Patient - Dossier Farmaceutico - Definitions - HL7 FHIR Implementation Guide Dossier Farmaceutico v0.1.1

Is Modifier false

Summary true

4. Patient.meta

Definition

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

Short Metadata about the resource

Control 0..1

Meta

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

6. Patient.implicitRules

Definition

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

Short A set of rules under which this content was created

Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control 0..1

Is Modifier true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

8. Patient.language

Definition

The base language in which the resource is written.

Short Language of the resource content

Comments

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

Control 0..1

The codes SHOULD be taken from CommonLanguages
(preferred to http://hl7.org/fhir/ValueSet/languages)

A human language.

Additional Bindings

Purpose

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

10. Patient.text

Definition

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

Short Text summary of the resource, for human interpretation

Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

Control 0..1

Narrative

Is Modifier false

Summary false

Alternate Names narrative, html, xhtml, display

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

12. Patient.contained

Definition

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

Short Contained, inline Resources

Comments

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

Control 0..*

Resource

Is Modifier false

Summary false

Alternate Names inline resources, anonymous resources, contained resources

14. Patient.extension

Definition

An Extension

Short Extension

Control 0..*

Is Modifier false

Summary false

Invariants ele-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())

This element introduces a set of slices on Patient.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

16. Patient.extension:luogoNascita

Slice Name luogoNascita

Definition

Definizione dell'indirizzo base per la descrizione del luogo di nascita.

Short Luogo di nascita.

Control 0..1

Type Extension(Address Birth Place (Patient)) (Extension Type: Address(Address - base))

Is Modifier false

18. Patient.extension:certificazione

Slice Name certificazione

Definition

Indica che i dati presenti nella risorsa (non quelli referenziati) sono stati certificati da una specifica entità

Short Indica che i dati presenti nella risorsa sono stati certificati da una specifica entità

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(Certificazione) (Complex Extension)

Is Modifier false

20. Patient.extension:luogoNascitaCodeable

Slice Name luogoNascitaCodeable

Definition

Codice del comune e/o dello stato di nascita del paziente. In via eccezionle, può essere usato per indicare comune e/o stato di nascita in forma testuale

Short Codice del comune e/o dello stato di nascita

Control 0..*
This element is affected by the following invariants: ele-1

Type Extension(Codice comune e/o stato di nascita) (Extension Type: CodeableConcept)

Is Modifier false

22. Patient.extension:cittadinanza

Slice Name cittadinanza

Definition

Indica la cittadinanza del cittadino attraverso lo stato di provenienza

Short Cittadinanza

Control 0..1

Type Extension(Patient Citizenship) (Complex Extension)

Is Modifier false

24. Patient.extension:professione

Slice Name professione

Definition

Indica la professione del cittadino come semplice CodeableConcept

Short Professione

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(Professione del paziente (Patient)) (Extension Type: CodeableConcept)

Is Modifier false

Must Support false

26. Patient.extension:titoloStudio

Slice Name titoloStudio

Definition

Indica il titolo di studio del cittadino come semplice CodeableConcept

Short Titolo di studio

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(Titolo di Studio del paziente (Patient)) (Extension Type: CodeableConcept)

Is Modifier false

Must Support false

28. Patient.modifierExtension

Definition

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

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

Short Extensions that cannot be ignored

Comments

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

Control 0..*

Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them

Summary false

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 Names extensions, user content

30. Patient.identifier

Definition

An identifier for this patient.

Short Identificativo del paziente.

Note This is a business identifier, not a resource identifier (see discussion)

Control 1..*

Is Modifier false

Summary true

Requirements

Patients are almost always assigned specific numerical identifiers.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

This element introduces a set of slices on Patient.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ $this.system

32. Patient.identifier.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

34. Patient.identifier.extension

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

36. Patient.identifier.extension:certificazioneId

Slice Name certificazioneId

Definition

Indica che questo identificativo è stato certificato. Usato tipicamente per il Codice Fiscale.

