HL7 Europe Patient Summary
1.0.0-ci-build - ci-build 150

HL7 Europe Patient Summary, published by HL7 Europe. This guide is not an authorized publication; it is the continuous build for version 1.0.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/eps/ and changes regularly. See the Directory of published versions

## Resource Profile: PatientEuEps - XML Profile

Page standards status: Draft | Maturity Level: 1

XML representation of the patient-eu-eps resource profile.

Raw xml | Download

    <StructureDefinition xmlns="http://hl7.org/fhir">
      <id value="patient-eu-eps"/>
      <text>
        <status value="extensions"/>
        <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: StructureDefinition patient-eu-eps</b></p><a name="patient-eu-eps"> </a><a name="hcpatient-eu-eps"> </a><table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="The logical name of the element">Name</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Information about the use of the element">Flags</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Minimum and Maximum # of times the element can appear in the instance">Card.</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px; width: 100px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Reference to the type of the element">Type</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Additional information about the element">Description &amp; Constraints</a><span style="float: right"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_resource.png" alt="." style="background-color: white; background-color: inherit" title="Resource" class="hierarchy"/> <a href="StructureDefinition-patient-eu-eps-definitions.html#Patient">Patient</a><a name="Patient"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://build.fhir.org/ig/hl7-eu/base/StructureDefinition-patient-eu-core.html">PatientEuCore(2.0.0-ballot)</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="font-weight:bold">This profile also imposes the profile </span><a style="font-weight:bold; font-weight:bold; font-weight:bold; font-weight:bold" href="http://hl7.org/fhir/uv/ips/STU2/StructureDefinition-Patient-uv-ips.html">Patient (IPS) (2.0.0)</a></td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-patient-eu-eps-definitions.html#Patient.name">name</a><a name="Patient.name"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="padding-left: 3px; padding-right: 3px; border: 1px maroon solid; font-weight: bold; color: #301212; background-color: #fdf4f4;; padding-left: 3px; padding-right: 3px; border: 1px maroon solid; font-weight: bold; color: #301212; background-color: #fdf4f4;" href="http://hl7.org/fhir/R4/conformance-rules.html#constraints" title="This element has or is affected by constraints ( ips-pat-1 )">C</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5; opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#HumanName">HumanName</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">A name associated with the patient</span><br class="constraint"/><span title="null" class="constraint">Constraints: </span><span style="font-weight:bold" title="Patient.name.given, Patient.name.family or Patient.name.text SHALL be present" class="constraint">ips-pat-1</span></td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_reference.png" alt="." style="background-color: white; background-color: inherit" title="Reference to another Resource" class="hierarchy"/> <a href="StructureDefinition-patient-eu-eps-definitions.html#Patient.generalPractitioner">generalPractitioner</a><a name="Patient.generalPractitioner"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/references.html">Reference</a>(<a href="https://build.fhir.org/ig/hl7-eu/base/StructureDefinition-organization-eu-core.html">Organization (EU core)(2.0.0-ballot)</a> | <a href="https://build.fhir.org/ig/hl7-eu/base/StructureDefinition-practitionerRole-eu-core.html">PractitionerRole (EU core)(2.0.0-ballot)</a> | <a href="https://build.fhir.org/ig/hl7-eu/base/StructureDefinition-practitioner-eu-core.html">Practitioner (EU core)(2.0.0-ballot)</a>)</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Patient's nominated primary care provider.</span></td></tr>
    <tr><td colspan="5" class="hierarchy"><br/><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
      </text>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
        <valueInteger value="1"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
        <valueCode value="draft"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-imposeProfile">
        <valueCanonical
                        value="http://hl7.org/fhir/uv/ips/StructureDefinition/Patient-uv-ips"/>
      </extension>
      <url value="http://hl7.eu/fhir/eps/StructureDefinition/patient-eu-eps"/>
      <version value="1.0.0-ci-build"/>
      <name value="PatientEuEps"/>
      <title value="Patient (EPS)"/>
      <status value="draft"/>
      <date value="2025-12-26T09:07:46+00:00"/>
      <publisher value="HL7 Europe"/>
      <contact>
        <name value="HL7 Europe"/>
        <telecom>
          <system value="url"/>
          <value value="http://hl7.eu"/>
        </telecom>
      </contact>
      <description
                   value="This profile defines how to represent a human Patient in HL7 FHIR for the purpose of this guide."/>
      <jurisdiction>
        <coding>
          <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
          <code value="150"/>
          <display value="Europe"/>
        </coding>
      </jurisdiction>
      <copyright
                 value="Used by permission of HL7 Europe, all rights reserved Creative Commons License"/>
      <fhirVersion value="4.0.1"/>
      <mapping>
        <identity value="rim"/>
        <uri value="http://hl7.org/v3"/>
        <name value="RIM Mapping"/>
      </mapping>
      <mapping>
        <identity value="cda"/>
        <uri value="http://hl7.org/v3/cda"/>
        <name value="CDA (R2)"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <uri value="http://hl7.org/fhir/fivews"/>
        <name value="FiveWs Pattern Mapping"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <uri value="http://hl7.org/v2"/>
        <name value="HL7 v2 Mapping"/>
      </mapping>
      <mapping>
        <identity value="loinc"/>
        <uri value="http://loinc.org"/>
        <name value="LOINC code for the element"/>
      </mapping>
      <kind value="resource"/>
      <abstract value="false"/>
      <type value="Patient"/>
      <baseDefinition
                      value="http://hl7.eu/fhir/base/StructureDefinition/patient-eu-core"/>
      <derivation value="constraint"/>
      <snapshot>
        <extension
                   url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version">
          <valueString value="2.0.0-ballot"/>
        </extension>
        <element id="Patient">
          <path value="Patient"/>
          <short
                 value="Information about an individual or animal receiving health care services"/>
          <definition
                      value="Demographics and other administrative information about an individual or animal receiving care or other health-related services."/>
          <alias value="SubjectOfCare Client Resident"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Patient"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <constraint>
            <key value="dom-2"/>
            <severity value="error"/>
            <human
                   value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/>
            <expression value="contained.contained.empty()"/>
            <xpath value="not(parent::f:contained and f:contained)"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
          </constraint>
          <constraint>
            <key value="dom-3"/>
            <severity value="error"/>
            <human
                   value="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"/>
            <expression
                        value="contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()"/>
            <xpath
                   value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
          </constraint>
          <constraint>
            <key value="dom-4"/>
            <severity value="error"/>
