindingUnless not suitable, these codes SHALL be taken from PatientContactRelationshiphttp://hl7.org/fhir/ValueSet/patient-contactrelationship|4.0.1
            (extensible to http://hl7.org/fhir/ValueSet/patient-contactrelationship|4.0.1)

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

            TypeCodeableConcept
            Is Modifierfalse
            Summaryfalse
            Requirements

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

            Pattern Value{
              "coding" : [{
                "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
                "code" : "PRN"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            118. Patient.contact:nameOfParent.name
            Definition

            A name associated with the contact person.

            ShortA name associated with the contact person
            Control10..1
            TypeHumanName
            Is Modifierfalse
            Summaryfalse
            Requirements

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

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            120. Patient.contact:nameOfParent.gender
            Definition

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

            Shortmale | female | other | unknown
            Control0..1
            BindingThe codes SHALL be taken from 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
            Must Supporttrue
            Summaryfalse
            Requirements

            Needed to address the person correctly.

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

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

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

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

            Control0..*
            TypeBackboneElement
            Is Modifiertrue because This element is labeled as a modifier because it might not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'
            Summarytrue
            Requirements

            There are multiple use cases:

            • Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and
            • Distribution of patient information across multiple servers.
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            124. Patient.link.modifierExtension
            Definition

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

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

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

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            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, modifiers
            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())
            126. Patient.link.other
            Definition

            The other patient resource that the link refers to.

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

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

            Control1..1
            TypeReference(Patient, RelatedPerson)
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            128. Patient.link.type
            Definition

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

            Shortreplaced-by | replaces | refer | seealso
            Control1..1
            BindingThe codes SHALL be taken from LinkTypehttp://hl7.org/fhir/ValueSet/link-type|4.0.1
            (required to http://hl7.org/fhir/ValueSet/link-type|4.0.1)

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

            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()))

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

            0. Patient
            2. Patient.extension:placeOfBirth
            Slice NameplaceOfBirth
            4. Patient.extension:citizenship
            Slice Namecitizenship
            6. Patient.extension:religion
            Slice Namereligion
            Control0..0
            8. Patient.identifier
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control1..?
            10. Patient.identifier:EPR-SPID
            Slice NameEPR-SPID
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control1..1
            Must Supporttrue
            12. Patient.name
            Control1..?
            Must Supporttrue
            SlicingThis element introduces a set of slices on Patient.name. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • profile @ $this
            • 14. Patient.name.family
              16. Patient.name.given
              18. Patient.name:HumanName
              Slice NameHumanName
              Control1..*
              TypeHumanName(CH EPR FHIR HumanName)
              Must Supporttrue
              20. Patient.name:BirthName
              Slice NameBirthName
              ShortThe birthname of the patient
              Comments

              The birthname is added with the ISO 21090 qualifier https://www.hl7.org/fhir/extension-iso21090-en-qualifier.html BR

              Control0..1
              TypeHumanName(CH EPR FHIR BirthName)
              Must Supporttrue
              22. Patient.gender
              24. Patient.birthDate
              LOINC Code
              26. Patient.deceased[x]
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              SlicingThis element introduces a set of slices on Patient.deceased[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • type @ $this
              • 28. Patient.deceased[x]:deceasedDateTime
                Slice NamedeceasedDateTime
                Control0..1
                TypedateTime
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                30. Patient.contact:nameOfParent
                Slice NamenameOfParent
                Must Supporttrue
                32. Patient.contact:nameOfParent.name
                34. Patient.contact:nameOfParent.gender
                Must Supporttrue

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

                0. Patient
                Definition

                The CH Core Patient is based upon the core FHIR Patient Resource and designed to meet the applicable patient demographic data elements in Switzerland. See also https://www.bfs.admin.ch/bfs/de/home/register/personenregister/registerharmonisierung/nomenklaturen.html for further information

                ShortCH Core Patient
                Control0..*
                Is Modifierfalse
                Summaryfalse
                Alternate NamesSubjectOfCare Client Resident
                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())
                ch-pat-1: If one ore more human names are provided, at least one human name should have a family and a given name. (name.where(family.exists() and given.exists()).count()>0 or name.empty())
                ch-pat-2: gender 'unknown' is currently not used in Switzerland in eCH and the EPR (gender.empty() or gender!='unknown')
                2. Patient.id
                Definition

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

                ShortLogical id of this artifact
                Comments

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

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

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

                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. Patient.implicitRules
                Definition

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

                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..1
                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()))
                8. Patient.language
                Definition

                The base language in which the resource is written.

                ShortLanguage of the resource content
                Comments

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

                Control0..1
                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()))
                10. Patient.text
                Definition

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

                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..1
                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()))
                12. Patient.contained
                Definition

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

                ShortContained, inline Resources
                Comments

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

                Control0..*
                TypeResource
                Is Modifierfalse
                Summaryfalse
                Alternate Namesinline resources, anonymous resources, contained resources
                14. Patient.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 Patient.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 16. Patient.extension:placeOfBirth
                  Slice NameplaceOfBirth
                  Definition

                  The registered place of birth of the patient.