Short Identificativo certificato (tipicamente per CF)

Control 0..1

Type Extension(Certificazione) (Complex Extension)

Is Modifier false

38. Patient.identifier.use

Definition

The purpose of this identifier.

Short usual | official | temp | secondary | old (If known)

Comments

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

Control 0..1

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

Identifies the purpose for this identifier, if known .

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

40. Patient.identifier.type

Definition

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

Short Description of identifier

Comments

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

Control 0..1

Binding Unless not suitable, these codes SHALL be taken from Tipo identificatore
(extensible to https://www.hl7.it/fhir/terminology/ValueSet/VstipoIdentificatore)

Is Modifier false

Summary true

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

42. Patient.identifier.system

Definition

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

Short The namespace for the identifier value

Comments

Identifier.system is always case sensitive.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

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

Example General:http://www.acme.com/identifiers/patient

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

44. Patient.identifier.value

Definition

Identifictivo del paziente.

Short ID del paziente (e.g. Codice Fiscale).

Comments

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

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Example General:123456

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

46. Patient.identifier.period

Definition

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

Short Time period when id is/was valid for use

Control 0..1

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

48. Patient.identifier.assigner

Definition

Organization that issued/manages the identifier.

Short Organization that issued id (may be just text)

Comments

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

Control 0..1

Type Reference(Organization)

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

50. Patient.identifier:codiceFiscale

Slice Name codiceFiscale

Definition

An identifier for this patient.

Short Codice Fiscale.

Note This is a business identifier, not a resource identifier (see discussion)

Control 0..1

Is Modifier false

Summary true

Requirements

Patients are almost always assigned specific numerical identifiers.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

52. Patient.identifier:codiceFiscale.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

54. Patient.identifier:codiceFiscale.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

56. Patient.identifier:codiceFiscale.extension:certificazioneId

Slice Name certificazioneId

Definition

Indica che questo identificativo è stato certificato. Usato tipicamente per il Codice Fiscale.

Short Identificativo certificato (tipicamente per CF)

Control 0..1

Type Extension(Certificazione) (Complex Extension)

Is Modifier false

58. Patient.identifier:codiceFiscale.use

Definition

The purpose of this identifier.

Short usual | official | temp | secondary | old (If known)

Comments

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

Control 0..1

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

Identifies the purpose for this identifier, if known .

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

60. Patient.identifier:codiceFiscale.type

Definition

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

Short Description of identifier

Comments

Control 0..1

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

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

Is Modifier false

Summary true

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

62. Patient.identifier:codiceFiscale.system

Definition

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

Short Namespace per il valore dell'identifier.

Comments

Identifier.system is always case sensitive.

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

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

Fixed Value http://hl7.it/sid/codiceFiscale

Example General:http://www.acme.com/identifiers/patient

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

64. Patient.identifier:codiceFiscale.value

Definition

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

Short Valore dell'identifier.

Comments

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Example General:123456

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
pat-id-cf-1: Il Codice Fiscale deve essere di 16 caratteri alfanumerici (3 per il cognome; 3 per il nome; 2 caratteri numerici per l'anno di nascita; 1 per il mese di nascita; 2 caratteri numerici per il giorno di nascita ed il sesso; 4 associati al Comune oppure allo Stato estero di nascita. 1 carattere di controllo. (matches('^[A-Za-z]{6}[0-9LMNPQRSTUV]{2}[A-Za-z]{1}[0-9LMNPQRSTUV]{2}[A-Za-z]{1}[0-9LMNPQRSTUV]{3}[A-Za-z]{1}$'))

66. Patient.identifier:codiceFiscale.period

Definition

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

Short Time period when id is/was valid for use

Control 0..1

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

68. Patient.identifier:codiceFiscale.assigner

Definition

Organization that issued/manages the identifier.

Short Organization that issued id (may be just text)

Comments

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

Control 0..1

Type Reference(Organization)

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

70. Patient.identifier:anpr

Slice Name anpr

Definition

An identifier for this patient.

Short Identificativo del paziente nell'Anagrafe nazionale della popolazione residente.