            <human
                   value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated"/>
            <expression
                        value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/>
            <xpath
                   value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
          </constraint>
          <constraint>
            <key value="dom-5"/>
            <severity value="error"/>
            <human
                   value="If a resource is contained in another resource, it SHALL NOT have a security label"/>
            <expression value="contained.meta.security.empty()"/>
            <xpath value="not(exists(f:contained/*/f:meta/f:security))"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
          </constraint>
          <constraint>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
              <valueBoolean value="true"/>
            </extension>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
              <valueMarkdown
                             value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."/>
            </extension>
            <key value="dom-6"/>
            <severity value="warning"/>
            <human
                   value="A resource should have narrative for robust management"/>
            <expression value="text.`div`.exists()"/>
            <xpath value="exists(f:text/h:div)"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="Entity. Role, or Act"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="Patient[classCode=PAT]"/>
          </mapping>
          <mapping>
            <identity value="cda"/>
            <map value="ClinicalDocument.recordTarget.patientRole"/>
          </mapping>
        </element>
        <element id="Patient.id">
          <path value="Patient.id"/>
          <short value="Logical id of this artifact"/>
          <definition
                      value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/>
          <comment
                   value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Resource.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="id"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <isModifier value="false"/>
          <isSummary value="true"/>
        </element>
        <element id="Patient.meta">
          <path value="Patient.meta"/>
          <short value="Metadata about the resource"/>
          <definition
                      value="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."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Resource.meta"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Meta"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
        </element>
        <element id="Patient.implicitRules">
          <path value="Patient.implicitRules"/>
          <short value="A set of rules under which this content was created"/>
          <definition
                      value="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."/>
          <comment
                   value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Resource.implicitRules"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="uri"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation"/>
          <isSummary value="true"/>
        </element>
        <element id="Patient.language">
          <path value="Patient.language"/>
          <short value="Language of the resource content"/>
          <definition
                      value="The base language in which the resource is written."/>
          <comment
                   value="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)."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Resource.language"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="code"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
              <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages"/>
            </extension>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="Language"/>
            </extension>
            <strength value="preferred"/>
            <description value="A human language."/>
            <valueSet value="http://hl7.org/fhir/ValueSet/languages|4.0.1"/>
          </binding>
        </element>
        <element id="Patient.text">
          <path value="Patient.text"/>
          <short value="Text summary of the resource, for human interpretation"/>
          <definition
                      value="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 &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety."/>
          <comment
                   value="Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a &quot;text blob&quot; or where text is additionally entered raw or narrated and encoded information is added later."/>
          <alias value="narrative"/>
          <alias value="html"/>
          <alias value="xhtml"/>
          <alias value="display"/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="DomainResource.text"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Narrative"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="Act.text?"/>
          </mapping>
        </element>
        <element id="Patient.contained">
          <path value="Patient.contained"/>
          <short value="Contained, inline Resources"/>
          <definition
                      value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope."/>
          <comment
                   value="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."/>
          <alias value="inline resources"/>
          <alias value="anonymous resources"/>
          <alias value="contained resources"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="DomainResource.contained"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Resource"/>
          </type>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="Patient.extension">
          <path value="Patient.extension"/>
          <slicing>
            <discriminator>
              <type value="value"/>
              <path value="url"/>
            </discriminator>
            <ordered value="false"/>
            <rules value="open"/>
          </slicing>
          <short value="Extension"/>
          <definition value="An Extension"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="DomainResource.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="Patient.extension:birthPlace">
          <path value="Patient.extension"/>
          <sliceName value="birthPlace"/>
          <short value="Place of Birth for patient"/>
          <definition
                      value="The registered place of birth of the patient. A sytem may use the address.text if they don't store the birthPlace address in discrete elements."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="DomainResource.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
            <profile
                     value="http://hl7.org/fhir/StructureDefinition/patient-birthPlace"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="Patient.extension:birthPlace.id">
          <path value="Patient.extension.id"/>
          <representation value="xmlAttr"/>
          <short value="Unique id for inter-element referencing"/>
          <definition
                      value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="id"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <condition value="ele-1"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Patient.extension:birthPlace.extension">
          <path value="Patient.extension.extension"/>
          <slicing>
            <discriminator>
              <type value="value"/>
              <path value="url"/>
            </discriminator>
            <description value="Extensions are always sliced by (at least) url"/>
            <rules value="open"/>
          </slicing>
          <short value="Extension"/>
          <definition value="An Extension"/>
          <min value="0"/>
          <max value="0"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="Patient.extension:birthPlace.url">
          <path value="Patient.extension.url"/>
          <representation value="xmlAttr"/>
          <short value="identifies the meaning of the extension"/>
          <definition
