HL7 Europe Hospital Discharge Report
0.0.1-ci - ci-build 150

HL7 Europe Hospital Discharge Report, published by HL7 Europe. This guide is not an authorized publication; it is the continuous build for version 0.0.1-ci built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/hdr/ and changes regularly. See the Directory of published versions

Logical Model: PatientHistoryEhn - Detailed Descriptions

Draft as of 2024-11-06

Definitions for the PatientHistory logical model.

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

0. PatientHistory
Definition

Hospital Discharge Report - Patient history - A.2.6 eHN

ShortA.2.6 - Patient history (eHN)
Logical ModelInstances of this logical model are not marked to be the target of a Reference
2. PatientHistory.medicalHistory
Definition

Medical history

ShortA.2.6.1 - Medical history
Control1..1
TypeBackboneElement
4. PatientHistory.medicalHistory.historyOfConditions
Definition

A list of conditions of a patient that the patient suffered in the past or still suffers. Unlike diagnostic summary, medical history is not only a list of problems, but could contain broader description of the condition and its progress, details about treatment including medication and patient response to treatment. Past problem section (unlike the same section of the patient summary) should include only conditions that are important for continuity of care. This section, if provided, complements the diagnostic summary section of the discharge report.

ShortA.2.6.1.1 - History of problems
Control1..*
TypeBackboneElement
6. PatientHistory.medicalHistory.historyOfConditions.conditionSpecification
Definition

Problem specification

ShortA.2.6.1.1.1 - Problem description
Control1..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
8. PatientHistory.medicalHistory.historyOfConditions.conditionDetails
Definition

Problem details include code that identifies problem, specification of the body structure, laterality, and other aspects of the problem.

ShortA.2.6.1.1.2 - Problem details
Control0..*
TypeBackboneElement
10. PatientHistory.medicalHistory.historyOfConditions.onsetDate
Definition

Onset date of the problem/condition

ShortA.2.6.1.1.3 - Onset date
Control1..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
12. PatientHistory.medicalHistory.historyOfConditions.endDate
Definition

The date or estimated date that the condition resolved or went into remission.

ShortA.2.6.1.1.4 - End date
Control0..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
14. PatientHistory.medicalHistory.historyOfConditions.clinicalStatus
Definition

Status of the condition/problem (active, resolved, inactive, ...)

ShortA.2.6.1.1.5 - Clinical status
Control0..1
TypeCodeableConcept
16. PatientHistory.medicalHistory.historyOfConditions.resolution
Definition

Describes the reason for which the status of the problem changed from current to inactive (e.g. surgical procedure, medical treatment, etc.). This field includes "free text" if the resolution circumstances are not already included in other fields such as surgical procedure, medical device, etc., e.g. hepatic cystectomy (this will be the resolution circumstances for the problem "hepatic cyst" and will be included in surgical procedures).

ShortA.2.6.1.1.6 - Resolution circumstances
Control0..1
TypeBackboneElement
18. PatientHistory.medicalHistory.historyOfConditions.severity
Definition

A subjective assessment of the severity of the condition as evaluated by the clinician.

ShortA.2.6.1.1.7 - Severity
Control0..1
TypeCodeableConcept
20. PatientHistory.medicalHistory.historyOfConditions.stage
Definition

Stage/grade, usually assessed formally using a specific staging/grading system.

ShortA.2.6.1.1.8 - Stage
Control0..*
TypeCodeableConcept
22. PatientHistory.medicalHistory.medicalDevices
Definition

Devices and Implants

ShortA.2.6.1.2 - Devices and Implants
Control1..*
TypeBackboneElement
24. PatientHistory.medicalHistory.medicalDevices.description
Definition

Describes the patient's implanted and external medical devices and equipment upon which their health status depends. Includes devices such as cardiac pacemakers, implantable fibrillator, prosthesis, ferromagnetic bone implants, etc. of which the HP needs to be aware.

ShortA.2.6.1.2.1 - Device and implant description
Control1..1
TypeCodeableConcept
26. PatientHistory.medicalHistory.medicalDevices.identifier
Definition

Normalised identifier of the device instance such as UDI according to REGULATION (EU) 2017/745

ShortA.2.6.1.2.2 - Device ID
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..1
TypeIdentifier
28. PatientHistory.medicalHistory.medicalDevices.implantDate
Definition

The date and time the device was implanted or when its use began.

ShortA.2.6.1.2.3 - Implant date
Control1..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
30. PatientHistory.medicalHistory.medicalDevices.endDate
Definition

Date and time when the device was explanted from the patient or the external device was no longer in use; likewise when the device is planned to be explanted

ShortA.2.6.1.2.4 - End date
Control0..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
32. PatientHistory.medicalHistory.medicalDevices.reason
Definition

The medical reason for use of the medical device.

ShortA.2.6.1.2.5 - Reason
Control0..*
TypeCodeableConcept
34. PatientHistory.medicalHistory.historyOfProcedures
Definition

Historical procedures performed on or for a patient, relevant for the current encounter.

ShortA.2.6.1.3 - History of procedures
Control0..*
TypeBackboneElement
36. PatientHistory.medicalHistory.historyOfProcedures.procedureCode
Definition

Procedure code

ShortA.2.6.1.3.1 - Procedure code
Control0..1
TypeCodeableConcept
38. PatientHistory.medicalHistory.historyOfProcedures.description
Definition

Narrative description of the procedure

ShortA.2.6.1.3.2 - Procedure description
Control1..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
40. PatientHistory.medicalHistory.historyOfProcedures.bodySite
Definition

Procedure target body site and laterality

ShortA.2.6.1.3.3 - Body site
Control0..1
TypeCodeableConcept
42. PatientHistory.medicalHistory.historyOfProcedures.date
Definition

Date and time when procedure was performed

ShortA.2.6.1.3.4 - Procedure date
Control0..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
44. PatientHistory.medicalHistory.historyOfProcedures.reason
Definition

The coded reason why the procedure was performed. This may be a coded entity or may simply be present as text.

ShortA.2.6.1.3.5 - Procedure reason
Control0..1
TypeCodeableConcept
46. PatientHistory.medicalHistory.historyOfProcedures.outcome
Definition

The outcome of the procedure - did it resolve the reasons for the procedure being performed? Applicable mainly on surgical procedures.

ShortA.2.6.1.3.6 - Outcome
Control0..1
TypeCodeableConcept
48. PatientHistory.medicalHistory.historyOfProcedures.focalDevice
Definition

A reference to the device or devices that is implanted, removed or otherwise manipulated (calibration, battery replacement, fitting a prosthesis, attaching a wound-vac, etc.) as a focal portion of the Procedure.

ShortA.2.6.1.3.7 - Focal device
Control0..*
TypeCodeableReference
50. PatientHistory.medicalHistory.vaccination
Definition

Vaccination history of the patient.

ShortA.2.6.1.4 - Vaccination
Control0..*
TypeBackboneElement
52. PatientHistory.medicalHistory.vaccination.diseaseOrAgent
Definition

Disease or agent that the vaccination provides protection against

ShortA.2.6.1.4.1 - Disease or agent targeted
Control0..*
TypeCodeableConcept
54. PatientHistory.medicalHistory.vaccination.vaccine
Definition

Generic description of the vaccine/prophylaxis or its component(s)

ShortA.2.6.1.4.2 - Vaccine/prophylaxis
Control1..1
TypeCodeableConcept
56. PatientHistory.medicalHistory.vaccination.productName
Definition

Medicinal product name

ShortA.2.6.1.4.4 - Vaccine medicinal product
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
58. PatientHistory.medicalHistory.vaccination.manufacturerOrMAH
Definition

Marketing Authorisation Holder or manufacturer (Identifier and name)

ShortA.2.6.1.4.5 - Marketing Authorisation Holder
Control0..1
TypeBackboneElement
60. PatientHistory.medicalHistory.vaccination.orderNumber
Definition

Order in the vaccination course.