                  ShortPlace of birth for patient according to eCH-0011
                  Control0..1
                  This element is affected by the following invariants: ele-1
                  TypeExtension(Place of Birth according to eCH-0011) (Extension Type: Address(Address for Place of Birth))
                  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())
                  18. Patient.extension:placeOfOrigin
                  Slice NameplaceOfOrigin
                  Definition

                  The registered place of origin of the patient.

                  ShortPlace of origin(s) of the patient
                  Control0..*
                  This element is affected by the following invariants: ele-1
                  TypeExtension(Place of Origin according to eCH-0011) (Extension Type: Address)
                  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())
                  20. Patient.extension:citizenship
                  Slice Namecitizenship
                  Definition

                  The patient's legal status as citizen of a country.

                  ShortNation(s) where the patient claims citizenship
                  Control0..*
                  This element is affected by the following invariants: ele-1
                  TypeExtension(Patient Citizenship) (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())
                  ch-pat-3: ISO Country Alpha-2 or ISO Country Alpha-3 code (((extension.where(url='code').value.coding.code.length()=2) and extension.where(url='code').value.coding.code.memberOf('http://hl7.org/fhir/ValueSet/iso3166-1-2')) or ((extension.where(url='code').value.coding.code.length() = 3) and extension.where(url='code').value.coding.code.memberOf('http://hl7.org/fhir/ValueSet/iso3166-1-3')))
                  22. Patient.extension:religion
                  Slice Namereligion
                  Definition

                  The patient's professed religious affiliations.

                  ShortThe patient's professed religious affiliations
                  Control0..0
                  This element is affected by the following invariants: ele-1
                  TypeExtension(Patient Religion) (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())
                  24. Patient.modifierExtension
                  Definition

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

                  ShortExtensions that cannot be ignored
                  Comments

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

                  Control0..*
                  TypeExtension
                  Is Modifiertrue because 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())
                  26. Patient.identifier
                  Definition

                  An identifier for this patient.

                  ShortAn identifier for this patient
                  NoteThis is a business identifier, not a resource identifier (see discussion)
                  Control1..*
                  TypeIdentifier
                  Is Modifierfalse
                  Summarytrue
                  Requirements

                  Patients are almost always assigned specific numerical identifiers.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  SlicingThis element introduces a set of slices on Patient.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ $this
                  • 28. Patient.identifier:EPR-SPID
                    Slice NameEPR-SPID
                    Definition

                    EPR-SPID: The Central Compensation Office (ZAS; CCO) assigns and manages the new patient identification number according to the EPRA (EPR-SPID), which is only linked internally in the CCO with the AHV number. It maintains the UPI identification database (Unique Personal Identifier Database), which the EPR communities may access. The law regulates how the the EPR-SPID can be used. SR 816.111 states (Art. 10 para. 3 EPDV) that communities must ensure that the EPR-SPID number cannot be not stored in document repositories or document registries.

                    ShortEPR-SPID
                    NoteThis is a business identifier, not a resource identifier (see discussion)
                    Control1..1
                    TypeIdentifier(EPR-SPID Identifier)
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Patients are almost always assigned specific numerical identifiers.

                    Pattern Value{
                      "system" : "urn:oid:2.16.756.5.30.1.127.3.10.3"
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    30. Patient.identifier:AHVN13
                    Slice NameAHVN13
                    Definition

                    The AHVN13 / NAVS13 - (abbreviation for new thirteen-digit Social Security number) - is an administrative identifier for natural persons in Switzerland. It is issued, announced and administered by the Central Compensation Office. It is available to all organisations and communities for which there is a legal basis.

                    ShortAHVN13 / NAVS13 of the patient (13 digits starting with 756, no separation points)
                    NoteThis is a business identifier, not a resource identifier (see discussion)
                    Control0..*
                    TypeIdentifier(AHVN13 / NAVS13 Identifier)
                    Is Modifierfalse
                    Summarytrue
                    Requirements

                    Patients are almost always assigned specific numerical identifiers.

                    Pattern Value{
                      "system" : "urn:oid:2.16.756.5.32"
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    32. Patient.identifier:LocalPid
                    Slice NameLocalPid
                    Definition

                    An identifier for this patient.

                    ShortLocal patient identifier(s)
                    NoteThis is a business identifier, not a resource identifier (see discussion)
                    Control0..*
                    TypeIdentifier
                    Is Modifierfalse
                    Summarytrue
                    Requirements

                    Patients are almost always assigned specific numerical identifiers.

                    Pattern Value{
                      "type" : {
                        "coding" : [{
                          "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                          "code" : "MR"
                        }]
                      }
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    34. Patient.identifier:LocalPid.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
                    36. Patient.identifier:LocalPid.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 Patient.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 38. Patient.identifier:LocalPid.use
                      Definition

                      The purpose of this identifier.

