Care Coordination Management
0.0.1 - ci-build Estonia (EST)

Care Coordination Management, published by Helex OÜ. This guide is not an authorized publication; it is the continuous build for version 0.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/helexlab/ig-ccm/ and changes regularly. See the Directory of published versions

Resource Profile: PatientCcm - Detailed Descriptions

Draft as of 2025-12-05

Definitions for the patient-ccm resource profile.

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

0. Patient
Definition

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

ShortInformation about an individual or animal receiving health care services
Control0..*
Is Modifierfalse
Must Supportfalse
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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. 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 its 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 its meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Patient.contained
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

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..*
This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
TypeResource
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
6. 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 managable, 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
Must Supportfalse
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
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())
8. 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
Must Supporttrue
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()))
10. Patient.identifier.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|5.0.0
(required to http://hl7.org/fhir/ValueSet/identifier-use|5.0.0)

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()))
12. Patient.identifier.system
Definition

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

ShortThe namespace for the identifier value
Comments

Identifier.system is always case sensitive.

Control10..1
BindingThe codes SHALL be taken from For codes, see Patient Identifier Domain
(required to https://fhir.ee/ValueSet/patient-identifier-domain)
Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
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()))
14. Patient.identifier.value
Definition

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

ShortPatient identification code or document number.The 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 http://hl7.org/fhir/StructureDefinition/rendered-value). 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
This element is affected by the following invariants: ident-1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
ExampleGeneral: 123456
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. 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.

Control10..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
Must Supporttrue
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()))
18. Patient.name
Definition

Patsiendi nimi


A name associated with the individual.

ShortPatient nameA 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. Animal names may be communicated as given names, and optionally may include a family name.

Control10..*
TypeHumanName
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:
  • value @ use
  • 20. Patient.name:official
    Slice Nameofficial
    Definition

    A name associated with the individual.

    ShortAmetlik nimiA 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. Animal names may be communicated as given names, and optionally may include a family name.

    Control10..1*
    TypeHumanName
    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()))
    22. Patient.name:official.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.

    Control10..1
    BindingThe codes SHALL be taken from NameUsehttp://hl7.org/fhir/ValueSet/name-use|5.0.0
    (required to http://hl7.org/fhir/ValueSet/name-use|5.0.0)

    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
    Must Supporttrue
    Summarytrue
    Requirements

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

    Fixed Valueofficial
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    24. Patient.name:official.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
    Must Supporttrue
    Summarytrue
    Requirements

    A renderable, unencoded form.

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

    ShortPerekonnanimiFamily name (often called 'Surname')
    Comments

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

    Control10..1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Alternate Namessurname
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    28. Patient.name:official.given
    Definition

    Given name.

    ShortEesnimiGiven 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.

    Control10..1*
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Alternate Namesfirst name, middle name
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    30. Patient.name:official.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..1*
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    32. Patient.name:official.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
    Must Supporttrue
    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()))
    34. Patient.name:nickname
    Slice Namenickname
    Definition

    A name associated with the individual.

    ShortTundmatu või anonüümse patsiendi nimiA 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. Animal names may be communicated as given names, and optionally may include a family name.

    Control0..1*
    TypeHumanName
    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()))
    36. Patient.name:nickname.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.

    Control10..1
    BindingThe codes SHALL be taken from NameUsehttp://hl7.org/fhir/ValueSet/name-use|5.0.0
    (required to http://hl7.org/fhir/ValueSet/name-use|5.0.0)

    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
    Must Supporttrue
    Summarytrue
    Requirements

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

    Fixed Valuenickname
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    38. Patient.name:nickname.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.

    ShortTundmatu patsiendi hüüdnimiText 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.

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

    A renderable, unencoded form.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    40. Patient.name:nickname.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..01
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Alternate Namessurname
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    42. Patient.name:nickname.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..0*
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Alternate Namesfirst name, middle name
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    44. Patient.name:nickname.prefix
    Definition

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

    ShortParts that come before the name
    Control0..0*
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    46. Patient.name:nickname.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..0*
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    48. 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
    Must Supporttrue
    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()))
    50. 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|5.0.0
    (required to http://hl7.org/fhir/ValueSet/contact-point-system|5.0.0)

    Telecommunications form for contact point.