ShortA.2.6.1.4.6 - Number in a series of vaccinations / doses
Control0..1
Typeinteger
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
62. PatientHistory.medicalHistory.vaccination.vaccinationDate
Definition

The date and time when the vaccination was administered

ShortA.2.6.1.4.7 - Date of vaccination
Control1..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
64. PatientHistory.medicalHistory.vaccination.nextVaccinationDate
Definition

The date when the vaccination is planned to be given/repeated (e.g. next dose)

ShortA.2.6.1.4.8 - Next vaccination date
Control0..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
66. PatientHistory.medicalHistory.epidemiologicalHistory
Definition

Travel history and infectious contacts

ShortA.2.6.1.5 - Epidemiological history
Control0..1
TypeBackboneElement
68. PatientHistory.medicalHistory.epidemiologicalHistory.infectiousContacts
Definition

Infectious contacts of the patient

ShortA.2.6.1.5.1 - Infectious contacts
Control0..*
TypeBackboneElement
70. PatientHistory.medicalHistory.epidemiologicalHistory.infectiousContacts.period
Definition

A date and duration or date time interval of contact. Partial dates are allowed.

ShortA.2.6.1.5.1.1 - Time period
Control0..1
TypePeriod
72. PatientHistory.medicalHistory.epidemiologicalHistory.infectiousContacts.infectiousAgent
Definition

Information about a suspected infectious agent or agents the person was exposed to.

ShortA.2.6.1.5.1.2 - Infectious agent
Control0..*
TypeCodeableConcept
74. PatientHistory.medicalHistory.epidemiologicalHistory.infectiousContacts.proximity
Definition

Proximity to the source/carrier of the infectious agent during exposure. Proximity could be expressed by text, code (direct, indirect) or value specifying distance from the InfectiousAgentCarrier.

ShortA.2.6.1.5.1.3 - Proximity
Control0..1
TypeCodeableConcept
76. PatientHistory.medicalHistory.epidemiologicalHistory.infectiousContacts.country
Definition

Country in which the person was potentially exposed to an infectious agent.

ShortA.2.6.1.5.1.4 - Country
Control0..1
TypeCodeableConcept
78. PatientHistory.medicalHistory.epidemiologicalHistory.infectiousContacts.note
Definition

A textual note with additional information about infectious contact.

ShortA.2.6.1.5.1.5 - Additional information
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
80. PatientHistory.medicalHistory.epidemiologicalHistory.travelHistory
Definition

Travel history reported by the patient. Multiple records could be provided.

ShortA.2.6.1.5.2 - Travel history
Control0..*
TypeBackboneElement
82. PatientHistory.medicalHistory.epidemiologicalHistory.travelHistory.period
Definition

Start and end date or end date and duration of stay in a country. Partial dates are allowed.

ShortA.2.6.1.5.2.1 - Time period
Control0..1
TypePeriod
84. PatientHistory.medicalHistory.epidemiologicalHistory.travelHistory.country
Definition

A country visited by the patient.

ShortA.2.6.1.5.2.2 - Country visited
Control1..1
TypeCodeableConcept
86. PatientHistory.medicalHistory.epidemiologicalHistory.travelHistory.comment
Definition

Relevant notes on the travel stay.

ShortA.2.6.1.5.2.3 - Comment
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
88. PatientHistory.familyHistory
Definition

Information about serious illnesses in close blood relatives with known or suspected genetic potential or with possible impact on patient care.

ShortA.2.6.2 - Family history
Control0..*
TypeBackboneElement
90. PatientHistory.familyHistory.relationship
Definition

The family relation between the related person and the patient.

ShortA.2.6.2.1 - Patient relationship
Control0..1
TypeCodeableConcept
92. PatientHistory.familyHistory.birthDate
Definition

Full or partial date of birth

ShortA.2.6.2.2 - Date of birth
Control0..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
94. PatientHistory.familyHistory.deathDateOrAge
Definition

Age or date of the death of the family member.

ShortA.2.6.2.3 - Age or date of death
Control0..1
TypeBackboneElement
96. PatientHistory.familyHistory.conditions
Definition

Medical problems this person suffers or suffered.

ShortA.2.6.2.5 - Condition
Control0..*
TypeBackboneElement
98. PatientHistory.familyHistory.causeOfDeath
Definition

Information about disease or condition that was the main cause of death.

ShortA.2.6.2.6 - Cause of death
Control0..1
TypeCodeableConcept
100. PatientHistory.socialDeterminants
Definition

Information about social determinants of health.

ShortA.2.6.3 - Social determinants of health
Control0..1
TypeBackboneElement
102. PatientHistory.socialDeterminants.participationInSociety
Definition

Participation in society details.

ShortA.2.6.3.1 - Participation in society
Control0..1
TypeBackboneElement
104. PatientHistory.socialDeterminants.participationInSociety.workSituation
Definition

Work Situation describes the extent to which and in what way the patient participates in the workforce. Work is meant in the broadest sense of the word: activities that contribute to the person themselves, their environment or society. This includes both paid and unpaid work.

ShortA.2.6.3.1.1 - Work situation
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
106. PatientHistory.socialDeterminants.participationInSociety.hobby
Definition

An activity the patient enjoys doing in their free time.

ShortA.2.6.3.1.2 - Hobby
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
108. PatientHistory.socialDeterminants.participationInSociety.socailNetwork
Definition

A description of the patient’s social network, such as family, neighbours and friends.

ShortA.2.6.3.1.3 - Social network
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
110. PatientHistory.socialDeterminants.education
Definition

Education

ShortA.2.6.3.2 - Education
Control0..1
TypeBackboneElement
112. PatientHistory.socialDeterminants.education.level
Definition

Indication of the highest level of education achieved.

ShortA.2.6.3.2.1 - Education level
Control0..1
TypeCodeableConcept
114. PatientHistory.socialDeterminants.education.comment
Definition

If deemed relevant, a specification of the degree program can be provided by means of an explanation (e.g.: patient is in medical school).

ShortA.2.6.3.2.2 - Comment
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
116. PatientHistory.socialDeterminants.livingSituation
Definition

Household type and other related living situation information.

ShortA.2.6.3.3 - Living situation
Control0..1
TypeBackboneElement
118. PatientHistory.socialDeterminants.livingSituation.houseType
Definition

Type of home the patient lives in.

ShortA.2.6.3.3.1 - House type
Control0..1
TypeCodeableConcept
120. PatientHistory.socialDeterminants.livingSituation.homeAdaption
Definition

Adaptions present in the home that have been made in the context of the illness or disability to make the functioning of the patient safer and more comfortable and to enable independent living. Multiple data elements could be provided.

ShortA.2.6.3.3.2 - Home adaption
Control0..*
TypeCodeableConcept
122. PatientHistory.socialDeterminants.livingSituation.livingConditions
Definition

Conditions that affect the accessibility of the home or the stay in the home. Multiple data elements could be provided.

ShortA.2.6.3.3.3 - Living conditions
Control0..*
TypeCodeableConcept
124. PatientHistory.socialDeterminants.familySituation
Definition

Family situation details.

ShortA.2.6.3.4 - Family situation
Control0..1
TypeBackboneElement
126. PatientHistory.socialDeterminants.familySituation.comment
Definition

A comment on the family situation.

ShortA.2.6.3.4.1 - Comment
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
128. PatientHistory.socialDeterminants.familySituation.familyComposition
Definition

The family composition describes the patient’s home situation and the form of cohabitation.

ShortA.2.6.3.4.2 - Family composition
Control0..1
TypeCodeableConcept
130. PatientHistory.socialDeterminants.familySituation.maritalStatus
Definition

A person’s marital status according to the terms and definition in the national civil code.

ShortA.2.6.3.4.3 - Marital status
Control0..1
TypeCodeableConcept
132. PatientHistory.socialDeterminants.familySituation.numberOfChildren
Definition

The number of children the patient has. Children in the context of this information model include step children, foster children, biological and adopted children.

ShortA.2.6.3.4.4 - Number of children
Control0..1
Typeinteger
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
134. PatientHistory.socialDeterminants.familySituation.numberOfChildrenAtHome
Definition

The number of children living at home with the patient.