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

                      Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                      Control0..1
                      BindingThe codes SHALL be taken from IdentifierUse
                      (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                      Identifies the purpose for this identifier, if known .

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

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

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      40. Patient.identifier:LocalPid.type
                      Definition

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

                      ShortDescription of identifier
                      Comments

                      This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                      Control0..1
                      BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                      (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.0.1)

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

                      TypeCodeableConcept
                      Is Modifierfalse
                      Summarytrue
                      Requirements

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

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      42. Patient.identifier:LocalPid.system
                      Definition

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

                      ShortThe namespace for the identifier value
                      Comments

                      Identifier.system is always case sensitive.

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

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

                      ExampleGeneral: http://www.acme.com/identifiers/patient
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      44. Patient.identifier:LocalPid.value
                      Definition

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

                      ShortThe value that is unique
                      Comments

                      If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                      Control1..1
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      ExampleGeneral: 123456
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      46. Patient.identifier:LocalPid.period
                      Definition

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

                      ShortTime period when id is/was valid for use
                      Control0..1
                      TypePeriod
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      48. Patient.identifier:LocalPid.assigner
                      Definition

                      Organization that issued/manages the identifier.

                      ShortOrganization that issued id (may be just text)
                      Comments

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

                      Control0..1
                      TypeReference(Organization)
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      50. Patient.identifier:insuranceCardNumber
                      Slice NameinsuranceCardNumber
                      Definition

                      Cardnumber Swiss insurance card v1

                      ShortInsurance card number of the patient (20 digits)
                      NoteThis is a business identifier, not a resource identifier (see discussion)
                      Control0..*
                      TypeIdentifier(Insurance Card Number (Identifier))
                      Is Modifierfalse
                      Summarytrue
                      Requirements

                      Patients are almost always assigned specific numerical identifiers.

                      Pattern Value{
                        "system" : "urn:oid:2.16.756.5.30.1.123.100.1.1.1"
                      }
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      52. Patient.active
                      Definition

                      Whether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules.

                      It is often used to filter patient lists to exclude inactive patients

                      Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death.

                      ShortWhether this patient's record is in active use
                      Comments

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

                      Control0..1
                      Typeboolean
                      Is Modifiertrue because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

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

                      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()))
                      54. Patient.name
                      Definition

                      A name associated with the individual.

                      ShortA name associated with the patient
                      Comments

                      A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.

                      Control1..*
                      TypeHumanName(Human Name)
                      Is Modifierfalse
                      Must Supporttrue
                      Summarytrue
                      Requirements

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

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      SlicingThis element introduces a set of slices on Patient.name. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • profile @ $this
                      • 56. Patient.name.id
                        Definition

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

                        ShortUnique id for inter-element referencing
                        Control0..1
                        Typestring
                        Is Modifierfalse
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Summaryfalse
                        58. Patient.name.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 Patient.name.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 60. Patient.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..1
                          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()))
                          62. Patient.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..1
                          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()))
                          64. Patient.name.family
                          Definition

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

                          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()))
                          66. Patient.name.family.id
                          Definition

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

                          Shortxml:id (or equivalent in JSON)
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          68. Patient.name.family.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 Patient.name.family.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 70. Patient.name.family.extension:ech11name
                            Slice Nameech11name
                            Definition

                            Extension for eCH-0011 - namedatatype

                            ShortExtension
                            Control0..1
                            This element is affected by the following invariants: ele-1
                            TypeExtension(Name) (Extension Type: Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta)
                            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())
                            72. Patient.name.family.value
                            Definition

                            The actual value

                            ShortPrimitive value for string
                            Control0..1
                            Typestring
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            Max Length:1048576
                            74. Patient.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()))
                            76. Patient.name.given.id
                            Definition

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

                            Shortxml:id (or equivalent in JSON)
                            Control0..1
                            Typestring
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            78. Patient.name.given.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 Patient.name.given.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 80. Patient.name.given.extension:ech11firstname
                              Slice Nameech11firstname
                              Definition

                              eCH-0011: Extension to define first name type

                              ShortExtension
                              Control0..1
                              This element is affected by the following invariants: ele-1
                              TypeExtension(First Name) (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())
                              82. Patient.name.given.value
                              Definition

                              The actual value

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

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

                              ShortFor a salutation use a prefix without the iso21090-EN-qualifier extension. For academical titles and legal status use the http://hl7.org/fhir/ExtensionDefinition/iso21090-EN-qualifier with the codes AC, LS.
                              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()))
                              86. Patient.name.prefix.id
                              Definition

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

                              Shortxml:id (or equivalent in JSON)
                              Control0..1
                              Typestring
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              88. Patient.name.prefix.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 Patient.name.prefix.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 90. Patient.name.prefix.extension:salutationandtitle
                                Slice Namesalutationandtitle
                                Definition

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

                                ShortFor academical titles and legal status use the http://hl7.org/fhir/ExtensionDefinition/iso21090-EN-qualifier with the codes AC, LS.
                                Comments

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

                                Control0..*
                                This element is affected by the following invariants: ele-1
                                TypeExtension(EN Qualifier) (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())
                                92. Patient.name.prefix.value
                                Definition

                                The actual value

                                ShortPrimitive value for string
                                Control0..1
                                Typestring
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                Max Length:1048576
                                94. Patient.name.suffix
                                Definition

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

                                ShortParts that come after the name
                                Control0..*
                                Typestring
                                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()))
                                96. Patient.name.period
                                Definition

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

                                ShortTime period when name was/is in use
                                Control0..1
                                TypePeriod
                                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()))
                                98. Patient.name:HumanName
                                Slice NameHumanName
                                Definition

                                A name associated with the individual.