    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    52. 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
    This element is affected by the following invariants: cpt-2
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    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()))
    54. 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|5.0.0
    (required to http://hl7.org/fhir/ValueSet/contact-point-use|5.0.0)

    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
    Must Supporttrue
    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()))
    56. 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
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    58. Patient.gender
    Definition

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

    Shortmale | female | other | unknown
    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 Administrative Genderhttp://hl7.org/fhir/ValueSet/administrative-gender|5.0.0
    (required to https://fhir.ee/ValueSet/administrative-gender)
    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    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()))
    60. Patient.birthDate
    Definition

    The date of birth for the individual.

    ShortThe date of birth for the individual
    Comments

    Partial dates are allowed if the specific date of birth 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
    Must Supporttrue
    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
    62. Patient.birthDate.extension:birthTime
    Slice NamebirthTime
    Definition

    The time of day that the Patient/Person/RelatedPerson/Practitioner was born. This includes the date to ensure that the timezone information can be communicated effectively.

    ShortSünniaeg
    Comments

    The patient prefix on the extension was retained to ensure backward compatibility with existing data (the content itself is provided to assist in sharing data across patient resources effectively)

    Control0..1
    TypeExtension(Patient/Person/RelatedPerson/Practitioner Birth Time) (Extension Type: dateTime)
    Is Modifierfalse
    Must Supporttrue
    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())
    64. Patient.birthDate.extension:birthTime.extension
    Definition

    An Extension


    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 managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

    ShortExtensionAdditional content defined by implementations
    Comments

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

    Control0..0*
    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.birthDate.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 66. Patient.birthDate.extension:birthTime.url
      Definition

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

      Shortidentifies the meaning of the extension
      Comments

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

      Control1..1
      Typeuri
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      Fixed Valuehttp://hl7.org/fhir/StructureDefinition/patient-birthTime
      68. Patient.birthDate.extension:birthTime.value[x]
      Definition

      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

      ShortValue of extension
      Control10..1
      This element is affected by the following invariants: ext-1
      TypedateTime, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, RatioRange, Coding, SampledData, id, positiveInt, Distance, Availability, integer64, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ExtendedContactDetail, CodeableConcept, ParameterDefinition, code, string, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, CodeableReference, Signature, unsignedInt, time
      [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
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      70. Patient.birthDate.extension:age
      Slice Nameage
      Definition

      Patient age measure and unit

      ShortVanus
      Control0..1
      TypeExtension(EEBase PatientAge) (Extension Type: Age)
      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.birthDate.extension:accuracyIndicator
      Slice NameaccuracyIndicator
      Definition

      General date accuracy indicator coding.

      ShortKuupäeva täpsuse indikaator
      Comments

      In some circumstances, systems may capture date or dateTime data that has unknown or estimated parts. This coding indicates the accuracy of the day, month and year parts. This concept is equivalent to Australian Institute of Health and Welfare data element 294418 Date—accuracy indicator.

      Control0..1
      TypeExtension(EEBase Date Accuracy Indicator) (Extension Type: Coding)
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      74. 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
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      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()))
      76. Patient.deceased[x].extension:accuracyIndicator
      Slice NameaccuracyIndicator
      Definition

      General date accuracy indicator coding.

      ShortDate accuracy indicator
      Comments

      In some circumstances, systems may capture date or dateTime data that has unknown or estimated parts. This coding indicates the accuracy of the day, month and year parts. This concept is equivalent to Australian Institute of Health and Welfare data element 294418 Date—accuracy indicator.

      Control0..1
      TypeExtension(EEBase Date Accuracy Indicator) (Extension Type: Coding)
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      78. 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(EEBase Address)
      Is Modifierfalse
      Must Supporttrue
      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()))
      80. Patient.address.extension:adsAdrId
      Slice NameadsAdrId
      Definition

      Aadressiandmete süsteemi (ADS) aadressi versiooni unikaalne identifikaator

      ShortADS AdrId
      Control0..1
      TypeExtension(EEBase ADS AdrId) (Extension Type: Coding)
      Is Modifierfalse
      Must Supporttrue
      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.address.extension:adsOid
      Slice NameadsOid
      Definition

      Aadressiandmete süsteemi (ADS) aadressi objekti identifikaator. Omab sama väärtust erinevate versioonide (ehk aadressite identifikaatorite lõikes).