Note This is a business identifier, not a resource identifier (see discussion)

Control 0..1

Is Modifier false

Summary true

Requirements

Patients are almost always assigned specific numerical identifiers.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

72. Patient.identifier:anpr.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

74. Patient.identifier:anpr.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

76. Patient.identifier:anpr.extension:certificazioneId

Slice Name certificazioneId

Definition

Indica che questo identificativo è stato certificato. Usato tipicamente per il Codice Fiscale.

Short Identificativo certificato (tipicamente per CF)

Control 0..1

Type Extension(Certificazione) (Complex Extension)

Is Modifier false

78. Patient.identifier:anpr.use

Definition

The purpose of this identifier.

Short usual | official | temp | secondary | old (If known)

Comments

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

Control 0..1

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

Identifies the purpose for this identifier, if known .

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

80. Patient.identifier:anpr.type

Definition

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

Short Description of identifier

Comments

Control 0..1

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

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

Is Modifier false

Summary true

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

82. Patient.identifier:anpr.system

Definition

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

Short Namespace per il valore dell'identifier.

Comments

Identifier.system is always case sensitive.

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

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

Pattern Value http://hl7.it/sid/anpr

Example General:http://www.acme.com/identifiers/patient

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

84. Patient.identifier:anpr.value

Definition

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

Short The value that is unique

Comments

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Example General:123456

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

86. Patient.identifier:anpr.period

Definition

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

Short Time period when id is/was valid for use

Control 0..1

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

88. Patient.identifier:anpr.assigner

Definition

Organization that issued/manages the identifier.

Short Organization that issued id (may be just text)

Comments

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

Control 0..1

Type Reference(Organization)

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

90. Patient.identifier:idRegionale

Slice Name idRegionale

Definition

An identifier for this patient.

Short Identificativo Regionale.

Note This is a business identifier, not a resource identifier (see discussion)

Control 0..1

Is Modifier false

Summary true

Requirements

Patients are almost always assigned specific numerical identifiers.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

92. Patient.identifier:idRegionale.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

94. Patient.identifier:idRegionale.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

96. Patient.identifier:idRegionale.extension:certificazioneId

Slice Name certificazioneId

Definition

Indica che questo identificativo è stato certificato. Usato tipicamente per il Codice Fiscale.

Short Identificativo certificato (tipicamente per CF)

Control 0..1

Type Extension(Certificazione) (Complex Extension)

Is Modifier false

98. Patient.identifier:idRegionale.use

Definition

The purpose of this identifier.

Short usual | official | temp | secondary | old (If known)

Comments

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

Control 0..1

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

Identifies the purpose for this identifier, if known .

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

100. Patient.identifier:idRegionale.type

Definition

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

Short Description of identifier

Comments

Control 0..1

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

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

Is Modifier false

Summary true

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

102. Patient.identifier:idRegionale.system

Definition

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

Short Namespace per il valore dell'identifier.

Comments

Identifier.system is always case sensitive.

Control 1..1

Binding The codes SHALL be taken from VS-Anagrafi Regionali
(required to https://www.hl7.it/fhir/terminology/ValueSet/vs-anagrafi-regionali)

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

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

Example General:http://www.acme.com/identifiers/patient

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

104. Patient.identifier:idRegionale.value

Definition

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

Short The value that is unique

Comments

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Example General:123456

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

106. Patient.identifier:idRegionale.period

Definition

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

Short Time period when id is/was valid for use

Control 0..1

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

108. Patient.identifier:idRegionale.assigner

Definition

Organization that issued/manages the identifier.

Short Organization that issued id (may be just text)

Comments

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

Control 0..1

Type Reference(Organization)

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

110. Patient.identifier:codiceENI

Slice Name codiceENI

Definition

An identifier for this patient.

Short Codice ENI.

Note This is a business identifier, not a resource identifier (see discussion)

Control 0..1

Is Modifier false

Summary true

Requirements

Patients are almost always assigned specific numerical identifiers.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

112. Patient.identifier:codiceENI.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

114. Patient.identifier:codiceENI.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

116. Patient.identifier:codiceENI.extension:certificazioneId

Slice Name certificazioneId

Definition

Indica che questo identificativo è stato certificato. Usato tipicamente per il Codice Fiscale.