ShortA.2.6.3.4.5 - Number of children at home
Control0..1
Typeinteger
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
136. PatientHistory.socialDeterminants.familySituation.childDetails
Definition

Child age, co-living status and comment. Multiple child details could be provided.

ShortA.2.6.3.4.6 - Child details
Control0..*
TypeBackboneElement
138. PatientHistory.socialDeterminants.familySituation.careResponsibility
Definition

The activities the patient carries out to care for a dependent family member.

ShortA.2.6.3.4.7 - Care responsibility
Control0..*
TypeBackboneElement
140. PatientHistory.useOfSubstances
Definition

Use of substances

ShortA.2.6.4 - Use of substances
Control0..1
TypeBackboneElement
142. PatientHistory.useOfSubstances.alcohol
Definition

Alcohol consumption by the patient. Multiple records on alcohol use could be provided.

ShortA.2.6.4.1 - Alcohol use
Control0..*
TypeBackboneElement
144. PatientHistory.useOfSubstances.alcohol.currentStatus
Definition

The status of the patient’s alcohol use.

ShortA.2.6.4.1.1 - Status
Control0..1
TypeCodeableConcept
146. PatientHistory.useOfSubstances.alcohol.periodAndQuantity
Definition

Period of use and amount (The extent of the patient’s alcohol use in units of alcohol per time period.)

ShortA.2.6.4.1.2 - Period and quantity
Control0..*
TypeCodeableConcept
148. PatientHistory.useOfSubstances.alcohol.comment
Definition

Textual comment.

ShortA.2.6.4.1.3 - Comment
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
150. PatientHistory.useOfSubstances.tobacco
Definition

Represent smoking or tobacco habits. Multiple records on tobacco use could be provided.

ShortA.2.6.4.2 - Tobacco use
Control0..*
TypeBackboneElement
152. PatientHistory.useOfSubstances.tobacco.currentStatus
Definition

The status of the patient’s tobacco use.

ShortA.2.6.4.2.1 - Status
Control0..1
TypeCodeableConcept
154. PatientHistory.useOfSubstances.tobacco.periodAndQuantity
Definition

Period of use and amount (The extent of the patient’s tobacco use in units of alcohol per time period.)

ShortA.2.6.4.2.2 - Period and quantity
Control0..*
TypeBackboneElement
156. PatientHistory.useOfSubstances.tobacco.comment
Definition

Textual comment.

ShortA.2.6.4.2.3 - Comment
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
158. PatientHistory.useOfSubstances.drugConsumption
Definition

Consumption of drugs and other substances (in terms of abuse).

ShortA.2.6.4.3 - Drug consumption
Control0..*
TypeBackboneElement
160. PatientHistory.useOfSubstances.drugConsumption.currentStatus
Definition

The status of the patient’s drug use.

ShortA.2.6.4.3.1 - Status
Control0..1
TypeCodeableConcept
162. PatientHistory.useOfSubstances.drugConsumption.periodAndQuantity
Definition

Period of use and amount.

ShortA.2.6.4.3.2 - Period and quantity
Control0..1
TypeBackboneElement
164. PatientHistory.useOfSubstances.drugConsumption.drugType
Definition

Type of the drug consumption

ShortA.2.6.4.3.3 - Drug or medication type
Control0..1
TypeCodeableConcept
166. PatientHistory.useOfSubstances.drugConsumption.route
Definition

Route or routes of administration

ShortA.2.6.4.3.4 - Route of administration
Control0..*
TypeCodeableConcept
168. PatientHistory.useOfSubstances.drugConsumption.comment
Definition

Textual comment

ShortA.2.6.4.3.5 - Comment
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension

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

0. PatientHistory
Definition

Hospital Discharge Report - Patient history - A.2.6 eHN

ShortA.2.6 - Patient history (eHN)
Control0..*
Is Modifierfalse
Logical ModelInstances of this logical model are not marked to be the target of a Reference
2. PatientHistory.medicalHistory
Definition

Medical history

ShortA.2.6.1 - Medical history
Control1..1
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. PatientHistory.medicalHistory.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

ShortExtensions that cannot be ignored even if unrecognized
Comments

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

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

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

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

A list of conditions of a patient that the patient suffered in the past or still suffers. Unlike diagnostic summary, medical history is not only a list of problems, but could contain broader description of the condition and its progress, details about treatment including medication and patient response to treatment. Past problem section (unlike the same section of the patient summary) should include only conditions that are important for continuity of care. This section, if provided, complements the diagnostic summary section of the discharge report.

ShortA.2.6.1.1 - History of problems
Control1..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. PatientHistory.medicalHistory.historyOfConditions.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

ShortExtensions that cannot be ignored even if unrecognized
Comments

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

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

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

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

Problem specification

ShortA.2.6.1.1.1 - Problem description
Control1..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
12. PatientHistory.medicalHistory.historyOfConditions.conditionDetails
Definition

Problem details include code that identifies problem, specification of the body structure, laterality, and other aspects of the problem.

ShortA.2.6.1.1.2 - Problem details
Control0..*
TypeBackboneElement
14. PatientHistory.medicalHistory.historyOfConditions.onsetDate
Definition

Onset date of the problem/condition

ShortA.2.6.1.1.3 - Onset date
Control1..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
16. PatientHistory.medicalHistory.historyOfConditions.endDate
Definition

The date or estimated date that the condition resolved or went into remission.

ShortA.2.6.1.1.4 - End date
Control0..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
18. PatientHistory.medicalHistory.historyOfConditions.clinicalStatus
Definition

Status of the condition/problem (active, resolved, inactive, ...)

ShortA.2.6.1.1.5 - Clinical status
Control0..1
TypeCodeableConcept
20. PatientHistory.medicalHistory.historyOfConditions.resolution
Definition

Describes the reason for which the status of the problem changed from current to inactive (e.g. surgical procedure, medical treatment, etc.). This field includes "free text" if the resolution circumstances are not already included in other fields such as surgical procedure, medical device, etc., e.g. hepatic cystectomy (this will be the resolution circumstances for the problem "hepatic cyst" and will be included in surgical procedures).

ShortA.2.6.1.1.6 - Resolution circumstances
Control0..1
TypeBackboneElement
22. PatientHistory.medicalHistory.historyOfConditions.severity
Definition

A subjective assessment of the severity of the condition as evaluated by the clinician.

ShortA.2.6.1.1.7 - Severity
Control0..1
TypeCodeableConcept
24. PatientHistory.medicalHistory.historyOfConditions.stage
Definition

Stage/grade, usually assessed formally using a specific staging/grading system.

ShortA.2.6.1.1.8 - Stage
Control0..*
TypeCodeableConcept
26. PatientHistory.medicalHistory.medicalDevices
Definition

Devices and Implants

ShortA.2.6.1.2 - Devices and Implants
Control1..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. PatientHistory.medicalHistory.medicalDevices.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

ShortExtensions that cannot be ignored even if unrecognized
Comments

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

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

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

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

Describes the patient's implanted and external medical devices and equipment upon which their health status depends. Includes devices such as cardiac pacemakers, implantable fibrillator, prosthesis, ferromagnetic bone implants, etc. of which the HP needs to be aware.

ShortA.2.6.1.2.1 - Device and implant description
Control1..1
TypeCodeableConcept
32. PatientHistory.medicalHistory.medicalDevices.identifier
Definition

Normalised identifier of the device instance such as UDI according to REGULATION (EU) 2017/745

ShortA.2.6.1.2.2 - Device ID
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..1
TypeIdentifier
34. PatientHistory.medicalHistory.medicalDevices.implantDate
Definition

The date and time the device was implanted or when its use began.

ShortA.2.6.1.2.3 - Implant date
Control1..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
36. PatientHistory.medicalHistory.medicalDevices.endDate
Definition

Date and time when the device was explanted from the patient or the external device was no longer in use; likewise when the device is planned to be explanted

ShortA.2.6.1.2.4 - End date
Control0..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
38. PatientHistory.medicalHistory.medicalDevices.reason
Definition

The medical reason for use of the medical device.

ShortA.2.6.1.2.5 - Reason
Control0..*
TypeCodeableConcept
40. PatientHistory.medicalHistory.historyOfProcedures
Definition

Historical procedures performed on or for a patient, relevant for the current encounter.