      ShortADS Oid
      Control0..1
      TypeExtension(EEBase ADS Oid) (Extension Type: Coding)
      Is Modifierfalse
      Must Supporttrue
      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())
      84. Patient.address.extension:ehak
      Slice Nameehak
      Definition

      Eesti haldus- ja asustusjaotuse klassifikaator (EHAK) on ette nähtud territoriaalse paiknemise tähistamiseks. Igale klassifitseerimisobjektile on antud unikaalne neljakohaline kood ja näidatud on objekti nimi ning rööpnimi (kui see on olemas).

      ShortEHAK code
      Control0..1
      TypeExtension(EEBase EHAK) (Extension Type: Coding)
      Is Modifierfalse
      Must Supporttrue
      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())
      86. Patient.address.extension:official
      Slice Nameofficial
      Definition

      This extension allows to specify if this address is or it is not the official address, or to indicate that this is the official address for that country (true assumed). Note: It does not make sense to repeat this extension without the valueCodeableConcept to specify jurisdictions.

      ShortIndicator of address of residency
      Control0..1
      TypeExtension(Official Address) (Extension Type: Choice of: boolean, CodeableConcept)
      Is Modifierfalse
      Must Supporttrue
      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())
      88. Patient.address.extension:notice
      Slice Namenotice
      Definition

      Aadressi hoiused või märkused

      ShortAddress notices and warnings
      Control0..*
      TypeExtension(EEBase Address Notice) (Extension Type: Coding)
      Is Modifierfalse
      Must Supporttrue
      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())
      90. Patient.address.use
      Definition

      The purpose of this address.

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

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

      Control10..1
      BindingThe codes SHALL be taken from AddressUsehttp://hl7.org/fhir/ValueSet/address-use|5.0.0
      (required to http://hl7.org/fhir/ValueSet/address-use|5.0.0)

      The use of an address (home / work / etc.).

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

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

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

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

      ShortText representation of the address
      Comments

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

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

      A renderable, unencoded form.

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

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

      ShortStreet name, number, direction & P.O. Box etc.
      Control10..1*
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      ExampleGeneral: 137 Nowhere Street
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      96. Patient.address.line.extension:censusTract
      Slice NamecensusTract
      Definition

      Väikekoht (AÜ, SÜ, GÜ, vkt). Vastab Maa-ameti ADS-iga liidestumise juhendis tasemele 4.

      ShortA geographic sub-unit delineated for demographic purposes.
      Control0..1
      TypeExtension(ADXP Census Tract) (Extension Type: string)
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      98. Patient.address.line.extension:streetName
      Slice NamestreetName
      Definition

      Liikluspind (tee, tänav, puiestee, maantee). Vastab Maa-ameti ADS-iga liidestumise juhendis tasemele 5.

      ShortStreet name
      Control0..1
      TypeExtension(ADXP Street Name) (Extension Type: string)
      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())
      100. Patient.address.line.extension:streetNameBase
      Slice NamestreetNameBase
      Definition

      Nimi (kohanimi, maaüksuse nimi). Vastab Maa-ameti ADS-iga liidestumise juhendis tasemele 6.

      ShortThe base name of a roadway or artery recognized by a municipality (excluding street type and direction).
      Control0..1
      TypeExtension(ADXP Street Name Base) (Extension Type: string)
      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())
      102. Patient.address.line.extension:houseNumber
      Slice NamehouseNumber
      Definition

      Aadressinumber (maaüksuse või hoone erilisand). Vastab Maa-ameti ADS-iga liidestumise juhendis tasemele 7.

      ShortHouse number
      Control0..1
      TypeExtension(ADXP House Number) (Extension Type: string)
      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())
      104. Patient.address.line.extension:additionalLocator
      Slice NameadditionalLocator
      Definition

      Korteri või muu hooneosa number. Vastab Maa-ameti ADS-iga liidestumise juhendis tasemele 8.

      ShortAdditional locator
      Control0..1
      TypeExtension(ADXP Additional Locator) (Extension Type: string)
      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())
      106. Patient.address.country
      Definition

      Riigi kood (lubatud ISO-3166-2 koodid)


      Country - a nation as commonly understood or generally accepted.

      ShortShould use a 2 digit ISO 3166 codeCountry (e.g. may be ISO 3166 2 or 3 letter code)
      Comments

      ISO 3166 2- or 3- letter codes MAY be used in place of a human readable country name.