                      value="Source of the definition for the extension code - a logical name or a URL."/>
          <comment
                   value="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."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="Extension.url"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="uri"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <fixedUri
                    value="http://hl7.org/fhir/StructureDefinition/patient-birthPlace"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="Patient.extension:birthPlace.value[x]">
          <path value="Patient.extension.value[x]"/>
          <short value="Value of extension"/>
          <definition
                      value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R5/extensibility.html) for a list)."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="Extension.value[x]"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Address"/>
            <profile
                     value="http://hl7.eu/fhir/base/StructureDefinition/Address-eu"/>
          </type>
          <condition value="ext-1"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="Patient.extension:sex-for-clinical-use">
          <path value="Patient.extension"/>
          <sliceName value="sex-for-clinical-use"/>
          <short value="Sex for clinical use"/>
          <definition
                      value="A parameter that provides guidance on how a recipient should apply settings or reference ranges that are derived from observable information such as an organ inventory, recent hormone lab tests, genetic testing, menstrual status, obstetric history, etc.."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="DomainResource.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
            <profile
                     value="http://hl7.org/fhir/StructureDefinition/patient-sexParameterForClinicalUse"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="Patient.extension:gender-identity">
          <path value="Patient.extension"/>
          <sliceName value="gender-identity"/>
          <short value="Gender identity"/>
          <definition
                      value="An individual's personal sense of being a man, woman, boy, girl, nonbinary, or something else."/>
          <comment
                   value="This represents an individual’s identity, ascertained by asking them what that identity is."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="DomainResource.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
            <profile
                     value="http://hl7.org/fhir/StructureDefinition/individual-genderIdentity"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="Patient.extension:pronouns">
          <path value="Patient.extension"/>
          <sliceName value="pronouns"/>
          <short value="Pronouns"/>
          <definition
                      value="The pronouns to use when referring to an individual in verbal or written communication."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="DomainResource.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
            <profile
                     value="http://hl7.org/fhir/StructureDefinition/individual-pronouns"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="Patient.extension:patient-citizenship">
          <path value="Patient.extension"/>
          <sliceName value="patient-citizenship"/>
          <short value="Citizenship"/>
          <definition
                      value="The patient's legal status as citizen of a country."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="DomainResource.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
            <profile
                     value="http://hl7.org/fhir/StructureDefinition/patient-citizenship"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="Patient.extension:patient-nationality">
          <path value="Patient.extension"/>
          <sliceName value="patient-nationality"/>
          <short value="Nationality"/>
          <definition value="The nationality of the patient."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="DomainResource.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
            <profile
                     value="http://hl7.org/fhir/StructureDefinition/patient-nationality"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="Patient.extension:birthTime">
          <path value="Patient.extension"/>
          <sliceName value="birthTime"/>
          <short value="Birth time"/>
          <definition
                      value="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."/>
          <comment
                   value="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)"/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="DomainResource.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
            <profile
                     value="http://hl7.org/fhir/StructureDefinition/patient-birthTime"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
        </element>
        <element id="Patient.modifierExtension">
          <path value="Patient.modifierExtension"/>
          <short value="Extensions that cannot be ignored"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
          <comment
                   value="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."/>
          <requirements
                        value="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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="DomainResource.modifierExtension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="Patient.identifier">
          <path value="Patient.identifier"/>
          <short value="Patient identifiers"/>
          <definition value="An identifier for this patient."/>
          <requirements
                        value="Patients are almost always assigned specific numerical identifiers."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Patient.identifier"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Identifier"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="w5"/>
            <map value="FiveWs.identifier"/>
          </mapping>
          <mapping>
            <identity value="v2"/>
            <map value="PID-3"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="id"/>
          </mapping>
          <mapping>
            <identity value="cda"/>
            <map value=".id"/>
          </mapping>
        </element>
        <element id="Patient.active">
          <path value="Patient.active"/>
          <short value="Whether this patient's record is in active use"/>
          <definition
                      value="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."/>
          <comment
                   value="If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient."/>
          <requirements
                        value="Need to be able to mark a patient record as not to be used because it was created in error."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Patient.active"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="boolean"/>
          </type>
          <meaningWhenMissing
                              value="This resource is generally assumed to be active if no value is provided for the active element"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="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"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="w5"/>
            <map value="FiveWs.status"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="statusCode"/>
          </mapping>
          <mapping>
            <identity value="cda"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Patient.name">
          <path value="Patient.name"/>
          <short value="A name associated with the patient"/>
          <definition value="A name associated with the individual."/>
          <comment
                   value="A patient may have multiple names with different uses or applicable periods. For animals, the name is a &quot;HumanName&quot; in the sense that is assigned and used by humans and has the same patterns."/>
          <requirements
                        value="Need to be able to track the patient by multiple names. Examples are your official name and a partner name.