Short Identificativo certificato (tipicamente per CF)

Control 0..1

Type Extension(Certificazione) (Complex Extension)

Is Modifier false

118. Patient.identifier:codiceENI.use

Definition

The purpose of this identifier.

Short usual | official | temp | secondary | old (If known)

Comments

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

Control 0..1

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

Identifies the purpose for this identifier, if known .

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

120. Patient.identifier:codiceENI.type

Definition

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

Short Description of identifier

Comments

Control 0..1

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

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

Is Modifier false

Summary true

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

122. Patient.identifier:codiceENI.system

Definition

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

Short Namespace per il valore dell'identifier.

Comments

Identifier.system is always case sensitive.

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

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

Pattern Value urn:oid:2.16.840.1.113883.2.9.4.3.18

Example General:http://www.acme.com/identifiers/patient

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

124. Patient.identifier:codiceENI.value

Definition

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

Short The value that is unique

Comments

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Example General:123456

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

126. Patient.identifier:codiceENI.period

Definition

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

Short Time period when id is/was valid for use

Control 0..1

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

128. Patient.identifier:codiceENI.assigner

Definition

Organization that issued/manages the identifier.

Short Organization that issued id (may be just text)

Comments

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

Control 0..1

Type Reference(Organization)

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

130. Patient.identifier:codiceANA

Slice Name codiceANA

Definition

An identifier for this patient.

Short Codice ANA.

Note This is a business identifier, not a resource identifier (see discussion)

Control 0..1

Is Modifier false

Summary true

Requirements

Patients are almost always assigned specific numerical identifiers.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

132. Patient.identifier:codiceANA.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

134. Patient.identifier:codiceANA.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

136. Patient.identifier:codiceANA.extension:certificazioneId

Slice Name certificazioneId

Definition

Indica che questo identificativo è stato certificato. Usato tipicamente per il Codice Fiscale.

Short Identificativo certificato (tipicamente per CF)

Control 0..1

Type Extension(Certificazione) (Complex Extension)

Is Modifier false

138. Patient.identifier:codiceANA.use

Definition

The purpose of this identifier.

Short usual | official | temp | secondary | old (If known)

Comments

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

Control 0..1

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

Identifies the purpose for this identifier, if known .

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

140. Patient.identifier:codiceANA.type

Definition

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

Short Description of identifier

Comments

Control 0..1

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

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

Is Modifier false

Summary true

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

142. Patient.identifier:codiceANA.system

Definition

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

Short Namespace per il valore dell'identifier.

Comments

Identifier.system is always case sensitive.

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

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

Pattern Value urn:oid:2.16.840.1.113883.2.9.4.3.15

Example General:http://www.acme.com/identifiers/patient

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

144. Patient.identifier:codiceANA.value

Definition

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

Short The value that is unique

Comments

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Example General:123456

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

146. Patient.identifier:codiceANA.period

Definition

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

Short Time period when id is/was valid for use

Control 0..1

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

148. Patient.identifier:codiceANA.assigner

Definition

Organization that issued/manages the identifier.

Short Organization that issued id (may be just text)

Comments

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

Control 0..1

Type Reference(Organization)

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

150. Patient.identifier:tesseraTEAM

Slice Name tesseraTEAM

Definition

An identifier for this patient.

Short Tessera TEAM.

Note This is a business identifier, not a resource identifier (see discussion)

Control 0..1

Is Modifier false

Summary true

Requirements

Patients are almost always assigned specific numerical identifiers.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

152. Patient.identifier:tesseraTEAM.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

154. Patient.identifier:tesseraTEAM.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

156. Patient.identifier:tesseraTEAM.extension:certificazioneId

Slice Name certificazioneId

Definition

Indica che questo identificativo è stato certificato. Usato tipicamente per il Codice Fiscale.