      Control10..1
      BindingThe codes SHALL be taken from For codes, see Iso316612
      (required to http://hl7.org/fhir/ValueSet/iso3166-1-2)
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      108. 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
      Must Supporttrue
      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()))
      110. 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 managable, 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())
      112. 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-AU" for Australian 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 SHALL be taken from AllLanguageshttp://hl7.org/fhir/ValueSet/all-languages|5.0.0
      (required to http://hl7.org/fhir/ValueSet/all-languages|5.0.0)

      IETF language tag for a human language

      TypeCodeableConcept
      Is Modifierfalse
      Must Supportfalse
      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()))
      114. 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(EEBase Practitioner, EEBase PractitionerRole, Organization, Practitioner, PractitionerRole)
      Is Modifierfalse
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summaryfalse
      Alternate NamescareProvider
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      116. Patient.link
      Definition

      Link to a Patient or RelatedPerson resource that concerns the same actual individual.

      ShortLink to a Patient or RelatedPerson resource that concerns the same actual individual
      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'
      Must Supporttrue
      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()))
      118. 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 managable, 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())
      120. Patient.link.other
      Definition

      Link to a Patient or RelatedPerson resource that concerns the same actual individual.

      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(EEBase Patient, EEBase RelatedPerson, Patient, RelatedPerson)
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      122. 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|5.0.0
      (required to http://hl7.org/fhir/ValueSet/link-type|5.0.0)

      The type of link between this patient resource and another Patient resource, or Patient/RelatedPerson when using the seealso code

      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      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.name
      Control1..?
      4. Patient.name:official
      Slice Nameofficial
      Control1..?
      6. Patient.address
      8. Patient.address.line
      Control1..1
      Must Supporttrue
      10. Patient.communication
      Must Supporttrue

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

      0. Patient
      Definition

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

      ShortInformation about an individual or animal receiving health care services
      Control0..*
      Is Modifierfalse
      Must Supportfalse
      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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
      dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
      dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      2. 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

      Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

      Control0..1
      Typeid
      Is Modifierfalse
      Must Supportfalse
      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
      Must Supportfalse
      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 its 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 its meaning or interpretation
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      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 SHALL be taken from AllLanguages
      (required to http://hl7.org/fhir/ValueSet/all-languages|5.0.0)

      IETF language tag for a human language

      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      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 a 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
      This element is affected by the following invariants: dom-6
      TypeNarrative
      Is Modifierfalse
      Must Supportfalse
      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, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

      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..*
      This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
      TypeResource
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Alternate Namesinline resources, anonymous resources, contained resources
      14. Patient.extension
      Definition

      May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and managable, 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
      Must Supportfalse
      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())
      16. 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 managable, 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
      Must Supportfalse
      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
      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.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
      Must Supporttrue
      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()))
      20. Patient.identifier.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
      This element is affected by the following invariants: ele-1
      Typeid
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      22. Patient.identifier.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 managable, 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
      • 24. Patient.identifier.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|5.0.0)

        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()))
        26. Patient.identifier.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 IdentifierTypeCodes
        (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

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

        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()))
        28. Patient.identifier.system
        Definition

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

        ShortThe namespace for the identifier value
        Comments

        Identifier.system is always case sensitive.

        Control1..1
        BindingThe codes SHALL be taken from Patient Identifier Domain
        (required to https://fhir.ee/ValueSet/patient-identifier-domain)
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        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()))
        30. Patient.identifier.value
        Definition

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

        ShortPatient identification code or document number.
        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 http://hl7.org/fhir/StructureDefinition/rendered-value). 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
        This element is affected by the following invariants: ident-1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        ExampleGeneral: 123456
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        32. Patient.identifier.period
        Definition

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

        ShortValidity period of the identifier of identification document.
        Control0..1
        TypePeriod
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        34. Patient.identifier.assigner
        Definition

        Organization that issued/manages the identifier.

        ShortOrganization that issued the document. Can be used as a reference to an organization or as free 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()))
        36. 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.

        Control1..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
        Must Supporttrue
        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()))
        38. Patient.name
        Definition

        Patsiendi nimi

        ShortPatient name
        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. Animal names may be communicated as given names, and optionally may include a family name.

        Control1..*
        TypeHumanName
        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:
        • value @ use
        • 40. Patient.name:official
          Slice Nameofficial
          Definition

          A name associated with the individual.