    The Alphabetic representation of the name SHALL be always provided"/>
          <min value="1"/>
          <max value="*"/>
          <base>
            <path value="Patient.name"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="HumanName"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="eu-pat-1"/>
            <severity value="error"/>
            <human
                   value="given, family, text or a data-absent-reason extension SHALL be present"/>
            <expression
                        value="family.exists() or given.exists() or text.exists() or extension('http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()"/>
            <source
                    value="http://hl7.eu/fhir/base/StructureDefinition/patient-eu-core"/>
          </constraint>
          <constraint>
            <key value="ips-pat-1"/>
            <severity value="error"/>
            <human
                   value="Patient.name.given, Patient.name.family or Patient.name.text SHALL be present"/>
            <expression
                        value="family.exists() or given.exists() or text.exists()"/>
            <xpath value="f:given or f:family or f:text"/>
            <source
                    value="http://hl7.eu/fhir/eps/StructureDefinition/patient-eu-eps"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="v2"/>
            <map value="PID-5, PID-9"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="name"/>
          </mapping>
          <mapping>
            <identity value="cda"/>
            <map value=".patient.name"/>
          </mapping>
        </element>
        <element id="Patient.name.id">
          <path value="Patient.name.id"/>
          <representation value="xmlAttr"/>
          <short value="Unique id for inter-element referencing"/>
          <definition
                      value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Patient.name.extension">
          <path value="Patient.name.extension"/>
          <slicing>
            <discriminator>
              <type value="value"/>
              <path value="url"/>
            </discriminator>
            <description value="Extensions are always sliced by (at least) url"/>
            <rules value="open"/>
          </slicing>
          <short value="Additional content defined by implementations"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
          <comment
                   value="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."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Patient.name.use">
          <path value="Patient.name.use"/>
          <short
                 value="usual | official | temp | nickname | anonymous | old | maiden"/>
          <definition value="Identifies the purpose for this name."/>
          <comment
                   value="Applications can assume that a name is current unless it explicitly says that it is temporary or old."/>
          <requirements
                        value="Allows the appropriate name for a particular context of use to be selected from among a set of names."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="HumanName.use"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="code"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary or old name etc.for a current/permanent one"/>
          <isSummary value="true"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="NameUse"/>
            </extension>
            <strength value="required"/>
            <description value="The use of a human name."/>
            <valueSet value="http://hl7.org/fhir/ValueSet/name-use|4.0.1"/>
          </binding>
          <mapping>
            <identity value="v2"/>
            <map
                 value="XPN.7, but often indicated by which field contains the name"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="unique(./use)"/>
          </mapping>
          <mapping>
            <identity value="servd"/>
            <map value="./NamePurpose"/>
          </mapping>
        </element>
        <element id="Patient.name.text">
          <path value="Patient.name.text"/>
          <short value="Text representation of the full name."/>
          <definition
                      value="Text representation of the full name. Due to the cultural variance around the world a consuming system may not know how to present the name correctly; moreover not all the parts of the name go in given or family. Creators are therefore strongly encouraged to provide through this element a presented version of the name. Future versions of this guide may require this element."/>
          <comment
                   value="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."/>
          <requirements value="A renderable, unencoded form."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="HumanName.text"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="string"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="v2"/>
            <map value="implied by XPN.11"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="./formatted"/>
          </mapping>
        </element>
        <element id="Patient.name.family">
          <path value="Patient.name.family"/>
          <short value="Family name."/>
          <definition
                      value="Family name. When more the family is composed by more than one names, this element documents the full composed family name with the proper * name.familyrder. The parts are recorded in the fhater and mother family names extensions."/>
          <comment
                   value="Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures)."/>
          <alias value="surname"/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="HumanName.family"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="string"/>
          </type>
          <example>
            <label value="spanish"/>
            <valueString value="Valero Iglesias"/>
          </example>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="v2"/>
            <map value="XPN.1/FN.1"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="./part[partType = FAM]"/>
          </mapping>
          <mapping>
            <identity value="servd"/>
            <map value="./FamilyName"/>
          </mapping>
        </element>
        <element id="Patient.name.given">
          <path value="Patient.name.given"/>
          <short value="Given names. Includes middle names"/>
          <definition value="Given name."/>
          <comment
                   value="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 &quot;first name&quot; since given names do not always come first."/>
          <alias value="first name"/>
          <alias value="middle name"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="HumanName.given"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="string"/>
          </type>
          <orderMeaning
                        value="Given Names appear in the correct order for presenting the name"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="v2"/>
            <map value="XPN.2 + XPN.3"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="./part[partType = GIV]"/>
          </mapping>
          <mapping>
            <identity value="servd"/>
            <map value="./GivenNames"/>
          </mapping>
        </element>
        <element id="Patient.name.prefix">
          <path value="Patient.name.prefix"/>
          <short value="Parts that come before the name"/>
          <definition
                      value="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."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="HumanName.prefix"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="string"/>
          </type>
          <orderMeaning
                        value="Prefixes appear in the correct order for presenting the name"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="v2"/>
            <map value="XPN.5"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="./part[partType = PFX]"/>
          </mapping>
          <mapping>
            <identity value="servd"/>