Short Identificativo certificato (tipicamente per CF)

Control 0..1

Type Extension(Certificazione) (Complex Extension)

Is Modifier false

158. Patient.identifier:tesseraTEAM.use

Definition

The purpose of this identifier.

Short usual | official | temp | secondary | old (If known)

Comments

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

Control 0..1

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

Identifies the purpose for this identifier, if known .

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

160. Patient.identifier:tesseraTEAM.type

Definition

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

Short Description of identifier

Comments

Control 0..1

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

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

Is Modifier false

Summary true

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

162. Patient.identifier:tesseraTEAM.system

Definition

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

Short Namespace per il valore dell'identifier.

Comments

Identifier.system is always case sensitive.

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

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

Pattern Value urn:oid:2.16.840.1.113883.2.9.4.3.7

Example General:http://www.acme.com/identifiers/patient

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

164. Patient.identifier:tesseraTEAM.value

Definition

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

Short The value that is unique

Comments

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Example General:123456

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

166. Patient.identifier:tesseraTEAM.period

Definition

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

Short Time period when id is/was valid for use

Control 0..1

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

168. Patient.identifier:tesseraTEAM.assigner

Definition

Organization that issued/manages the identifier.

Short Organization that issued id (may be just text)

Comments

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

Control 0..1

Type Reference(Organization)

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

170. Patient.identifier:codiceSTP

Slice Name codiceSTP

Definition

An identifier for this patient.

Short Codice STP.

Note This is a business identifier, not a resource identifier (see discussion)

Control 0..1

Is Modifier false

Summary true

Requirements

Patients are almost always assigned specific numerical identifiers.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

172. Patient.identifier:codiceSTP.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

174. Patient.identifier:codiceSTP.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

176. Patient.identifier:codiceSTP.extension:certificazioneId

Slice Name certificazioneId

Definition

Indica che questo identificativo è stato certificato. Usato tipicamente per il Codice Fiscale.

Short Identificativo certificato (tipicamente per CF)

Control 0..1

Type Extension(Certificazione) (Complex Extension)

Is Modifier false

178. Patient.identifier:codiceSTP.use

Definition

The purpose of this identifier.

Short usual | official | temp | secondary | old (If known)

Comments

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

Control 0..1

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

Identifies the purpose for this identifier, if known .

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

180. Patient.identifier:codiceSTP.type

Definition

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

Short Description of identifier

Comments

Control 0..1

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

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

Is Modifier false

Summary true

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

182. Patient.identifier:codiceSTP.system

Definition

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

Short Namespace per il valore dell'identifier.

Comments

Identifier.system is always case sensitive.

Control 1..1

Binding The codes SHALL be taken from Identificativi per codici STP regionali
(required to https://www.hl7.it/fhir/terminology/ValueSet/URI-idStp)

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

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

Example General:http://www.acme.com/identifiers/patient

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

184. Patient.identifier:codiceSTP.value

Definition

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

Short The value that is unique

Comments

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Example General:123456

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

186. Patient.identifier:codiceSTP.period

Definition

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

Short Time period when id is/was valid for use

Control 0..1

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

188. Patient.identifier:codiceSTP.assigner

Definition

Organization that issued/manages the identifier.

Short Organization that issued id (may be just text)

Comments

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

Control 0..1

Type Reference(Organization)

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

190. Patient.active

Definition

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

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

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

Short Whether this patient's record is in active use

Comments

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

Control 0..1

boolean

Is Modifier true because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

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

Meaning if Missing This resource is generally assumed to be active if no value is provided for the active element

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

192. Patient.name

Definition

A name associated with the individual.

Short Nome associato al paziente.

Comments

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

Control 1..*

HumanName

Is Modifier false

Summary true

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
it-pat-name-1: Il nome deve contenere almeno una delle aprti che compongono il nome (nome, cognome) (family.exists() or given.exists())

194. Patient.telecom

Definition

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

Short A contact detail for the individual

Comments

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

Control 0..*

ContactPoint

Is Modifier false

Summary true

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

196. Patient.gender

Definition

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

Short male | female | other | unknown

Comments

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

Control 0..1

The codes SHALL be taken from AdministrativeGender
(required to http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1)

The gender of a person used for administrative purposes.