          ShortAmetlik nimi
          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. Animal names may be communicated as given names, and optionally may include a family name.

          Control1..1
          TypeHumanName
          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()))
          42. Patient.name:official.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
          This element is affected by the following invariants: ele-1
          Typeid
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          44. Patient.name:official.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 managable, 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
          • 46. Patient.name:official.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.

            Control1..1
            BindingThe codes SHALL be taken from NameUse
            (required to http://hl7.org/fhir/ValueSet/name-use|5.0.0)

            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
            Must Supporttrue
            Summarytrue
            Requirements

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

            Fixed Valueofficial
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            48. Patient.name:official.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
            Must Supporttrue
            Summarytrue
            Requirements

            A renderable, unencoded form.

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

            ShortPerekonnanimi
            Comments

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

            Control1..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Alternate Namessurname
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            52. Patient.name:official.given
            Definition

            Given name.

            ShortEesnimi
            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.

            Control1..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Alternate Namesfirst name, middle name
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            54. Patient.name:official.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..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            56. Patient.name:official.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()))
            58. Patient.name:official.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
            Must Supporttrue
            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()))
            60. Patient.name:nickname
            Slice Namenickname
            Definition

            A name associated with the individual.

            ShortTundmatu või anonüümse patsiendi nimi
            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. Animal names may be communicated as given names, and optionally may include a family name.

            Control0..1
            TypeHumanName
            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()))
            62. Patient.name:nickname.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
            This element is affected by the following invariants: ele-1
            Typeid
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            64. Patient.name:nickname.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 managable, 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
            • 66. Patient.name:nickname.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.

              Control1..1
              BindingThe codes SHALL be taken from NameUse
              (required to http://hl7.org/fhir/ValueSet/name-use|5.0.0)

              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
              Must Supporttrue
              Summarytrue
              Requirements

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

              Fixed Valuenickname
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              68. Patient.name:nickname.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.

              ShortTundmatu patsiendi hüüdnimi
              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.

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

              A renderable, unencoded form.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              70. Patient.name:nickname.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..0
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summarytrue
              Alternate Namessurname
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              72. Patient.name:nickname.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..0
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summarytrue
              Alternate Namesfirst name, middle name
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              74. Patient.name:nickname.prefix
              Definition

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

              ShortParts that come before the name
              Control0..0
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              76. Patient.name:nickname.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..0
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              78. Patient.name:nickname.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()))
              80. 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
              Must Supporttrue
              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.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
              This element is affected by the following invariants: ele-1
              Typeid
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              84. 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 managable, 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
              • 86. 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|5.0.0)

                Telecommunications form for contact point.

                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                88. 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
                This element is affected by the following invariants: cpt-2
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                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()))
                90. 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|5.0.0)

                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
                Must Supporttrue
                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()))
                92. 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.

                Ranks need not be unique. E.g. it's possible to have multiple contacts with rank=1. If the ranks have different systems or uses, this would be interpreted to mean "X is my most preferred phone number, Y is my most preferred email address" or "X is my preferred home email and Y is my preferred work email". If the system and use for equally-ranked contacts are the same, then the level of preference is equivalent for both repetitions.

                Ranks need not be sequential and not all repetitions must have a rank. For example, it's possible to have 4 contacts with ranks of 2, 5 and two with no rank specified. That would be interpreted to mean the first is preferred over the second and no preference stated for the remaining contacts.

                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()))
                94. 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
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                96. Patient.gender
                Definition

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

                Shortmale | female | other | unknown
                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 Administrative Gender
                (required to https://fhir.ee/ValueSet/administrative-gender)
                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                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()))
                98. Patient.birthDate
                Definition

                The date of birth for the individual.

                ShortThe date of birth for the individual
                Comments

                Partial dates are allowed if the specific date of birth 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
                Must Supporttrue
                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
                100. Patient.birthDate.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
                102. Patient.birthDate.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.birthDate.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 104. Patient.birthDate.extension:birthTime
                  Slice NamebirthTime
                  Definition

                  The time of day that the Patient/Person/RelatedPerson/Practitioner was born. This includes the date to ensure that the timezone information can be communicated effectively.