ShortA.2.6.1.3 - History of procedures
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
42. PatientHistory.medicalHistory.historyOfProcedures.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

ShortExtensions that cannot be ignored even if unrecognized
Comments

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

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

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

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

Procedure code

ShortA.2.6.1.3.1 - Procedure code
Control0..1
TypeCodeableConcept
46. PatientHistory.medicalHistory.historyOfProcedures.description
Definition

Narrative description of the procedure

ShortA.2.6.1.3.2 - Procedure description
Control1..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
48. PatientHistory.medicalHistory.historyOfProcedures.bodySite
Definition

Procedure target body site and laterality

ShortA.2.6.1.3.3 - Body site
Control0..1
TypeCodeableConcept
50. PatientHistory.medicalHistory.historyOfProcedures.date
Definition

Date and time when procedure was performed

ShortA.2.6.1.3.4 - Procedure date
Control0..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
52. PatientHistory.medicalHistory.historyOfProcedures.reason
Definition

The coded reason why the procedure was performed. This may be a coded entity or may simply be present as text.

ShortA.2.6.1.3.5 - Procedure reason
Control0..1
TypeCodeableConcept
54. PatientHistory.medicalHistory.historyOfProcedures.outcome
Definition

The outcome of the procedure - did it resolve the reasons for the procedure being performed? Applicable mainly on surgical procedures.

ShortA.2.6.1.3.6 - Outcome
Control0..1
TypeCodeableConcept
56. PatientHistory.medicalHistory.historyOfProcedures.focalDevice
Definition

A reference to the device or devices that is implanted, removed or otherwise manipulated (calibration, battery replacement, fitting a prosthesis, attaching a wound-vac, etc.) as a focal portion of the Procedure.

ShortA.2.6.1.3.7 - Focal device
Control0..*
TypeCodeableReference
58. PatientHistory.medicalHistory.vaccination
Definition

Vaccination history of the patient.

ShortA.2.6.1.4 - Vaccination
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
60. PatientHistory.medicalHistory.vaccination.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

ShortExtensions that cannot be ignored even if unrecognized
Comments

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

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

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

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

Disease or agent that the vaccination provides protection against

ShortA.2.6.1.4.1 - Disease or agent targeted
Control0..*
TypeCodeableConcept
64. PatientHistory.medicalHistory.vaccination.vaccine
Definition

Generic description of the vaccine/prophylaxis or its component(s)

ShortA.2.6.1.4.2 - Vaccine/prophylaxis
Control1..1
TypeCodeableConcept
66. PatientHistory.medicalHistory.vaccination.productName
Definition

Medicinal product name

ShortA.2.6.1.4.4 - Vaccine medicinal product
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
68. PatientHistory.medicalHistory.vaccination.manufacturerOrMAH
Definition

Marketing Authorisation Holder or manufacturer (Identifier and name)

ShortA.2.6.1.4.5 - Marketing Authorisation Holder
Control0..1
TypeBackboneElement
70. PatientHistory.medicalHistory.vaccination.orderNumber
Definition

Order in the vaccination course.

ShortA.2.6.1.4.6 - Number in a series of vaccinations / doses
Control0..1
Typeinteger
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
72. PatientHistory.medicalHistory.vaccination.vaccinationDate
Definition

The date and time when the vaccination was administered

ShortA.2.6.1.4.7 - Date of vaccination
Control1..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
74. PatientHistory.medicalHistory.vaccination.nextVaccinationDate
Definition

The date when the vaccination is planned to be given/repeated (e.g. next dose)

ShortA.2.6.1.4.8 - Next vaccination date
Control0..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
76. PatientHistory.medicalHistory.epidemiologicalHistory
Definition

Travel history and infectious contacts

ShortA.2.6.1.5 - Epidemiological history
Control0..1
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
78. PatientHistory.medicalHistory.epidemiologicalHistory.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

ShortExtensions that cannot be ignored even if unrecognized
Comments

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

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

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

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

Infectious contacts of the patient

ShortA.2.6.1.5.1 - Infectious contacts
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
82. PatientHistory.medicalHistory.epidemiologicalHistory.infectiousContacts.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

ShortExtensions that cannot be ignored even if unrecognized
Comments

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

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

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

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

A date and duration or date time interval of contact. Partial dates are allowed.

ShortA.2.6.1.5.1.1 - Time period
Control0..1
TypePeriod
86. PatientHistory.medicalHistory.epidemiologicalHistory.infectiousContacts.infectiousAgent
Definition

Information about a suspected infectious agent or agents the person was exposed to.

ShortA.2.6.1.5.1.2 - Infectious agent
Control0..*
TypeCodeableConcept
88. PatientHistory.medicalHistory.epidemiologicalHistory.infectiousContacts.proximity
Definition

Proximity to the source/carrier of the infectious agent during exposure. Proximity could be expressed by text, code (direct, indirect) or value specifying distance from the InfectiousAgentCarrier.

ShortA.2.6.1.5.1.3 - Proximity
Control0..1
TypeCodeableConcept
90. PatientHistory.medicalHistory.epidemiologicalHistory.infectiousContacts.country
Definition

Country in which the person was potentially exposed to an infectious agent.

ShortA.2.6.1.5.1.4 - Country
Control0..1
TypeCodeableConcept
92. PatientHistory.medicalHistory.epidemiologicalHistory.infectiousContacts.note
Definition

A textual note with additional information about infectious contact.

ShortA.2.6.1.5.1.5 - Additional information
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
94. PatientHistory.medicalHistory.epidemiologicalHistory.travelHistory
Definition

Travel history reported by the patient. Multiple records could be provided.

ShortA.2.6.1.5.2 - Travel history
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
96. PatientHistory.medicalHistory.epidemiologicalHistory.travelHistory.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

ShortExtensions that cannot be ignored even if unrecognized
Comments

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

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

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

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

Start and end date or end date and duration of stay in a country. Partial dates are allowed.

ShortA.2.6.1.5.2.1 - Time period
Control0..1
TypePeriod
100. PatientHistory.medicalHistory.epidemiologicalHistory.travelHistory.country
Definition

A country visited by the patient.

ShortA.2.6.1.5.2.2 - Country visited
Control1..1
TypeCodeableConcept
102. PatientHistory.medicalHistory.epidemiologicalHistory.travelHistory.comment
Definition

Relevant notes on the travel stay.

ShortA.2.6.1.5.2.3 - Comment
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
104. PatientHistory.familyHistory
Definition

Information about serious illnesses in close blood relatives with known or suspected genetic potential or with possible impact on patient care.

ShortA.2.6.2 - Family history
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
106. PatientHistory.familyHistory.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

ShortExtensions that cannot be ignored even if unrecognized
Comments

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

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

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

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

The family relation between the related person and the patient.

ShortA.2.6.2.1 - Patient relationship
Control0..1
TypeCodeableConcept
110. PatientHistory.familyHistory.birthDate
Definition

Full or partial date of birth

ShortA.2.6.2.2 - Date of birth
Control0..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
112. PatientHistory.familyHistory.deathDateOrAge
Definition

Age or date of the death of the family member.

ShortA.2.6.2.3 - Age or date of death
Control0..1
TypeBackboneElement
114. PatientHistory.familyHistory.conditions
Definition

Medical problems this person suffers or suffered.

ShortA.2.6.2.5 - Condition
Control0..*
TypeBackboneElement
116. PatientHistory.familyHistory.causeOfDeath
Definition

Information about disease or condition that was the main cause of death.

ShortA.2.6.2.6 - Cause of death
Control0..1
TypeCodeableConcept
118. PatientHistory.socialDeterminants
Definition

Information about social determinants of health.

ShortA.2.6.3 - Social determinants of health
Control0..1
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
120. PatientHistory.socialDeterminants.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

ShortExtensions that cannot be ignored even if unrecognized
Comments

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

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

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

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

Participation in society details.