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

198. Patient.birthDate

Definition

The date of birth for the individual.

Short The date of birth for the individual

Comments

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

Control 1..1

date

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Age of the individual drives many clinical processes.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

LOINC Code 21112-8

200. Patient.deceased[x]

Definition

Indicates if the individual is deceased or not.

Short Indicates if the individual is deceased or not

Comments

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

Control 0..1

Type Choice of: boolean, dateTime

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier true because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

202. Patient.address

Definition

Esiste una varietà di formati di indirizzi postali definiti in tutto il mondo. Questo profilo (Address-it-base) estende il datatype base Address includendo una serie di informazioni rilevanti per esprimere gli indirizzi in Italia.

Un Address-it-base è un indirizzo FHIR valido; i sistemi che non supportano le estensioni utilizzate saranno in grado comunque di eseguire il rendering e lavorare con un Address-it-base.

Un indirizzo Address-it-base rende alcune parti di indirizzo comunicabili separatamente. Queste parti sono necessarie in alcuni scenari d'uso italiani, ma potrebbero non avere valore per i sistemi internazionali quando le informazioni vengono inviate all'estero.

Short Indirizzo fisico o postale

Comments

Nota: address è per indirizzi postali, non per la localizzazione fisica.

Control 0..*
This element is affected by the following invariants: ele-1

Type Address(Address - base)

Is Modifier false

Requirements

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

Alternate Names Indirizzo

Example Completo:{ "line" : ["Via dei Ciliegi 15"], "city" : "Artimino", "state" : "PO", "postalCode" : "59015", "country" : "IT" }

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
it-address-official: Se Address rappresenta la residenza allora city e line devono essere inclusi (extension.where(url = 'http://hl7.org/fhir/StructureDefinition/address-official').valueBoolean.where(true).empty() or ( line.exists() and city.exists() ))

204. Patient.maritalStatus

Definition

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

Short Marital (civil) status of a patient

Control 0..1

Unless not suitable, these codes SHALL be taken from Marital Status Codes
(extensible to http://hl7.org/fhir/ValueSet/marital-status)

The domestic partnership status of a person.

Is Modifier false

Summary false

Requirements

Most, if not all systems capture it.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

206. Patient.multipleBirth[x]

Definition

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

Short Whether patient is part of a multiple birth

Comments

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

Control 0..1

Type Choice of: boolean, integer

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

208. Patient.photo

Definition

Image of the patient.

Short Image of the patient

Comments

Guidelines:

Use id photos, not clinical photos.
Limit dimensions to thumbnail.
Keep byte count low to ease resource updates.

Control 0..*

Attachment

Is Modifier false

Summary false

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

210. Patient.contact

Definition

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

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

Comments

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

Control 0..*

BackboneElement

Is Modifier false

Summary false

Requirements

Need to track people you can contact about the patient.

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

212. Patient.contact.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

214. Patient.contact.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

216. Patient.contact.modifierExtension

Definition

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

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

Short Extensions that cannot be ignored even if unrecognized

Comments

Control 0..*

Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

Summary true

Requirements

Alternate Names extensions, user content, modifiers

218. Patient.contact.relationship

Definition

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

Short The kind of relationship

Control 0..*

Unless not suitable, these codes SHALL be taken from PatientContactRelationship
(extensible to http://hl7.org/fhir/ValueSet/patient-contactrelationship)

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

Is Modifier false

Summary false

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

220. Patient.contact.name

Definition

A name associated with the contact person.

Short A name associated with the contact person

Control 0..1

HumanName

Is Modifier false

Summary false

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

222. Patient.contact.telecom

Definition

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

Short A contact detail for the person

Comments

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

Control 0..*

ContactPoint

Is Modifier false

Summary false

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

224. Patient.contact.address

Definition

Address for the contact person.