            <map value="./TitleCode"/>
          </mapping>
        </element>
        <element id="Patient.name.suffix">
          <path value="Patient.name.suffix"/>
          <short value="Parts that come after the name"/>
          <definition
                      value="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."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="HumanName.suffix"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="string"/>
          </type>
          <orderMeaning
                        value="Suffixes appear in the correct order for presenting the name"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="v2"/>
            <map value="XPN/4"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="./part[partType = SFX]"/>
          </mapping>
        </element>
        <element id="Patient.name.period">
          <path value="Patient.name.period"/>
          <short value="Time period when name was/is in use"/>
          <definition
                      value="Indicates the period of time when this name was valid for the named person."/>
          <requirements value="Allows names to be placed in historical context."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="HumanName.period"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Period"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="v2"/>
            <map value="XPN.13 + XPN.14"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="./usablePeriod[type=&quot;IVL&lt;TS&gt;&quot;]"/>
          </mapping>
          <mapping>
            <identity value="servd"/>
            <map value="./StartDate and ./EndDate"/>
          </mapping>
        </element>
        <element id="Patient.telecom">
          <path value="Patient.telecom"/>
          <short value="A contact detail for the patient"/>
          <definition
                      value="A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted."/>
          <comment
                   value="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)."/>
          <requirements
                        value="People have (primary) ways to contact them in some way such as phone, email."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Patient.telecom"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="ContactPoint"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="v2"/>
            <map value="PID-13, PID-14, PID-40"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="telecom"/>
          </mapping>
          <mapping>
            <identity value="cda"/>
            <map value=".telecom"/>
          </mapping>
        </element>
        <element id="Patient.gender">
          <path value="Patient.gender"/>
          <short value="Administrative Gender"/>
          <definition
                      value="Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes."/>
          <comment
                   value="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 &quot;hard&quot; error.  See the Patient Gender and Sex section for additional information about communicating patient gender and sex."/>
          <requirements
                        value="Needed for identification of the individual, in combination with (at least) name and birth date."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Patient.gender"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="code"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="AdministrativeGender"/>
            </extension>
            <strength value="required"/>
            <description
                         value="The gender of a person used for administrative purposes."/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1"/>
          </binding>
          <mapping>
            <identity value="v2"/>
            <map value="PID-8"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map
                 value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender"/>
          </mapping>
          <mapping>
            <identity value="cda"/>
            <map value=".patient.administrativeGenderCode"/>
          </mapping>
        </element>
        <element id="Patient.birthDate">
          <path value="Patient.birthDate"/>
          <short value="The date of birth for the patient"/>
          <definition value="The date of birth for the individual."/>
          <comment
                   value="At least an estimated year should be provided as a guess if the real DOB is unknown  There is a standard extension &quot;patient-birthTime&quot; available that should be used where Time is required (such as in maternity/infant care systems)."/>
          <requirements
                        value="Age of the individual drives many clinical processes."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="Patient.birthDate"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="date"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="v2"/>
            <map value="PID-7"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map
                 value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/birthTime"/>
          </mapping>
          <mapping>
            <identity value="cda"/>
            <map value=".patient.birthTime"/>
          </mapping>
          <mapping>
            <identity value="loinc"/>
            <map value="21112-8"/>
          </mapping>
        </element>
        <element id="Patient.deceased[x]">
          <path value="Patient.deceased[x]"/>
          <short value="Indicates if the individual is deceased or not"/>
          <definition value="Indicates if the individual is deceased or not."/>
          <comment
                   value="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."/>
          <requirements
                        value="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."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Patient.deceased[x]"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="boolean"/>
          </type>
          <type>
            <code value="dateTime"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="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."/>
          <isSummary value="true"/>
          <mapping>
            <identity value="v2"/>
            <map value="PID-30  (bool) and PID-29 (datetime)"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map
                 value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedTime"/>
          </mapping>
          <mapping>
            <identity value="cda"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Patient.address">
          <path value="Patient.address"/>
          <short value="An address for the individual"/>
          <definition value="An address for the individual."/>
          <comment
                   value="Patient may have multiple addresses with different uses or applicable periods."/>
          <requirements
                        value="May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Patient.address"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Address"/>
            <profile
                     value="http://hl7.eu/fhir/base/StructureDefinition/Address-eu"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="v2"/>
            <map value="PID-11"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="addr"/>
          </mapping>
          <mapping>
            <identity value="cda"/>
            <map value=".addr"/>
          </mapping>
        </element>
        <element id="Patient.maritalStatus">
          <path value="Patient.maritalStatus"/>
          <short value="Marital status"/>
          <definition
                      value="This field contains a patient's most recent marital (civil) status."/>
          <requirements value="Most, if not all systems capture it."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Patient.maritalStatus"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="MaritalStatus"/>
            </extension>
            <strength value="extensible"/>
            <description value="The domestic partnership status of a person."/>