ShortA.2.6.3.1 - Participation in society
Control0..1
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
124. PatientHistory.socialDeterminants.participationInSociety.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

ShortExtensions that cannot be ignored even if unrecognized
Comments

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

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

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

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

Work Situation describes the extent to which and in what way the patient participates in the workforce. Work is meant in the broadest sense of the word: activities that contribute to the person themselves, their environment or society. This includes both paid and unpaid work.

ShortA.2.6.3.1.1 - Work situation
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
128. PatientHistory.socialDeterminants.participationInSociety.hobby
Definition

An activity the patient enjoys doing in their free time.

ShortA.2.6.3.1.2 - Hobby
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
130. PatientHistory.socialDeterminants.participationInSociety.socailNetwork
Definition

A description of the patient’s social network, such as family, neighbours and friends.

ShortA.2.6.3.1.3 - Social network
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
132. PatientHistory.socialDeterminants.education
Definition

Education

ShortA.2.6.3.2 - Education
Control0..1
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
134. PatientHistory.socialDeterminants.education.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

ShortExtensions that cannot be ignored even if unrecognized
Comments

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

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

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

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

Indication of the highest level of education achieved.

ShortA.2.6.3.2.1 - Education level
Control0..1
TypeCodeableConcept
138. PatientHistory.socialDeterminants.education.comment
Definition

If deemed relevant, a specification of the degree program can be provided by means of an explanation (e.g.: patient is in medical school).

ShortA.2.6.3.2.2 - Comment
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
140. PatientHistory.socialDeterminants.livingSituation
Definition

Household type and other related living situation information.

ShortA.2.6.3.3 - Living situation
Control0..1
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
142. PatientHistory.socialDeterminants.livingSituation.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

ShortExtensions that cannot be ignored even if unrecognized
Comments

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

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

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

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

Type of home the patient lives in.

ShortA.2.6.3.3.1 - House type
Control0..1
TypeCodeableConcept
146. PatientHistory.socialDeterminants.livingSituation.homeAdaption
Definition

Adaptions present in the home that have been made in the context of the illness or disability to make the functioning of the patient safer and more comfortable and to enable independent living. Multiple data elements could be provided.

ShortA.2.6.3.3.2 - Home adaption
Control0..*
TypeCodeableConcept
148. PatientHistory.socialDeterminants.livingSituation.livingConditions
Definition

Conditions that affect the accessibility of the home or the stay in the home. Multiple data elements could be provided.

ShortA.2.6.3.3.3 - Living conditions
Control0..*
TypeCodeableConcept
150. PatientHistory.socialDeterminants.familySituation
Definition

Family situation details.

ShortA.2.6.3.4 - Family situation
Control0..1
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
152. PatientHistory.socialDeterminants.familySituation.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

ShortExtensions that cannot be ignored even if unrecognized
Comments

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

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

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

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

A comment on the family situation.

ShortA.2.6.3.4.1 - Comment
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
156. PatientHistory.socialDeterminants.familySituation.familyComposition
Definition

The family composition describes the patient’s home situation and the form of cohabitation.

ShortA.2.6.3.4.2 - Family composition
Control0..1
TypeCodeableConcept
158. PatientHistory.socialDeterminants.familySituation.maritalStatus
Definition

A person’s marital status according to the terms and definition in the national civil code.

ShortA.2.6.3.4.3 - Marital status
Control0..1
TypeCodeableConcept
160. PatientHistory.socialDeterminants.familySituation.numberOfChildren
Definition

The number of children the patient has. Children in the context of this information model include step children, foster children, biological and adopted children.

ShortA.2.6.3.4.4 - Number of children
Control0..1
Typeinteger
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
162. PatientHistory.socialDeterminants.familySituation.numberOfChildrenAtHome
Definition

The number of children living at home with the patient.

ShortA.2.6.3.4.5 - Number of children at home
Control0..1
Typeinteger
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
164. PatientHistory.socialDeterminants.familySituation.childDetails
Definition

Child age, co-living status and comment. Multiple child details could be provided.

ShortA.2.6.3.4.6 - Child details
Control0..*
TypeBackboneElement
166. PatientHistory.socialDeterminants.familySituation.careResponsibility
Definition

The activities the patient carries out to care for a dependent family member.

ShortA.2.6.3.4.7 - Care responsibility
Control0..*
TypeBackboneElement
168. PatientHistory.useOfSubstances
Definition

Use of substances

ShortA.2.6.4 - Use of substances
Control0..1
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
170. PatientHistory.useOfSubstances.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

ShortExtensions that cannot be ignored even if unrecognized
Comments

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

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

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

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

Alcohol consumption by the patient. Multiple records on alcohol use could be provided.

ShortA.2.6.4.1 - Alcohol use
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
174. PatientHistory.useOfSubstances.alcohol.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

ShortExtensions that cannot be ignored even if unrecognized
Comments

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

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

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

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

The status of the patient’s alcohol use.

ShortA.2.6.4.1.1 - Status
Control0..1
TypeCodeableConcept
178. PatientHistory.useOfSubstances.alcohol.periodAndQuantity
Definition

Period of use and amount (The extent of the patient’s alcohol use in units of alcohol per time period.)

ShortA.2.6.4.1.2 - Period and quantity
Control0..*
TypeCodeableConcept
180. PatientHistory.useOfSubstances.alcohol.comment
Definition

Textual comment.

ShortA.2.6.4.1.3 - Comment
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
182. PatientHistory.useOfSubstances.tobacco
Definition

Represent smoking or tobacco habits. Multiple records on tobacco use could be provided.

ShortA.2.6.4.2 - Tobacco use
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
184. PatientHistory.useOfSubstances.tobacco.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

ShortExtensions that cannot be ignored even if unrecognized
Comments

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

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

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

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

The status of the patient’s tobacco use.

ShortA.2.6.4.2.1 - Status
Control0..1
TypeCodeableConcept
188. PatientHistory.useOfSubstances.tobacco.periodAndQuantity
Definition

Period of use and amount (The extent of the patient’s tobacco use in units of alcohol per time period.)

ShortA.2.6.4.2.2 - Period and quantity
Control0..*
TypeBackboneElement
190. PatientHistory.useOfSubstances.tobacco.comment
Definition

Textual comment.

ShortA.2.6.4.2.3 - Comment
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
192. PatientHistory.useOfSubstances.drugConsumption
Definition

Consumption of drugs and other substances (in terms of abuse).

ShortA.2.6.4.3 - Drug consumption
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
194. PatientHistory.useOfSubstances.drugConsumption.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

ShortExtensions that cannot be ignored even if unrecognized
Comments

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

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

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

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

The status of the patient’s drug use.

ShortA.2.6.4.3.1 - Status
Control0..1
TypeCodeableConcept
198. PatientHistory.useOfSubstances.drugConsumption.periodAndQuantity
Definition

Period of use and amount.

ShortA.2.6.4.3.2 - Period and quantity
Control0..1
TypeBackboneElement
200. PatientHistory.useOfSubstances.drugConsumption.drugType
Definition

Type of the drug consumption

ShortA.2.6.4.3.3 - Drug or medication type
Control0..1
TypeCodeableConcept
202. PatientHistory.useOfSubstances.drugConsumption.route
Definition

Route or routes of administration

ShortA.2.6.4.3.4 - Route of administration
Control0..*
TypeCodeableConcept
204. PatientHistory.useOfSubstances.drugConsumption.comment
Definition

Textual comment

ShortA.2.6.4.3.5 - Comment
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension

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

0. PatientHistory
Definition

Hospital Discharge Report - Patient history - A.2.6 eHN

ShortA.2.6 - Patient history (eHN)
Control0..*
Is Modifierfalse
Logical ModelInstances of this logical model are not marked to be the target of a Reference
2. PatientHistory.medicalHistory
Definition

Medical history

ShortA.2.6.1 - Medical history
Control1..1
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. PatientHistory.medicalHistory.id
Definition

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

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

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

ShortAdditional content defined by implementations
Comments

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

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

    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

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

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

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

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

    A list of conditions of a patient that the patient suffered in the past or still suffers. Unlike diagnostic summary, medical history is not only a list of problems, but could contain broader description of the condition and its progress, details about treatment including medication and patient response to treatment. Past problem section (unlike the same section of the patient summary) should include only conditions that are important for continuity of care. This section, if provided, complements the diagnostic summary section of the discharge report.