                                ShortA name associated with the patient
                                Comments

                                A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.

                                Control1..*
                                TypeHumanName(CH EPR FHIR HumanName)
                                Is Modifierfalse
                                Must Supporttrue
                                Summarytrue
                                Requirements

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

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                100. Patient.name:HumanName.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
                                102. Patient.name:HumanName.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 Patient.name.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 104. Patient.name:HumanName.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..1
                                  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()))
                                  106. Patient.name:HumanName.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..1
                                  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()))
                                  108. Patient.name:HumanName.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()))
                                  110. Patient.name:HumanName.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()))
                                  112. Patient.name:HumanName.prefix
                                  Definition

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

                                  ShortParts that come before the name
                                  Control0..*
                                  Typestring
                                  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()))
                                  114. Patient.name:HumanName.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()))
                                  116. Patient.name:HumanName.period
                                  Definition

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

                                  ShortTime period when name was/is in use
                                  Control0..1
                                  TypePeriod
                                  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()))
                                  118. Patient.name:BirthName
                                  Slice NameBirthName
                                  Definition

                                  A name associated with the individual.

                                  ShortThe birthname of the patient
                                  Comments

                                  The birthname is added with the ISO 21090 qualifier https://www.hl7.org/fhir/extension-iso21090-en-qualifier.html BR

                                  Control0..1
                                  TypeHumanName(CH EPR FHIR BirthName)
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summarytrue
                                  Requirements

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

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  120. Patient.name:BirthName.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
                                  122. Patient.name:BirthName.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 Patient.name.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 124. Patient.name:BirthName.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..1
                                    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()))
                                    126. Patient.name:BirthName.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..1
                                    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()))
                                    128. Patient.name:BirthName.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()))
                                    130. Patient.name:BirthName.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()))
                                    132. Patient.name:BirthName.prefix
                                    Definition

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

                                    ShortParts that come before the name
                                    Control0..*
                                    Typestring
                                    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()))
                                    134. Patient.name:BirthName.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()))
                                    136. Patient.name:BirthName.period
                                    Definition

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

                                    ShortTime period when name was/is in use
                                    Control0..1
                                    TypePeriod
                                    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()))
                                    138. Patient.telecom
                                    Definition

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

                                    ShortA contact detail for the individual
                                    Comments

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

                                    Control0..*
                                    TypeContactPoint
                                    Is Modifierfalse
                                    Summarytrue
                                    Requirements

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

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    SlicingThis element introduces a set of slices on Patient.telecom. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ system
                                    • 140. Patient.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..1
                                      Typestring
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      142. Patient.telecom.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 Patient.telecom.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 144. Patient.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
                                        Control1..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()))
                                        146. Patient.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.

                                        Control1..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()))
                                        148. Patient.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..1
                                        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()))
                                        150. Patient.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..1
                                        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()))
                                        152. Patient.telecom.period
                                        Definition

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

                                        ShortTime period when the contact point was/is in use
                                        Control0..1
                                        TypePeriod
                                        Is Modifierfalse
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        154. Patient.telecom:email
                                        Slice Nameemail
                                        Definition

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

                                        ShortA contact detail for the individual
                                        Comments

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

                                        Control0..*
                                        TypeContactPoint(CH Core ContactPoint eCH-0046 Email)
                                        Is Modifierfalse
                                        Summarytrue
                                        Requirements

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

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        156. Patient.telecom:email.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
                                        158. Patient.telecom:email.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 Patient.telecom.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • value @ url
                                        • 160. Patient.telecom:email.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
                                          Control1..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
                                          Fixed Valueemail
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          162. Patient.telecom:email.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.

                                          Control1..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()))
                                          164. Patient.telecom:email.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..1
                                          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()))
                                          166. Patient.telecom:email.use.id
                                          Definition

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

                                          Shortxml:id (or equivalent in JSON)
                                          Control0..1
                                          Typestring
                                          Is Modifierfalse
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          Summaryfalse
                                          168. Patient.telecom:email.use.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 Patient.telecom.use.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                          • value @ url
                                          • 170. Patient.telecom:email.use.extension:emailCategory
                                            Slice NameemailCategory
                                            Definition

                                            Optional Extension Element - found in all resources.