Short Address for the contact person

Control 0..1

Address

Is Modifier false

Summary false

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

226. Patient.contact.gender

Definition

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

Short male | female | other | unknown

Control 0..1

The codes SHALL be taken from AdministrativeGender
(required to http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1)

The gender of a person used for administrative purposes.

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Requirements

Needed to address the person correctly.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

228. Patient.contact.organization

Definition

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

Short Organization that is associated with the contact

Control 0..1
This element is affected by the following invariants: pat-1

Type Reference(Organization)

Is Modifier false

Summary false

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

230. Patient.contact.period

Definition

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

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

Control 0..1

Is Modifier false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

232. Patient.communication

Definition

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

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

Comments

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

Control 0..*

BackboneElement

Is Modifier false

Summary false

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

234. Patient.communication.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

236. Patient.communication.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

238. Patient.communication.modifierExtension

Definition

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

Short Extensions that cannot be ignored even if unrecognized

Comments

Control 0..*

Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

Summary true

Requirements

Alternate Names extensions, user content, modifiers

240. Patient.communication.language

Definition

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

Short The language which can be used to communicate with the patient about his or her health

Comments

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

Control 1..1

The codes SHOULD be taken from CommonLanguages
(preferred to http://hl7.org/fhir/ValueSet/languages)

A human language.

Additional Bindings

Purpose

Is Modifier false

Summary false

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

242. Patient.communication.preferred

Definition

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

Short Language preference indicator

Comments

This language is specifically identified for communicating healthcare information.

Control 0..1

boolean

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

244. Patient.generalPractitioner

Definition

Patient's nominated care provider.

Short Principale fornitore di cure del paziente.

Comments

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

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

Control 0..*

Type Reference(Organization, Practitioner, PractitionerRole)

Is Modifier false

Summary false

Alternate Names careProvider

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

This element introduces a set of slices on Patient.generalPractitioner. The slices areUnordered and Open, and can be differentiated using the following discriminators:

profile @ $this.resolve()

246. Patient.generalPractitioner:mmgPlsRole

Slice Name mmgPlsRole

Definition

Patient's nominated care provider.

Short Reference al ruolo MMG/PLS.

Comments

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

Control 0..*

Type Reference(PractitionerRole - Medico Prescrittore)

Is Modifier false

Summary false

Alternate Names careProvider

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

248. Patient.generalPractitioner:mmgPls

Slice Name mmgPls

Definition

Patient's nominated care provider.

Short Reference al MMG/PLS.

Comments

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

Control 0..*

Type Reference(Practitioner)

Is Modifier false

Summary false

Alternate Names careProvider

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

250. Patient.generalPractitioner:aziendaAssistenza

Slice Name aziendaAssistenza

Definition

Patient's nominated care provider.

Short Reference all'azienda che assiste il paziente.

Comments

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

Control 0..*

Type Reference(Organization)

Is Modifier false

Summary false

Alternate Names careProvider

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

252. Patient.managingOrganization

Definition

Organization that is the custodian of the patient record.

Short Organizzazione a cui è lasciata la custodia del dei dati del paziente.

Comments

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

Control 0..1

Type Reference(Organization)

Is Modifier false

Summary true

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

254. Patient.link

Definition

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

Short Link to another patient resource that concerns the same actual person

Comments

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

Control 0..*

BackboneElement

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

Summary true

Requirements

There are multiple use cases:

Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and
Distribution of patient information across multiple servers.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

256. Patient.link.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

258. Patient.link.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

260. Patient.link.modifierExtension

Definition

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

Short Extensions that cannot be ignored even if unrecognized

Comments

Control 0..*

Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

Summary true

Requirements

Alternate Names extensions, user content, modifiers

262. Patient.link.other

Definition

The other patient resource that the link refers to.

Short The other patient or related person resource that the link refers to

Comments

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

Control 1..1

Type Reference(Patient, RelatedPerson)

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

264. Patient.link.type

Definition

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

Short replaced-by | replaces | refer | seealso

Control 1..1

The codes SHALL be taken from LinkType
(required to http://hl7.org/fhir/ValueSet/link-type|4.0.1)

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