    ShortA.2.6.1.1 - History of problems
    Control1..*
    TypeBackboneElement
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    12. PatientHistory.medicalHistory.historyOfConditions.id
    Definition

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

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

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

    ShortAdditional content defined by implementations
    Comments

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

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

      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

      ShortExtensions that cannot be ignored even if unrecognized
      Comments

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

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

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

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

      Problem specification

      ShortA.2.6.1.1.1 - Problem description
      Control1..1
      Typestring
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      20. PatientHistory.medicalHistory.historyOfConditions.conditionDetails
      Definition

      Problem details include code that identifies problem, specification of the body structure, laterality, and other aspects of the problem.

      ShortA.2.6.1.1.2 - Problem details
      Control0..*
      TypeBackboneElement
      22. PatientHistory.medicalHistory.historyOfConditions.onsetDate
      Definition

      Onset date of the problem/condition

      ShortA.2.6.1.1.3 - Onset date
      Control1..1
      TypedateTime
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      24. PatientHistory.medicalHistory.historyOfConditions.endDate
      Definition

      The date or estimated date that the condition resolved or went into remission.

      ShortA.2.6.1.1.4 - End date
      Control0..1
      TypedateTime
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      26. PatientHistory.medicalHistory.historyOfConditions.clinicalStatus
      Definition

      Status of the condition/problem (active, resolved, inactive, ...)

      ShortA.2.6.1.1.5 - Clinical status
      Control0..1
      TypeCodeableConcept
      28. PatientHistory.medicalHistory.historyOfConditions.resolution
      Definition

      Describes the reason for which the status of the problem changed from current to inactive (e.g. surgical procedure, medical treatment, etc.). This field includes "free text" if the resolution circumstances are not already included in other fields such as surgical procedure, medical device, etc., e.g. hepatic cystectomy (this will be the resolution circumstances for the problem "hepatic cyst" and will be included in surgical procedures).

      ShortA.2.6.1.1.6 - Resolution circumstances
      Control0..1
      TypeBackboneElement
      30. PatientHistory.medicalHistory.historyOfConditions.severity
      Definition

      A subjective assessment of the severity of the condition as evaluated by the clinician.

      ShortA.2.6.1.1.7 - Severity
      Control0..1
      TypeCodeableConcept
      32. PatientHistory.medicalHistory.historyOfConditions.stage
      Definition

      Stage/grade, usually assessed formally using a specific staging/grading system.

      ShortA.2.6.1.1.8 - Stage
      Control0..*
      TypeCodeableConcept
      34. PatientHistory.medicalHistory.medicalDevices
      Definition

      Devices and Implants

      ShortA.2.6.1.2 - Devices and Implants
      Control1..*
      TypeBackboneElement
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. PatientHistory.medicalHistory.medicalDevices.id
      Definition

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

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

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

      ShortAdditional content defined by implementations
      Comments

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

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

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

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

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

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

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

        Describes the patient's implanted and external medical devices and equipment upon which their health status depends. Includes devices such as cardiac pacemakers, implantable fibrillator, prosthesis, ferromagnetic bone implants, etc. of which the HP needs to be aware.

        ShortA.2.6.1.2.1 - Device and implant description
        Control1..1
        TypeCodeableConcept
        44. PatientHistory.medicalHistory.medicalDevices.identifier
        Definition

        Normalised identifier of the device instance such as UDI according to REGULATION (EU) 2017/745

        ShortA.2.6.1.2.2 - Device ID
        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..1
        TypeIdentifier
        46. PatientHistory.medicalHistory.medicalDevices.implantDate
        Definition

        The date and time the device was implanted or when its use began.

        ShortA.2.6.1.2.3 - Implant date
        Control1..1
        TypedateTime
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        48. PatientHistory.medicalHistory.medicalDevices.endDate
        Definition

        Date and time when the device was explanted from the patient or the external device was no longer in use; likewise when the device is planned to be explanted

        ShortA.2.6.1.2.4 - End date
        Control0..1
        TypedateTime
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        50. PatientHistory.medicalHistory.medicalDevices.reason
        Definition

        The medical reason for use of the medical device.

        ShortA.2.6.1.2.5 - Reason
        Control0..*
        TypeCodeableConcept
        52. PatientHistory.medicalHistory.historyOfProcedures
        Definition

        Historical procedures performed on or for a patient, relevant for the current encounter.

        ShortA.2.6.1.3 - History of procedures
        Control0..*
        TypeBackboneElement
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        54. PatientHistory.medicalHistory.historyOfProcedures.id
        Definition

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

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

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

        ShortAdditional content defined by implementations
        Comments

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

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

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

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

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

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

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

          Procedure code

          ShortA.2.6.1.3.1 - Procedure code
          Control0..1
          TypeCodeableConcept
          62. PatientHistory.medicalHistory.historyOfProcedures.description
          Definition

          Narrative description of the procedure

          ShortA.2.6.1.3.2 - Procedure description
          Control1..1
          Typestring
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          64. PatientHistory.medicalHistory.historyOfProcedures.bodySite
          Definition

          Procedure target body site and laterality

          ShortA.2.6.1.3.3 - Body site
          Control0..1
          TypeCodeableConcept
          66. PatientHistory.medicalHistory.historyOfProcedures.date
          Definition

          Date and time when procedure was performed

          ShortA.2.6.1.3.4 - Procedure date
          Control0..1
          TypedateTime
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          68. PatientHistory.medicalHistory.historyOfProcedures.reason
          Definition

          The coded reason why the procedure was performed. This may be a coded entity or may simply be present as text.

          ShortA.2.6.1.3.5 - Procedure reason
          Control0..1
          TypeCodeableConcept
          70. PatientHistory.medicalHistory.historyOfProcedures.outcome
          Definition

          The outcome of the procedure - did it resolve the reasons for the procedure being performed? Applicable mainly on surgical procedures.

          ShortA.2.6.1.3.6 - Outcome
          Control0..1
          TypeCodeableConcept
          72. PatientHistory.medicalHistory.historyOfProcedures.focalDevice
          Definition

          A reference to the device or devices that is implanted, removed or otherwise manipulated (calibration, battery replacement, fitting a prosthesis, attaching a wound-vac, etc.) as a focal portion of the Procedure.

          ShortA.2.6.1.3.7 - Focal device
          Control0..*
          TypeCodeableReference
          74. PatientHistory.medicalHistory.vaccination
          Definition

          Vaccination history of the patient.

          ShortA.2.6.1.4 - Vaccination
          Control0..*
          TypeBackboneElement
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          76. PatientHistory.medicalHistory.vaccination.id
          Definition

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

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

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

          ShortAdditional content defined by implementations
          Comments

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

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

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

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

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

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

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

            Disease or agent that the vaccination provides protection against

            ShortA.2.6.1.4.1 - Disease or agent targeted
            Control0..*
            TypeCodeableConcept
            84. PatientHistory.medicalHistory.vaccination.vaccine
            Definition

            Generic description of the vaccine/prophylaxis or its component(s)

            ShortA.2.6.1.4.2 - Vaccine/prophylaxis
            Control1..1
            TypeCodeableConcept
            86. PatientHistory.medicalHistory.vaccination.productName
            Definition

            Medicinal product name

            ShortA.2.6.1.4.4 - Vaccine medicinal product
            Control0..1
            Typestring
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            88. PatientHistory.medicalHistory.vaccination.manufacturerOrMAH
            Definition

            Marketing Authorisation Holder or manufacturer (Identifier and name)

            ShortA.2.6.1.4.5 - Marketing Authorisation Holder
            Control0..1
            TypeBackboneElement
            90. PatientHistory.medicalHistory.vaccination.orderNumber
            Definition

            Order in the vaccination course.