                                            ShortOptional Extensions Element
                                            Control0..1
                                            This element is affected by the following invariants: ele-1
                                            TypeExtension(eCH-0046 Email Category) (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())
                                            172. Patient.telecom:email.use.value
                                            Definition

                                            Primitive value for code

                                            ShortPrimitive value for code
                                            Control0..1
                                            Typestring
                                            Is Modifierfalse
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            Summaryfalse
                                            174. Patient.telecom:email.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..1
                                            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()))
                                            176. Patient.telecom:email.period
                                            Definition

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

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

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

                                            ShortUnique id for inter-element referencing
                                            Control0..1
                                            Typestring
                                            Is Modifierfalse
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            Summaryfalse
                                            180. Patient.telecom:email.period.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 Patient.telecom.period.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • value @ url
                                            • 182. Patient.telecom:email.period.start
                                              Definition

                                              The start of the period. The boundary is inclusive.

                                              ShortStarting time with inclusive boundary
                                              Comments

                                              If the low element is missing, the meaning is that the low boundary is not known.

                                              Control0..1
                                              This element is affected by the following invariants: per-1
                                              TypedateTime
                                              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()))
                                              184. Patient.telecom:email.period.end
                                              Definition

                                              The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

                                              ShortEnd time with inclusive boundary, if not ongoing
                                              Comments

                                              The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

                                              Control0..1
                                              This element is affected by the following invariants: per-1
                                              TypedateTime
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summarytrue
                                              Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              186. Patient.telecom:phone
                                              Slice Namephone
                                              Definition

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

                                              ShortA contact detail for the individual
                                              Comments

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

                                              Control0..*
                                              TypeContactPoint(CH Core ContactPoint eCH-0046 Phone)
                                              Is Modifierfalse
                                              Summarytrue
                                              Requirements

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

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              188. Patient.telecom:phone.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
                                              190. Patient.telecom:phone.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 Patient.telecom.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • value @ url
                                              • 192. Patient.telecom:phone.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
                                                Control1..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
                                                Fixed Valuephone
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                194. Patient.telecom:phone.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.

                                                Control1..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()))
                                                196. Patient.telecom:phone.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..1
                                                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()))
                                                198. Patient.telecom:phone.use.id
                                                Definition

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

                                                Shortxml:id (or equivalent in JSON)
                                                Control0..1
                                                Typestring
                                                Is Modifierfalse
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                Summaryfalse
                                                200. Patient.telecom:phone.use.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 Patient.telecom.use.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                • value @ url
                                                • 202. Patient.telecom:phone.use.extension:phoneCategory
                                                  Slice NamephoneCategory
                                                  Definition

                                                  Optional Extension Element - found in all resources.

                                                  ShortOptional Extensions Element
                                                  Control0..1
                                                  This element is affected by the following invariants: ele-1
                                                  TypeExtension(eCH-0046 Phone Category) (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())
                                                  204. Patient.telecom:phone.use.value
                                                  Definition

                                                  Primitive value for code

                                                  ShortPrimitive value for code
                                                  Control0..1
                                                  Typestring
                                                  Is Modifierfalse
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  Summaryfalse
                                                  206. Patient.telecom:phone.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..1
                                                  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()))
                                                  208. Patient.telecom:phone.period
                                                  Definition

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

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

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

                                                  ShortUnique id for inter-element referencing
                                                  Control0..1
                                                  Typestring
                                                  Is Modifierfalse
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  Summaryfalse
                                                  212. Patient.telecom:phone.period.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 Patient.telecom.period.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                  • value @ url
                                                  • 214. Patient.telecom:phone.period.start
                                                    Definition

                                                    The start of the period. The boundary is inclusive.

                                                    ShortStarting time with inclusive boundary
                                                    Comments

                                                    If the low element is missing, the meaning is that the low boundary is not known.

                                                    Control0..1
                                                    This element is affected by the following invariants: per-1
                                                    TypedateTime
                                                    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()))
                                                    216. Patient.telecom:phone.period.end
                                                    Definition

                                                    The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

                                                    ShortEnd time with inclusive boundary, if not ongoing
                                                    Comments

                                                    The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

                                                    Control0..1
                                                    This element is affected by the following invariants: per-1
                                                    TypedateTime
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Summarytrue
                                                    Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    218. Patient.telecom:internet
                                                    Slice Nameinternet
                                                    Definition

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

                                                    ShortA contact detail for the individual
                                                    Comments

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

                                                    Control0..*
                                                    TypeContactPoint(CH Core ContactPoint eCH-0046 Internet)
                                                    Is Modifierfalse
                                                    Summarytrue
                                                    Requirements

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

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    220. Patient.telecom:internet.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
                                                    222. Patient.telecom:internet.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 Patient.telecom.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                    • value @ url
                                                    • 224. Patient.telecom:internet.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
                                                      Control1..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
                                                      Fixed Valueurl
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      226. Patient.telecom:internet.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.