                  ShortSünniaeg
                  Comments

                  The patient prefix on the extension was retained to ensure backward compatibility with existing data (the content itself is provided to assist in sharing data across patient resources effectively)

                  Control0..1
                  TypeExtension(Patient/Person/RelatedPerson/Practitioner Birth Time) (Extension Type: dateTime)
                  Is Modifierfalse
                  Must Supporttrue
                  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())
                  106. Patient.birthDate.extension:birthTime.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
                  This element is affected by the following invariants: ele-1
                  Typeid
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  108. Patient.birthDate.extension:birthTime.extension
                  Definition

                  An Extension

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

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

                    Shortidentifies the meaning of the extension
                    Comments

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

                    Control1..1
                    Typeuri
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    Fixed Valuehttp://hl7.org/fhir/StructureDefinition/patient-birthTime
                    112. Patient.birthDate.extension:birthTime.value[x]
                    Definition

                    Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                    ShortValue of extension
                    Control1..1
                    This element is affected by the following invariants: ext-1
                    TypedateTime
                    [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
                    Must Supporttrue
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    114. Patient.birthDate.extension:age
                    Slice Nameage
                    Definition

                    Patient age measure and unit

                    ShortVanus
                    Control0..1
                    TypeExtension(EEBase PatientAge) (Extension Type: Age)
                    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())
                    116. Patient.birthDate.extension:accuracyIndicator
                    Slice NameaccuracyIndicator
                    Definition

                    General date accuracy indicator coding.

                    ShortKuupäeva täpsuse indikaator
                    Comments

                    In some circumstances, systems may capture date or dateTime data that has unknown or estimated parts. This coding indicates the accuracy of the day, month and year parts. This concept is equivalent to Australian Institute of Health and Welfare data element 294418 Date—accuracy indicator.

                    Control0..1
                    TypeExtension(EEBase Date Accuracy Indicator) (Extension Type: Coding)
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    118. Patient.birthDate.value
                    Definition

                    The actual value

                    ShortPrimitive value for date
                    Control0..1
                    Typedate
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    120. 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
                    Must Supporttrue
                    Must Support TypesNo must-support rules about the choice of types/profiles
                    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()))
                    122. Patient.deceased[x].id
                    Definition

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

                    ShortUnique id for inter-element referencing
                    Control0..1
                    This element is affected by the following invariants: ele-1
                    Typestring
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    124. Patient.deceased[x].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 managable, 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.deceased[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 126. Patient.deceased[x].extension:accuracyIndicator
                      Slice NameaccuracyIndicator
                      Definition

                      General date accuracy indicator coding.

                      ShortDate accuracy indicator
                      Comments

                      In some circumstances, systems may capture date or dateTime data that has unknown or estimated parts. This coding indicates the accuracy of the day, month and year parts. This concept is equivalent to Australian Institute of Health and Welfare data element 294418 Date—accuracy indicator.

                      Control0..1
                      TypeExtension(EEBase Date Accuracy Indicator) (Extension Type: Coding)
                      Is Modifierfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      128. 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(EEBase Address)
                      Is Modifierfalse
                      Must Supporttrue
                      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()))
                      130. Patient.address.id
                      Definition

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

                      ShortUnique id for inter-element referencing
                      Control0..1
                      This element is affected by the following invariants: ele-1
                      Typeid
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      132. Patient.address.extension
                      Definition

                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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.address.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 134. Patient.address.extension:adsAdrId
                        Slice NameadsAdrId
                        Definition

                        Aadressiandmete süsteemi (ADS) aadressi versiooni unikaalne identifikaator

                        ShortADS AdrId
                        Control0..1
                        TypeExtension(EEBase ADS AdrId) (Extension Type: Coding)
                        Is Modifierfalse
                        Must Supporttrue
                        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())
                        136. Patient.address.extension:adsOid
                        Slice NameadsOid
                        Definition

                        Aadressiandmete süsteemi (ADS) aadressi objekti identifikaator. Omab sama väärtust erinevate versioonide (ehk aadressite identifikaatorite lõikes).

                        ShortADS Oid
                        Control0..1
                        TypeExtension(EEBase ADS Oid) (Extension Type: Coding)
                        Is Modifierfalse
                        Must Supporttrue
                        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())
                        138. Patient.address.extension:ehak
                        Slice Nameehak
                        Definition

                        Eesti haldus- ja asustusjaotuse klassifikaator (EHAK) on ette nähtud territoriaalse paiknemise tähistamiseks. Igale klassifitseerimisobjektile on antud unikaalne neljakohaline kood ja näidatud on objekti nimi ning rööpnimi (kui see on olemas).