            <valueSet value="http://hl7.org/fhir/ValueSet/marital-status|4.0.1"/>
          </binding>
          <mapping>
            <identity value="v2"/>
            <map value="PID-16"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="player[classCode=PSN]/maritalStatusCode"/>
          </mapping>
          <mapping>
            <identity value="cda"/>
            <map value=".patient.maritalStatusCode"/>
          </mapping>
        </element>
        <element id="Patient.multipleBirth[x]">
          <path value="Patient.multipleBirth[x]"/>
          <short value="Whether patient is part of a multiple birth"/>
          <definition
                      value="Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer)."/>
          <comment
                   value="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)."/>
          <requirements
                        value="For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Patient.multipleBirth[x]"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="boolean"/>
          </type>
          <type>
            <code value="integer"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="v2"/>
            <map value="PID-24 (bool), PID-25 (integer)"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map
                 value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthInd,  player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber"/>
          </mapping>
          <mapping>
            <identity value="cda"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Patient.photo">
          <path value="Patient.photo"/>
          <short value="Image of the patient"/>
          <definition value="Image of the patient."/>
          <comment
                   value="Guidelines:
    * Use id photos, not clinical photos.
    * Limit dimensions to thumbnail.
    * Keep byte count low to ease resource updates."/>
          <requirements
                        value="Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Patient.photo"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Attachment"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="v2"/>
            <map value="OBX-5 - needs a profile"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map
                 value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/desc"/>
          </mapping>
          <mapping>
            <identity value="cda"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Patient.contact">
          <path value="Patient.contact"/>
          <short
                 value="A contact party (e.g. guardian, partner, friend) for the patient"/>
          <definition
                      value="A contact party (e.g. guardian, partner, friend) for the patient."/>
          <comment
                   value="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."/>
          <requirements
                        value="Need to track people you can contact about the patient."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Patient.contact"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="BackboneElement"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="pat-1"/>
            <severity value="error"/>
            <human
                   value="SHALL at least contain a contact's details or a reference to an organization"/>
            <expression
                        value="name.exists() or telecom.exists() or address.exists() or organization.exists()"/>
            <xpath
                   value="exists(f:name) or exists(f:telecom) or exists(f:address) or exists(f:organization)"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Patient"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map
                 value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON]"/>
          </mapping>
          <mapping>
            <identity value="cda"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Patient.contact.id">
          <path value="Patient.contact.id"/>
          <representation value="xmlAttr"/>
          <short value="Unique id for inter-element referencing"/>
          <definition
                      value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Patient.contact.extension">
          <path value="Patient.contact.extension"/>
          <short value="Additional content defined by implementations"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
          <comment
                   value="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."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Patient.contact.modifierExtension">
          <path value="Patient.contact.modifierExtension"/>
          <short value="Extensions that cannot be ignored even if unrecognized"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
          <comment
                   value="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."/>
          <requirements
                        value="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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <alias value="modifiers"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="BackboneElement.modifierExtension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="Patient.contact.relationship">
          <path value="Patient.contact.relationship"/>
          <short value="Contact relationship"/>
          <definition
                      value="The nature of the relationship between the patient and the contact person."/>
          <requirements
                        value="Used to determine which contact person is the most relevant to approach, depending on circumstances."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Patient.contact.relationship"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="ContactRelationship"/>
            </extension>
            <strength value="extensible"/>
            <description
                         value="The nature of the relationship between a patient and a contact person for that patient."/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/patient-contactrelationship|4.0.1"/>
          </binding>
          <mapping>
            <identity value="v2"/>
            <map value="NK1-7, NK1-3"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="code"/>
          </mapping>
          <mapping>
            <identity value="cda"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Patient.contact.name">
          <path value="Patient.contact.name"/>
          <short value="Contact name"/>
          <definition value="A name associated with the contact person."/>
          <requirements
                        value="Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Patient.contact.name"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="HumanName"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="v2"/>
            <map value="NK1-2"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="name"/>
          </mapping>
          <mapping>
            <identity value="cda"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Patient.contact.telecom">
          <path value="Patient.contact.telecom"/>
          <short value="Contact details for the person"/>
          <definition
                      value="A contact detail for the person, e.g. a telephone number or an email address."/>
          <comment
                   value="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."/>
          <requirements
                        value="People have (primary) ways to contact them in some way such as phone, email."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Patient.contact.telecom"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="ContactPoint"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="v2"/>
            <map value="NK1-5, NK1-6, NK1-40"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="telecom"/>
          </mapping>
          <mapping>
            <identity value="cda"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Patient.contact.address">
          <path value="Patient.contact.address"/>