                                                      Control1..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()))
                                                      228. Patient.telecom:internet.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..1
                                                      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()))
                                                      230. Patient.telecom:internet.use.id
                                                      Definition

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

                                                      Shortxml:id (or equivalent in JSON)
                                                      Control0..1
                                                      Typestring
                                                      Is Modifierfalse
                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                      Summaryfalse
                                                      232. Patient.telecom:internet.use.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 Patient.telecom.use.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                      • value @ url
                                                      • 234. Patient.telecom:internet.use.extension:internetCategory
                                                        Slice NameinternetCategory
                                                        Definition

                                                        Optional Extension Element - found in all resources.

                                                        ShortOptional Extensions Element
                                                        Control0..1
                                                        This element is affected by the following invariants: ele-1
                                                        TypeExtension(eCH-0046 Internet Category) (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())
                                                        236. Patient.telecom:internet.use.value
                                                        Definition

                                                        Primitive value for code

                                                        ShortPrimitive value for code
                                                        Control0..1
                                                        Typestring
                                                        Is Modifierfalse
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        Summaryfalse
                                                        238. Patient.telecom:internet.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..1
                                                        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()))
                                                        240. Patient.telecom:internet.period
                                                        Definition

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

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

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

                                                        ShortUnique id for inter-element referencing
                                                        Control0..1
                                                        Typestring
                                                        Is Modifierfalse
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        Summaryfalse
                                                        244. Patient.telecom:internet.period.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 Patient.telecom.period.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                        • value @ url
                                                        • 246. Patient.telecom:internet.period.start
                                                          Definition

                                                          The start of the period. The boundary is inclusive.

                                                          ShortStarting time with inclusive boundary
                                                          Comments

                                                          If the low element is missing, the meaning is that the low boundary is not known.

                                                          Control0..1
                                                          This element is affected by the following invariants: per-1
                                                          TypedateTime
                                                          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()))
                                                          248. Patient.telecom:internet.period.end
                                                          Definition

                                                          The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

                                                          ShortEnd time with inclusive boundary, if not ongoing
                                                          Comments

                                                          The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

                                                          Control0..1
                                                          This element is affected by the following invariants: per-1
                                                          TypedateTime
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summarytrue
                                                          Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          250. Patient.gender
                                                          Definition

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

                                                          Shortmale | female | other | unknown* (* see warning 'ch-pat-2')
                                                          Comments

                                                          The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex.

                                                          Control0..1
                                                          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 for identification of the individual, in combination with (at least) name and birth date.

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

                                                          The date of birth for the individual.

                                                          ShortThe date of birth for the individual
                                                          Comments

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

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

                                                          Age of the individual drives many clinical processes.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          LOINC Code21112-8
                                                          254. Patient.deceased[x]
                                                          Definition

                                                          Indicates if the individual is deceased or not.

                                                          ShortIndicates if the individual is deceased or not
                                                          Comments

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

                                                          Control0..1
                                                          TypeChoice of: boolean, dateTime
                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                          Is Modifiertrue because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summarytrue
                                                          Requirements

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

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          SlicingThis element introduces a set of slices on Patient.deceased[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                          • type @ $this
                                                          • 256. Patient.deceased[x]:deceasedDateTime
                                                            Slice NamedeceasedDateTime
                                                            Definition

                                                            Indicates if the individual is deceased or not.

                                                            ShortIndicates if the individual is deceased or not
                                                            Comments

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

                                                            Control0..1
                                                            TypedateTime
                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                            Is Modifiertrue because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Summarytrue
                                                            Requirements

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

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

                                                            An address for the individual.

                                                            ShortAn address for the individual
                                                            Comments

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

                                                            Control0..*
                                                            TypeAddress(CH Core Address)
                                                            Is Modifierfalse
                                                            Summarytrue
                                                            Requirements

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

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

                                                            This field contains a patient's most recent marital (civil) status.

                                                            ShortMarital (civil) status of a patient
                                                            Control0..1
                                                            BindingUnless not suitable, these codes SHALL be taken from ChCoreMaritalStatus (3.4.0)
                                                            (extensible to http://fhir.ch/ig/ch-core/ValueSet/ch-core-maritalstatus|3.4.0)
                                                            TypeCodeableConcept
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Most, if not all systems capture it.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            262. Patient.maritalStatus.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
                                                            264. Patient.maritalStatus.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 Patient.maritalStatus.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                            • value @ url
                                                            • 266. Patient.maritalStatus.extension:maritalDataSeparation
                                                              Slice NamemaritalDataSeparation
                                                              Definition

                                                              Extension for eCH-0011 - MaritalData - separation

                                                              ShortMaritalData Separation
                                                              Control0..1
                                                              TypeExtension(Marital Data - Separation Type) (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())
                                                              268. Patient.maritalStatus.coding
                                                              Definition

                                                              A reference to a code defined by a terminology system.

                                                              ShortCode defined by a terminology system
                                                              Comments

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

                                                              Control0..*
                                                              TypeCoding
                                                              Is Modifierfalse
                                                              Summarytrue
                                                              Requirements

                                                              Allows for alternative encodings within a code system, and translations to other code systems.