                        ShortEHAK code
                        Control0..1
                        TypeExtension(EEBase EHAK) (Extension Type: Coding)
                        Is Modifierfalse
                        Must Supporttrue
                        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())
                        140. Patient.address.extension:official
                        Slice Nameofficial
                        Definition

                        This extension allows to specify if this address is or it is not the official address, or to indicate that this is the official address for that country (true assumed). Note: It does not make sense to repeat this extension without the valueCodeableConcept to specify jurisdictions.

                        ShortIndicator of address of residency
                        Control0..1
                        TypeExtension(Official Address) (Extension Type: Choice of: boolean, CodeableConcept)
                        Is Modifierfalse
                        Must Supporttrue
                        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())
                        142. Patient.address.extension:notice
                        Slice Namenotice
                        Definition

                        Aadressi hoiused või märkused

                        ShortAddress notices and warnings
                        Control0..*
                        TypeExtension(EEBase Address Notice) (Extension Type: Coding)
                        Is Modifierfalse
                        Must Supporttrue
                        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())
                        144. Patient.address.use
                        Definition

                        The purpose of this address.

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

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

                        Control1..1
                        BindingThe codes SHALL be taken from AddressUse
                        (required to http://hl7.org/fhir/ValueSet/address-use|5.0.0)

                        The use of an address (home / work / etc.).

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

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

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

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

                        Shortpostal | physical | both
                        Comments

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

                        Control0..1
                        BindingThe codes SHALL be taken from AddressType
                        (required to http://hl7.org/fhir/ValueSet/address-type|5.0.0)

                        The type of an address (physical / postal).

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

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

                        ShortText representation of the address
                        Comments

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

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

                        A renderable, unencoded form.

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

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

                        ShortStreet name, number, direction & P.O. Box etc.
                        Control1..1
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        ExampleGeneral: 137 Nowhere Street
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        152. Patient.address.line.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
                        154. Patient.address.line.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.address.line.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 156. Patient.address.line.extension:censusTract
                          Slice NamecensusTract
                          Definition

                          Väikekoht (AÜ, SÜ, GÜ, vkt). Vastab Maa-ameti ADS-iga liidestumise juhendis tasemele 4.

                          ShortA geographic sub-unit delineated for demographic purposes.
                          Control0..1
                          TypeExtension(ADXP Census Tract) (Extension Type: string)
                          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())
                          158. Patient.address.line.extension:streetName
                          Slice NamestreetName
                          Definition

                          Liikluspind (tee, tänav, puiestee, maantee). Vastab Maa-ameti ADS-iga liidestumise juhendis tasemele 5.

                          ShortStreet name
                          Control0..1
                          TypeExtension(ADXP Street Name) (Extension Type: string)
                          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())
                          160. Patient.address.line.extension:streetNameBase
                          Slice NamestreetNameBase
                          Definition

                          Nimi (kohanimi, maaüksuse nimi). Vastab Maa-ameti ADS-iga liidestumise juhendis tasemele 6.

                          ShortThe base name of a roadway or artery recognized by a municipality (excluding street type and direction).
                          Control0..1
                          TypeExtension(ADXP Street Name Base) (Extension Type: string)
                          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())
                          162. Patient.address.line.extension:houseNumber
                          Slice NamehouseNumber
                          Definition

                          Aadressinumber (maaüksuse või hoone erilisand). Vastab Maa-ameti ADS-iga liidestumise juhendis tasemele 7.

                          ShortHouse number
                          Control0..1
                          TypeExtension(ADXP House Number) (Extension Type: string)
                          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())
                          164. Patient.address.line.extension:additionalLocator
                          Slice NameadditionalLocator
                          Definition

                          Korteri või muu hooneosa number. Vastab Maa-ameti ADS-iga liidestumise juhendis tasemele 8.

                          ShortAdditional locator
                          Control0..1
                          TypeExtension(ADXP Additional Locator) (Extension Type: string)
                          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())
                          166. Patient.address.line.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
                          168. Patient.address.city
                          Definition

                          Asula (küla, alevik, alev, vallasisene linn) või linnaosa. Vastab Maa-ameti ADS-iga liidestumise juhendis tasemele 3.