          <short value="Contact person address"/>
          <definition value="Address for the contact person."/>
          <requirements
                        value="Need to keep track where the contact person can be contacted per postal mail or visited."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Patient.contact.address"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Address"/>
            <profile
                     value="http://hl7.eu/fhir/base/StructureDefinition/Address-eu"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="v2"/>
            <map value="NK1-4"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="addr"/>
          </mapping>
          <mapping>
            <identity value="cda"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Patient.contact.gender">
          <path value="Patient.contact.gender"/>
          <short value="male | female | other | unknown"/>
          <definition
                      value="Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes."/>
          <requirements value="Needed to address the person correctly."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Patient.contact.gender"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="code"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="AdministrativeGender"/>
            </extension>
            <strength value="required"/>
            <description
                         value="The gender of a person used for administrative purposes."/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1"/>
          </binding>
          <mapping>
            <identity value="v2"/>
            <map value="NK1-15"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map
                 value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender"/>
          </mapping>
          <mapping>
            <identity value="cda"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Patient.contact.organization">
          <path value="Patient.contact.organization"/>
          <short value="Organization that is associated with the contact"/>
          <definition
                      value="Organization on behalf of which the contact is acting or for which the contact is working."/>
          <requirements
                        value="For guardians or business related contacts, the organization is relevant."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Patient.contact.organization"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Organization|4.0.1"/>
          </type>
          <condition value="pat-1"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="v2"/>
            <map value="NK1-13, NK1-30, NK1-31, NK1-32, NK1-41"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="scoper"/>
          </mapping>
          <mapping>
            <identity value="cda"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Patient.contact.period">
          <path value="Patient.contact.period"/>
          <short
                 value="The period during which this contact person or organization is valid to be contacted relating to this patient"/>
          <definition
                      value="The period during which this contact person or organization is valid to be contacted relating to this patient."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Patient.contact.period"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Period"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="effectiveTime"/>
          </mapping>
          <mapping>
            <identity value="cda"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Patient.communication">
          <path value="Patient.communication"/>
          <short
                 value="A language which may be used to communicate with the patient about his or her health"/>
          <definition
                      value="A language which may be used to communicate with the patient about his or her health."/>
          <comment
                   value="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."/>
          <requirements
                        value="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."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Patient.communication"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="BackboneElement"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="LanguageCommunication"/>
          </mapping>
          <mapping>
            <identity value="cda"/>
            <map value="patient.languageCommunication"/>
          </mapping>
        </element>
        <element id="Patient.communication.id">
          <path value="Patient.communication.id"/>
          <representation value="xmlAttr"/>
          <short value="Unique id for inter-element referencing"/>
          <definition
                      value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Patient.communication.extension">
          <path value="Patient.communication.extension"/>
          <short value="Additional content defined by implementations"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
          <comment
                   value="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."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Patient.communication.modifierExtension">
          <path value="Patient.communication.modifierExtension"/>
          <short value="Extensions that cannot be ignored even if unrecognized"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
          <comment
                   value="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."/>
          <requirements
                        value="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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <alias value="modifiers"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="BackboneElement.modifierExtension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="Patient.communication.language">
          <path value="Patient.communication.language"/>
          <short value="Communication language"/>
          <definition
                      value="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. &quot;en&quot; for English, or &quot;en-US&quot; for American English versus &quot;en-EN&quot; for England English."/>
          <comment
                   value="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."/>
          <requirements
                        value="Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="Patient.communication.language"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
              <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages"/>
            </extension>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="Language"/>
            </extension>
            <strength value="preferred"/>
            <description value="A human language."/>
            <valueSet value="http://hl7.org/fhir/ValueSet/languages|4.0.1"/>
          </binding>
          <mapping>
            <identity value="v2"/>
            <map value="PID-15, LAN-2"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map
                 value="player[classCode=PSN|ANM and determinerCode=INSTANCE]/languageCommunication/code"/>
          </mapping>
          <mapping>
            <identity value="cda"/>
            <map value=".languageCode"/>
          </mapping>
        </element>
        <element id="Patient.communication.preferred">
          <path value="Patient.communication.preferred"/>
          <short value="Language preference indicator"/>
          <definition
                      value="Indicates whether or not the patient prefers this language (over other languages he masters up a certain level)."/>
          <comment
                   value="This language is specifically identified for communicating healthcare information."/>
          <requirements
                        value="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."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Patient.communication.preferred"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="boolean"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="v2"/>