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

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

                                                              ShortPlain text representation of the concept
                                                              Comments

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

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

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

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              272. Patient.multipleBirth[x]
                                                              Definition

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

                                                              ShortWhether patient is part of a multiple birth
                                                              Comments

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

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

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

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

                                                              Image of the patient.

                                                              ShortImage of the patient
                                                              Comments

                                                              Guidelines:

                                                              • Use id photos, not clinical photos.
                                                              • Limit dimensions to thumbnail.
                                                              • Keep byte count low to ease resource updates.
                                                              Control0..*
                                                              TypeAttachment
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Requirements

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

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

                                                              A contact party (e.g. guardian, partner, friend) for the patient.

                                                              ShortA contact party (e.g. guardian, partner, friend) for the patient
                                                              Comments

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

                                                              Control0..*
                                                              TypeBackboneElement
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Need to track people you can contact about the patient.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              pat-1: SHALL at least contain a contact's details or a reference to an organization (name.exists() or telecom.exists() or address.exists() or organization.exists())
                                                              SlicingThis element introduces a set of slices on Patient.contact. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                              • value @ relationship
                                                              • 278. Patient.contact.id
                                                                Definition

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

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

                                                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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())
                                                                282. Patient.contact.modifierExtension
                                                                Definition

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

                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                Comments

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

                                                                Control0..*
                                                                TypeExtension
                                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                Summarytrue
                                                                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, modifiers
                                                                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())
                                                                284. Patient.contact.relationship
                                                                Definition

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

                                                                ShortThe kind of relationship
                                                                Control0..*
                                                                BindingUnless not suitable, these codes SHALL be taken from PatientContactRelationship
                                                                (extensible to http://hl7.org/fhir/ValueSet/patient-contactrelationship|4.0.1)

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

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

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

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

                                                                A name associated with the contact person.

                                                                ShortA name associated with the contact person
                                                                Control0..1
                                                                TypeHumanName
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

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

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

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

                                                                ShortA contact detail for the person
                                                                Comments

                                                                Contact may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification.

                                                                Control0..*
                                                                TypeContactPoint
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

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

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

                                                                Address for the contact person.

                                                                ShortAddress for the contact person
                                                                Control0..1
                                                                TypeAddress
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

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

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

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

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

                                                                Needed to address the person correctly.

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

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

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

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

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

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

                                                                ShortThe period during which this contact person or organization is valid to be contacted relating to this patient
                                                                Control0..1
                                                                TypePeriod
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                298. Patient.contact:contact
                                                                Slice Namecontact
                                                                Definition

                                                                A contact party (e.g. guardian, partner, friend) for the patient.

                                                                ShortContact data if it is not the address of the patient
                                                                Comments

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

                                                                Control0..1
                                                                TypeBackboneElement
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Need to track people you can contact about the patient.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                pat-1: SHALL at least contain a contact's details or a reference to an organization (name.exists() or telecom.exists() or address.exists() or organization.exists())
                                                                300. Patient.contact:contact.id
                                                                Definition

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

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

                                                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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())
                                                                304. Patient.contact:contact.modifierExtension
                                                                Definition

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

                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                Comments

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

                                                                Control0..*
                                                                TypeExtension
                                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                Summarytrue
                                                                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, modifiers
                                                                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())
                                                                306. Patient.contact:contact.relationship
                                                                Definition

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

                                                                ShortThe kind of relationship
                                                                Control1..1
                                                                BindingUnless not suitable, these codes SHALL be taken from PatientContactRelationship
                                                                (extensible to http://hl7.org/fhir/ValueSet/patient-contactrelationship|4.0.1)

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

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

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

                                                                Pattern Value{
                                                                  "coding" : [{
                                                                    "system" : "http://fhir.ch/ig/ch-core/CodeSystem/ech-11",
                                                                    "code" : "contactData"
                                                                  }]
                                                                }
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                308. Patient.contact:contact.name
                                                                Definition

                                                                A name associated with the contact person.

                                                                ShortA name associated with the contact person
                                                                Control0..1
                                                                TypeHumanName
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

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

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

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

                                                                ShortA contact detail for the person
                                                                Comments

                                                                Contact may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification.

                                                                Control0..0
                                                                TypeContactPoint
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

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

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

                                                                Address for the contact person.

                                                                ShortAddress for the contact person
                                                                Control1..1
                                                                TypeAddress(CH Core Postal Address)
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

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

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

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

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

                                                                Needed to address the person correctly.

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

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

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

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

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

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

                                                                ShortThe period during which this contact person or organization is valid to be contacted relating to this patient
                                                                Control0..1
                                                                TypePeriod
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                320. Patient.contact:nameOfParent
                                                                Slice NamenameOfParent
                                                                Definition

                                                                A contact party (e.g. guardian, partner, friend) for the patient.