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

                          The name of the administrative area (county).

                          ShortAdministrative or political subdivision of a state or city
                          Comments

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

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

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

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

                          Postiindeks

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

                          Riigi kood (lubatud ISO-3166-2 koodid)

                          ShortShould use a 2 digit ISO 3166 code
                          Comments

                          ISO 3166 2- or 3- letter codes MAY be used in place of a human readable country name.

                          Control1..1
                          BindingThe codes SHALL be taken from Iso316612
                          (required to http://hl7.org/fhir/ValueSet/iso3166-1-2)
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          178. Patient.address.period
                          Definition

                          Time period when address was/is in use.

                          ShortTime period when address was/is in use
                          Control0..1
                          TypePeriod
                          Is Modifierfalse
                          Summarytrue
                          Requirements

                          Allows addresses to be placed in historical context.

                          ExampleGeneral: { "start" : "2010-03-23", "end" : "2010-07-01" }
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          180. 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 MaritalStatusCodes
                          (extensible to http://hl7.org/fhir/ValueSet/marital-status)

                          The domestic partnership status of a person.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Must Supportfalse
                          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()))
                          182. 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
                          Must Supportfalse
                          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()))
                          184. 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
                          Must Supportfalse
                          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()))
                          186. 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
                          Must Supportfalse
                          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())
                          188. 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
                          This element is affected by the following invariants: ele-1
                          Typestring
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          190. 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 managable, 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())
                          192. 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 managable, 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())
                          194. 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)

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

                          TypeCodeableConcept
                          Is Modifierfalse
                          Must Supportfalse
                          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()))
                          196. Patient.contact.name
                          Definition

                          A name associated with the contact person.

                          ShortA name associated with the contact person
                          Control0..1
                          This element is affected by the following invariants: pat-1
                          TypeHumanName
                          Is Modifierfalse
                          Must Supportfalse
                          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()))
                          198. 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..*
                          This element is affected by the following invariants: pat-1
                          TypeContactPoint
                          Is Modifierfalse
                          Must Supportfalse
                          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()))
                          200. Patient.contact.address
                          Definition

                          Address for the contact person.

                          ShortAddress for the contact person
                          Control0..1
                          This element is affected by the following invariants: pat-1
                          TypeAddress(EEBase Address)
                          Is Modifierfalse
                          Must Supportfalse
                          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()))
                          202. 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|5.0.0)

                          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 Supportfalse
                          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()))
                          204. 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(EEBase Organization)
                          Is Modifierfalse
                          Must Supportfalse
                          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()))
                          206. 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
                          Must Supportfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          208. 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
                          Must Supporttrue
                          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()))
                          210. 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
                          This element is affected by the following invariants: ele-1
                          Typestring
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          212. 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 managable, 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())
                          214. 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 managable, 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())
                          216. 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-AU" for Australian 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 SHALL be taken from AllLanguages
                          (required to http://hl7.org/fhir/ValueSet/all-languages|5.0.0)

                          IETF language tag for a human language

                          TypeCodeableConcept
                          Is Modifierfalse
                          Must Supportfalse
                          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()))
                          218. 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
                          Must Supportfalse
                          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()))
                          220. 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(EEBase Practitioner, EEBase PractitionerRole)
                          Is Modifierfalse
                          Must Supporttrue
                          Must Support TypesNo must-support rules about the choice of types/profiles
                          Summaryfalse
                          Alternate NamescareProvider
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          222. 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(EEBase Organization)
                          Is Modifierfalse
                          Must Supportfalse
                          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()))
                          224. Patient.link
                          Definition

                          Link to a Patient or RelatedPerson resource that concerns the same actual individual.

                          ShortLink to a Patient or RelatedPerson resource that concerns the same actual individual
                          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'
                          Must Supporttrue
                          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()))
                          226. 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
                          This element is affected by the following invariants: ele-1
                          Typestring
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          228. 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 managable, 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())
                          230. 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 managable, 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())
                          232. Patient.link.other
                          Definition

                          Link to a Patient or RelatedPerson resource that concerns the same actual individual.

                          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(EEBase Patient, EEBase RelatedPerson)
                          Is Modifierfalse
                          Must Supportfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          234. 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|5.0.0)

                          The type of link between this patient resource and another Patient resource, or Patient/RelatedPerson when using the seealso code

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