            ShortA.2.6.1.4.6 - Number in a series of vaccinations / doses
            Control0..1
            Typeinteger
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            92. PatientHistory.medicalHistory.vaccination.vaccinationDate
            Definition

            The date and time when the vaccination was administered

            ShortA.2.6.1.4.7 - Date of vaccination
            Control1..1
            TypedateTime
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            94. PatientHistory.medicalHistory.vaccination.nextVaccinationDate
            Definition

            The date when the vaccination is planned to be given/repeated (e.g. next dose)

            ShortA.2.6.1.4.8 - Next vaccination date
            Control0..1
            TypedateTime
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            96. PatientHistory.medicalHistory.epidemiologicalHistory
            Definition

            Travel history and infectious contacts

            ShortA.2.6.1.5 - Epidemiological history
            Control0..1
            TypeBackboneElement
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            98. PatientHistory.medicalHistory.epidemiologicalHistory.id
            Definition

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

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

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

            ShortAdditional content defined by implementations
            Comments

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

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

              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

              ShortExtensions that cannot be ignored even if unrecognized
              Comments

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

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

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

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

              Infectious contacts of the patient

              ShortA.2.6.1.5.1 - Infectious contacts
              Control0..*
              TypeBackboneElement
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              106. PatientHistory.medicalHistory.epidemiologicalHistory.infectiousContacts.id
              Definition

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

              ShortUnique id for inter-element referencing
              Control0..1
              Typestring
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              108. PatientHistory.medicalHistory.epidemiologicalHistory.infectiousContacts.extension
              Definition

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

              ShortAdditional content defined by implementations
              Comments

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

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

                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                ShortExtensions that cannot be ignored even if unrecognized
                Comments

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

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

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

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

                A date and duration or date time interval of contact. Partial dates are allowed.

                ShortA.2.6.1.5.1.1 - Time period
                Control0..1
                TypePeriod
                114. PatientHistory.medicalHistory.epidemiologicalHistory.infectiousContacts.infectiousAgent
                Definition

                Information about a suspected infectious agent or agents the person was exposed to.

                ShortA.2.6.1.5.1.2 - Infectious agent
                Control0..*
                TypeCodeableConcept
                116. PatientHistory.medicalHistory.epidemiologicalHistory.infectiousContacts.proximity
                Definition

                Proximity to the source/carrier of the infectious agent during exposure. Proximity could be expressed by text, code (direct, indirect) or value specifying distance from the InfectiousAgentCarrier.

                ShortA.2.6.1.5.1.3 - Proximity
                Control0..1
                TypeCodeableConcept
                118. PatientHistory.medicalHistory.epidemiologicalHistory.infectiousContacts.country
                Definition

                Country in which the person was potentially exposed to an infectious agent.

                ShortA.2.6.1.5.1.4 - Country
                Control0..1
                TypeCodeableConcept
                120. PatientHistory.medicalHistory.epidemiologicalHistory.infectiousContacts.note
                Definition

                A textual note with additional information about infectious contact.

                ShortA.2.6.1.5.1.5 - Additional information
                Control0..1
                Typestring
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                122. PatientHistory.medicalHistory.epidemiologicalHistory.travelHistory
                Definition

                Travel history reported by the patient. Multiple records could be provided.

                ShortA.2.6.1.5.2 - Travel history
                Control0..*
                TypeBackboneElement
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                124. PatientHistory.medicalHistory.epidemiologicalHistory.travelHistory.id
                Definition

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

                ShortUnique id for inter-element referencing
                Control0..1
                Typestring
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                126. PatientHistory.medicalHistory.epidemiologicalHistory.travelHistory.extension
                Definition

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

                ShortAdditional content defined by implementations
                Comments

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

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

                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                  ShortExtensions that cannot be ignored even if unrecognized
                  Comments

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

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

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

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

                  Start and end date or end date and duration of stay in a country. Partial dates are allowed.

                  ShortA.2.6.1.5.2.1 - Time period
                  Control0..1
                  TypePeriod
                  132. PatientHistory.medicalHistory.epidemiologicalHistory.travelHistory.country
                  Definition

                  A country visited by the patient.

                  ShortA.2.6.1.5.2.2 - Country visited
                  Control1..1
                  TypeCodeableConcept
                  134. PatientHistory.medicalHistory.epidemiologicalHistory.travelHistory.comment
                  Definition

                  Relevant notes on the travel stay.

                  ShortA.2.6.1.5.2.3 - Comment
                  Control0..1
                  Typestring
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  136. PatientHistory.familyHistory
                  Definition

                  Information about serious illnesses in close blood relatives with known or suspected genetic potential or with possible impact on patient care.

                  ShortA.2.6.2 - Family history
                  Control0..*
                  TypeBackboneElement
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  138. PatientHistory.familyHistory.id
                  Definition

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

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

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

                  ShortAdditional content defined by implementations
                  Comments

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

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

                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                    ShortExtensions that cannot be ignored even if unrecognized
                    Comments

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

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

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

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

                    The family relation between the related person and the patient.

                    ShortA.2.6.2.1 - Patient relationship
                    Control0..1
                    TypeCodeableConcept
                    146. PatientHistory.familyHistory.birthDate
                    Definition

                    Full or partial date of birth

                    ShortA.2.6.2.2 - Date of birth
                    Control0..1
                    TypedateTime
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    148. PatientHistory.familyHistory.deathDateOrAge
                    Definition

                    Age or date of the death of the family member.

                    ShortA.2.6.2.3 - Age or date of death
                    Control0..1
                    TypeBackboneElement
                    150. PatientHistory.familyHistory.conditions
                    Definition

                    Medical problems this person suffers or suffered.

                    ShortA.2.6.2.5 - Condition
                    Control0..*
                    TypeBackboneElement
                    152. PatientHistory.familyHistory.causeOfDeath
                    Definition

                    Information about disease or condition that was the main cause of death.

                    ShortA.2.6.2.6 - Cause of death
                    Control0..1
                    TypeCodeableConcept
                    154. PatientHistory.socialDeterminants
                    Definition

                    Information about social determinants of health.

                    ShortA.2.6.3 - Social determinants of health
                    Control0..1
                    TypeBackboneElement
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    156. PatientHistory.socialDeterminants.id
                    Definition

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

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

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

                    ShortAdditional content defined by implementations
                    Comments

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

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

                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                      ShortExtensions that cannot be ignored even if unrecognized
                      Comments

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

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

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

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

                      Participation in society details.

                      ShortA.2.6.3.1 - Participation in society
                      Control0..1
                      TypeBackboneElement
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      164. PatientHistory.socialDeterminants.participationInSociety.id
                      Definition

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

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

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

                      ShortAdditional content defined by implementations
                      Comments

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

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

                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                        ShortExtensions that cannot be ignored even if unrecognized
                        Comments

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

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

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

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

                        Work Situation describes the extent to which and in what way the patient participates in the workforce. Work is meant in the broadest sense of the word: activities that contribute to the person themselves, their environment or society. This includes both paid and unpaid work.

                        ShortA.2.6.3.1.1 - Work situation
                        Control0..1
                        Typestring
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        172. PatientHistory.socialDeterminants.participationInSociety.hobby
                        Definition

                        An activity the patient enjoys doing in their free time.

                        ShortA.2.6.3.1.2 - Hobby
                        Control0..1
                        Typestring
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        174. PatientHistory.socialDeterminants.participationInSociety.socailNetwork
                        Definition

                        A description of the patient’s social network, such as family, neighbours and friends.

                        ShortA.2.6.3.1.3 - Social network
                        Control0..1
                        Typestring
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        176. PatientHistory.socialDeterminants.education
                        Definition

                        Education

                        ShortA.2.6.3.2 - Education
                        Control0..1
                        TypeBackboneElement
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        178. PatientHistory.socialDeterminants.education.id
                        Definition

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

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

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

                        ShortAdditional content defined by implementations
                        Comments

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

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

                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                          ShortExtensions that cannot be ignored even if unrecognized
                          Comments

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

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

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

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

                          Indication of the highest level of education achieved.

                          ShortA.2.6.3.2.1 - Education level
                          Control0..1
                          TypeCodeableConcept
                          186. PatientHistory.socialDeterminants.education.comment
                          Definition

                          If deemed relevant, a specification of the degree program can be provided by means of an explanation (e.g.: patient is in medical school).