                                                                ShortName of parent
                                                                Comments

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

                                                                Control0..*
                                                                TypeBackboneElement
                                                                Is Modifierfalse
                                                                Must Supporttrue
                                                                Summaryfalse
                                                                Requirements

                                                                Need to track people you can contact about the patient.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                pat-1: SHALL at least contain a contact's details or a reference to an organization (name.exists() or telecom.exists() or address.exists() or organization.exists())
                                                                322. Patient.contact:nameOfParent.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
                                                                324. Patient.contact:nameOfParent.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())
                                                                326. Patient.contact:nameOfParent.modifierExtension
                                                                Definition

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

                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                Comments

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

                                                                Control0..*
                                                                TypeExtension
                                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                Summarytrue
                                                                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, modifiers
                                                                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())
                                                                328. Patient.contact:nameOfParent.relationship
                                                                Definition

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

                                                                ShortThe kind of relationship
                                                                Control1..1
                                                                BindingUnless not suitable, these codes SHALL be taken from PatientContactRelationship
                                                                (extensible to http://hl7.org/fhir/ValueSet/patient-contactrelationship|4.0.1)

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

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

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

                                                                Pattern Value{
                                                                  "coding" : [{
                                                                    "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
                                                                    "code" : "PRN"
                                                                  }]
                                                                }
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                330. Patient.contact:nameOfParent.name
                                                                Definition

                                                                A name associated with the contact person.

                                                                ShortA name associated with the contact person
                                                                Control1..1
                                                                TypeHumanName
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

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

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                332. Patient.contact:nameOfParent.telecom
                                                                Definition

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

                                                                ShortA contact detail for the person
                                                                Comments

                                                                Contact may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification.

                                                                Control0..*
                                                                TypeContactPoint
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

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

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                334. Patient.contact:nameOfParent.address
                                                                Definition

                                                                Address for the contact person.

                                                                ShortAddress for the contact person
                                                                Control0..1
                                                                TypeAddress
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

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

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                336. Patient.contact:nameOfParent.gender
                                                                Definition

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

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

                                                                Needed to address the person correctly.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                338. Patient.contact:nameOfParent.organization
                                                                Definition

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

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

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

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                340. Patient.contact:nameOfParent.period
                                                                Definition

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

                                                                ShortThe period during which this contact person or organization is valid to be contacted relating to this patient
                                                                Control0..1
                                                                TypePeriod
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                342. Patient.communication
                                                                Definition

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

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

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

                                                                Control0..*
                                                                TypeBackboneElement
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

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

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

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

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

                                                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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())
                                                                348. Patient.communication.modifierExtension
                                                                Definition

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

                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                Comments

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

                                                                Control0..*
                                                                TypeExtension
                                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                Summarytrue
                                                                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, modifiers
                                                                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())
                                                                350. Patient.communication.language
                                                                Definition

                                                                The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English.

                                                                ShortThe language which can be used to communicate with the patient about his or her health
                                                                Comments

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

                                                                Control1..1
                                                                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

                                                                Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.

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

                                                                Indicates whether or not the patient prefers this language (over other languages he masters up a certain level).

                                                                ShortLanguage preference indicator
                                                                Comments

                                                                This language is specifically identified for communicating healthcare information.

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

                                                                People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method.

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

                                                                Patient's nominated care provider.

                                                                ShortPatient's nominated primary care provider
                                                                Comments

                                                                This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues.

                                                                Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type.

                                                                Control0..*
                                                                TypeReference(Organization, Practitioner, PractitionerRole)
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Alternate NamescareProvider
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                356. Patient.managingOrganization
                                                                Definition

                                                                Organization that is the custodian of the patient record.

                                                                ShortOrganization that is the custodian of the patient record
                                                                Comments

                                                                There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association).

                                                                Control0..1
                                                                TypeReference(Organization)
                                                                Is Modifierfalse
                                                                Summarytrue
                                                                Requirements

                                                                Need to know who recognizes this patient record, manages and updates it.

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

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

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

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

                                                                Control0..*
                                                                TypeBackboneElement
                                                                Is Modifiertrue because This element is labeled as a modifier because it might not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'
                                                                Summarytrue
                                                                Requirements

                                                                There are multiple use cases:

                                                                • Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and
                                                                • Distribution of patient information across multiple servers.
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                360. Patient.link.id
                                                                Definition

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

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

                                                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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())
                                                                364. Patient.link.modifierExtension
                                                                Definition

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

                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                Comments

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

                                                                Control0..*
                                                                TypeExtension
                                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                Summarytrue
                                                                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, modifiers
                                                                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())
                                                                366. Patient.link.other
                                                                Definition

                                                                The other patient resource that the link refers to.

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

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

                                                                Control1..1
                                                                TypeReference(Patient, RelatedPerson)
                                                                Is Modifierfalse
                                                                Summarytrue
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                368. Patient.link.type
                                                                Definition

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

                                                                Shortreplaced-by | replaces | refer | seealso
                                                                Control1..1
                                                                BindingThe codes SHALL be taken from LinkType
                                                                (required to http://hl7.org/fhir/ValueSet/link-type|4.0.1)

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

                                                                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()))