            <map value="PID-15"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="preferenceInd"/>
          </mapping>
          <mapping>
            <identity value="cda"/>
            <map value=".preferenceInd"/>
          </mapping>
        </element>
        <element id="Patient.generalPractitioner">
          <path value="Patient.generalPractitioner"/>
          <short value="Patient's nominated primary care provider."/>
          <definition value="Patient's nominated care provider."/>
          <comment
                   value="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 &quot;fly-in/fly-out&quot; 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."/>
          <alias value="careProvider"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Patient.generalPractitioner"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.eu/fhir/base/StructureDefinition/organization-eu-core"/>
            <targetProfile
                           value="http://hl7.eu/fhir/base/StructureDefinition/practitionerRole-eu-core"/>
            <targetProfile
                           value="http://hl7.eu/fhir/base/StructureDefinition/practitioner-eu-core"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="v2"/>
            <map value="PD1-4"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="subjectOf.CareEvent.performer.AssignedEntity"/>
          </mapping>
          <mapping>
            <identity value="cda"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Patient.managingOrganization">
          <path value="Patient.managingOrganization"/>
          <short
                 value="Organization that is the custodian of the patient record"/>
          <definition
                      value="Organization that is the custodian of the patient record."/>
          <comment
                   value="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)."/>
          <requirements
                        value="Need to know who recognizes this patient record, manages and updates it."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Patient.managingOrganization"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Organization|4.0.1"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="scoper"/>
          </mapping>
          <mapping>
            <identity value="cda"/>
            <map value=".providerOrganization"/>
          </mapping>
        </element>
        <element id="Patient.link">
          <path value="Patient.link"/>
          <short
                 value="Link to another patient resource that concerns the same actual person"/>
          <definition
                      value="Link to another patient resource that concerns the same actual patient."/>
          <comment
                   value="There is no assumption that linked patient records have mutual links."/>
          <requirements
                        value="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."/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Patient.link"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="BackboneElement"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="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'"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="outboundLink"/>
          </mapping>
          <mapping>
            <identity value="cda"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Patient.link.id">
          <path value="Patient.link.id"/>
          <representation value="xmlAttr"/>
          <short value="Unique id for inter-element referencing"/>
          <definition
                      value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Patient.link.extension">
          <path value="Patient.link.extension"/>
          <short value="Additional content defined by implementations"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
          <comment
                   value="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."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Patient.link.modifierExtension">
          <path value="Patient.link.modifierExtension"/>
          <short value="Extensions that cannot be ignored even if unrecognized"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
          <comment
                   value="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."/>
          <requirements
                        value="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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <alias value="modifiers"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="BackboneElement.modifierExtension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="Patient.link.other">
          <path value="Patient.link.other"/>
          <short
                 value="The other patient or related person resource that the link refers to"/>
          <definition
                      value="The other patient resource that the link refers to."/>
          <comment
                   value="Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="Patient.link.other"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-hierarchy">
              <valueBoolean value="false"/>
            </extension>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Patient|4.0.1"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/RelatedPerson|4.0.1"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="v2"/>
            <map value="PID-3, MRG-1"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="id"/>
          </mapping>
          <mapping>
            <identity value="cda"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Patient.link.type">
          <path value="Patient.link.type"/>
          <short value="replaced-by | replaces | refer | seealso"/>
          <definition
                      value="The type of link between this patient resource and another patient resource."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="Patient.link.type"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="code"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <binding>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
              <valueString value="LinkType"/>
            </extension>
            <strength value="required"/>
            <description
                         value="The type of link between this patient resource and another patient resource."/>
            <valueSet value="http://hl7.org/fhir/ValueSet/link-type|4.0.1"/>
          </binding>
          <mapping>
            <identity value="rim"/>
            <map value="typeCode"/>
          </mapping>
          <mapping>
            <identity value="cda"/>
            <map value="n/a"/>
          </mapping>
        </element>
      </snapshot>
      <differential>
        <element id="Patient.name">
          <path value="Patient.name"/>
          <constraint>
            <key value="ips-pat-1"/>
            <severity value="error"/>
            <human
                   value="Patient.name.given, Patient.name.family or Patient.name.text SHALL be present"/>
            <expression
                        value="family.exists() or given.exists() or text.exists()"/>
            <xpath value="f:given or f:family or f:text"/>
            <source
                    value="http://hl7.eu/fhir/eps/StructureDefinition/patient-eu-eps"/>
          </constraint>
        </element>
        <element id="Patient.generalPractitioner">
          <path value="Patient.generalPractitioner"/>
          <type>
            <code value="Reference"/>
            <targetProfile
                           value="http://hl7.eu/fhir/base/StructureDefinition/organization-eu-core"/>
            <targetProfile
                           value="http://hl7.eu/fhir/base/StructureDefinition/practitionerRole-eu-core"/>
            <targetProfile
                           value="http://hl7.eu/fhir/base/StructureDefinition/practitioner-eu-core"/>
          </type>
        </element>
      </differential>
    </StructureDefinition>