                          ShortA.2.6.3.2.2 - Comment
                          Control0..1
                          Typestring
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          188. PatientHistory.socialDeterminants.livingSituation
                          Definition

                          Household type and other related living situation information.

                          ShortA.2.6.3.3 - Living situation
                          Control0..1
                          TypeBackboneElement
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          190. PatientHistory.socialDeterminants.livingSituation.id
                          Definition

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

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

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

                          ShortAdditional content defined by implementations
                          Comments

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

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

                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                            ShortExtensions that cannot be ignored even if unrecognized
                            Comments

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

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

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

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

                            Type of home the patient lives in.

                            ShortA.2.6.3.3.1 - House type
                            Control0..1
                            TypeCodeableConcept
                            198. PatientHistory.socialDeterminants.livingSituation.homeAdaption
                            Definition

                            Adaptions present in the home that have been made in the context of the illness or disability to make the functioning of the patient safer and more comfortable and to enable independent living. Multiple data elements could be provided.

                            ShortA.2.6.3.3.2 - Home adaption
                            Control0..*
                            TypeCodeableConcept
                            200. PatientHistory.socialDeterminants.livingSituation.livingConditions
                            Definition

                            Conditions that affect the accessibility of the home or the stay in the home. Multiple data elements could be provided.

                            ShortA.2.6.3.3.3 - Living conditions
                            Control0..*
                            TypeCodeableConcept
                            202. PatientHistory.socialDeterminants.familySituation
                            Definition

                            Family situation details.

                            ShortA.2.6.3.4 - Family situation
                            Control0..1
                            TypeBackboneElement
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            204. PatientHistory.socialDeterminants.familySituation.id
                            Definition

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

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

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

                            ShortAdditional content defined by implementations
                            Comments

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

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

                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                              ShortExtensions that cannot be ignored even if unrecognized
                              Comments

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

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

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

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

                              A comment on the family situation.

                              ShortA.2.6.3.4.1 - Comment
                              Control0..1
                              Typestring
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              212. PatientHistory.socialDeterminants.familySituation.familyComposition
                              Definition

                              The family composition describes the patient’s home situation and the form of cohabitation.

                              ShortA.2.6.3.4.2 - Family composition
                              Control0..1
                              TypeCodeableConcept
                              214. PatientHistory.socialDeterminants.familySituation.maritalStatus
                              Definition

                              A person’s marital status according to the terms and definition in the national civil code.

                              ShortA.2.6.3.4.3 - Marital status
                              Control0..1
                              TypeCodeableConcept
                              216. PatientHistory.socialDeterminants.familySituation.numberOfChildren
                              Definition

                              The number of children the patient has. Children in the context of this information model include step children, foster children, biological and adopted children.

                              ShortA.2.6.3.4.4 - Number of children
                              Control0..1
                              Typeinteger
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              218. PatientHistory.socialDeterminants.familySituation.numberOfChildrenAtHome
                              Definition

                              The number of children living at home with the patient.

                              ShortA.2.6.3.4.5 - Number of children at home
                              Control0..1
                              Typeinteger
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              220. PatientHistory.socialDeterminants.familySituation.childDetails
                              Definition

                              Child age, co-living status and comment. Multiple child details could be provided.

                              ShortA.2.6.3.4.6 - Child details
                              Control0..*
                              TypeBackboneElement
                              222. PatientHistory.socialDeterminants.familySituation.careResponsibility
                              Definition

                              The activities the patient carries out to care for a dependent family member.

                              ShortA.2.6.3.4.7 - Care responsibility
                              Control0..*
                              TypeBackboneElement
                              224. PatientHistory.useOfSubstances
                              Definition

                              Use of substances

                              ShortA.2.6.4 - Use of substances
                              Control0..1
                              TypeBackboneElement
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              226. PatientHistory.useOfSubstances.id
                              Definition

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

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

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

                              ShortAdditional content defined by implementations
                              Comments

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

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

                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                ShortExtensions that cannot be ignored even if unrecognized
                                Comments

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

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

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

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

                                Alcohol consumption by the patient. Multiple records on alcohol use could be provided.

                                ShortA.2.6.4.1 - Alcohol use
                                Control0..*
                                TypeBackboneElement
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                234. PatientHistory.useOfSubstances.alcohol.id
                                Definition

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

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

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

                                ShortAdditional content defined by implementations
                                Comments

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

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

                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                  ShortExtensions that cannot be ignored even if unrecognized
                                  Comments

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

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

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

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

                                  The status of the patient’s alcohol use.

                                  ShortA.2.6.4.1.1 - Status
                                  Control0..1
                                  TypeCodeableConcept
                                  242. PatientHistory.useOfSubstances.alcohol.periodAndQuantity
                                  Definition

                                  Period of use and amount (The extent of the patient’s alcohol use in units of alcohol per time period.)

                                  ShortA.2.6.4.1.2 - Period and quantity
                                  Control0..*
                                  TypeCodeableConcept
                                  244. PatientHistory.useOfSubstances.alcohol.comment
                                  Definition

                                  Textual comment.

                                  ShortA.2.6.4.1.3 - Comment
                                  Control0..1
                                  Typestring
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  246. PatientHistory.useOfSubstances.tobacco
                                  Definition

                                  Represent smoking or tobacco habits. Multiple records on tobacco use could be provided.

                                  ShortA.2.6.4.2 - Tobacco use
                                  Control0..*
                                  TypeBackboneElement
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  248. PatientHistory.useOfSubstances.tobacco.id
                                  Definition

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

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

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

                                  ShortAdditional content defined by implementations
                                  Comments

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

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

                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                    ShortExtensions that cannot be ignored even if unrecognized
                                    Comments

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

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

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

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

                                    The status of the patient’s tobacco use.

                                    ShortA.2.6.4.2.1 - Status
                                    Control0..1
                                    TypeCodeableConcept
                                    256. PatientHistory.useOfSubstances.tobacco.periodAndQuantity
                                    Definition

                                    Period of use and amount (The extent of the patient’s tobacco use in units of alcohol per time period.)

                                    ShortA.2.6.4.2.2 - Period and quantity
                                    Control0..*
                                    TypeBackboneElement
                                    258. PatientHistory.useOfSubstances.tobacco.comment
                                    Definition

                                    Textual comment.

                                    ShortA.2.6.4.2.3 - Comment
                                    Control0..1
                                    Typestring
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    260. PatientHistory.useOfSubstances.drugConsumption
                                    Definition

                                    Consumption of drugs and other substances (in terms of abuse).

                                    ShortA.2.6.4.3 - Drug consumption
                                    Control0..*
                                    TypeBackboneElement
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    262. PatientHistory.useOfSubstances.drugConsumption.id
                                    Definition

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

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

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

                                    ShortAdditional content defined by implementations
                                    Comments

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

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

                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                      ShortExtensions that cannot be ignored even if unrecognized
                                      Comments

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

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

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

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

                                      The status of the patient’s drug use.

                                      ShortA.2.6.4.3.1 - Status
                                      Control0..1
                                      TypeCodeableConcept
                                      270. PatientHistory.useOfSubstances.drugConsumption.periodAndQuantity
                                      Definition

                                      Period of use and amount.

                                      ShortA.2.6.4.3.2 - Period and quantity
                                      Control0..1
                                      TypeBackboneElement
                                      272. PatientHistory.useOfSubstances.drugConsumption.drugType
                                      Definition

                                      Type of the drug consumption

                                      ShortA.2.6.4.3.3 - Drug or medication type
                                      Control0..1
                                      TypeCodeableConcept
                                      274. PatientHistory.useOfSubstances.drugConsumption.route
                                      Definition

                                      Route or routes of administration

                                      ShortA.2.6.4.3.4 - Route of administration
                                      Control0..*
                                      TypeCodeableConcept
                                      276. PatientHistory.useOfSubstances.drugConsumption.comment
                                      Definition

                                      Textual comment

                                      ShortA.2.6.4.3.5 - Comment
                                      Control0..1
                                      Typestring
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension