HL7 PT FHIR Implementation Guide: Example IG Release 1 | STU1
1.0.0 - STU1 International flag

HL7 PT FHIR Implementation Guide: Example IG Release 1 | STU1, published by HL7 Portugal. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-pt/patient-admin-ig/ and changes regularly. See the Directory of published versions

Resource Profile: PTPatient - Detailed Descriptions

Active as of 2025-09-26

Definitions for the Patient-Pt resource profile.

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

0. Patient
Definition

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

ShortInformation about an individual or animal receiving health care services
Control0..*
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate NamesSubjectOfCare Client Resident
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where(((id.exists() and ('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url)))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(uri) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. Patient.id
Definition

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

ShortLogical id of this artifact
Comments

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

Control10..1
Typeid
Is Modifierfalse
Must Supporttrue
Summarytrue
4. Patient.implicitRules
Definition

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

ShortA set of rules under which this content was created
Comments

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

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. Patient.extension
Definition

An Extension


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

ShortExtensionAdditional content defined by implementations
Comments

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

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

    Optional Extension Element - found in all resources.

    ShortOptional Extensions Element
    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension(PTPersonOccupation) (Complex Extension)
    Is Modifierfalse
    Must Supporttrue
    Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    10. Patient.extension:patient-record-type
    Slice Namepatient-record-type
    Definition

    Optional Extension Element - found in all resources.

    ShortOptional Extensions Element
    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension(PTPersonRecordType) (Extension Type: boolean)
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    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())
    12. Patient.extension:patient-enrollment-category-primarycare
    Slice Namepatient-enrollment-category-primarycare
    Definition

    Optional Extension Element - found in all resources.

    ShortOptional Extensions Element
    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension(PTPatientEnrollmentCategoryPrimarycare) (Extension Type: CodeableConcept)
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    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())
    14. Patient.extension:nationality
    Slice Namenationality
    Definition

    An Extension

    ShortExtension
    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension(PTNationality) (Extension Type: CodeableConcept)
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    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())
    16. Patient.extension:birthplace
    Slice Namebirthplace
    Definition

    Optional Extension Element - found in all resources.

    ShortOptional Extensions Element
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(PTPersonBirthplace) (Complex Extension)
    Is Modifierfalse
    Must Supportfalse
    Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    18. Patient.modifierExtension
    Definition

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

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

    ShortExtensions that cannot be ignored
    Comments

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

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
    Must Supportfalse
    Summaryfalse
    Requirements

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

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

    An identifier for this patient.

    ShortAn identifier for this patient
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..*
    TypeIdentifier
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Requirements

    Patients are almost always assigned specific numerical identifiers.

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

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

      ShortUnique id for inter-element referencing
      Control0..01
      Typeid
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      24. Patient.identifier.use
      Definition

      The purpose of this identifier.

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

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

      Control0..1
      BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.3.0
      (required to http://hl7.org/fhir/ValueSet/identifier-use|4.3.0)
      Typecode
      Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. Patient.identifier:residentCardNumber
      Slice NameresidentCardNumber
      Definition

      Número do Título de Residência


      An identifier for this patient.

      ShortNúmero do Título de ResidênciaAn identifier for this patient
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..*
      TypeIdentifier
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      Patients are almost always assigned specific numerical identifiers.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      28. Patient.identifier:residentCardNumber.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..01
      Typeid
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      30. Patient.identifier:residentCardNumber.use
      Definition

      The purpose of this identifier.

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

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

      Control0..1
      BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.3.0
      (required to http://hl7.org/fhir/ValueSet/identifier-use|4.3.0)
      Typecode
      Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      32. Patient.identifier:citizenshipCardNumber
      Slice NamecitizenshipCardNumber
      Definition

      Número de Identificação Civil


      An identifier for this patient.

      ShortNúmero de Identificação CivilAn identifier for this patient
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..*
      TypeIdentifier
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      Patients are almost always assigned specific numerical identifiers.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      34. Patient.identifier:citizenshipCardNumber.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..01
      Typeid
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      36. Patient.identifier:citizenshipCardNumber.use
      Definition

      The purpose of this identifier.

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

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

      Control0..1
      BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.3.0
      (required to http://hl7.org/fhir/ValueSet/identifier-use|4.3.0)
      Typecode
      Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      38. Patient.identifier:taxIdNumber
      Slice NametaxIdNumber
      Definition

      Número de Identificação Fiscal


      An identifier for this patient.

      ShortNúmero de Identificação FiscalAn identifier for this patient
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..*
      TypeIdentifier
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      Patients are almost always assigned specific numerical identifiers.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      40. Patient.identifier:taxIdNumber.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..01
      Typeid
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      42. Patient.identifier:taxIdNumber.use
      Definition

      The purpose of this identifier.

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

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

      Control0..1
      BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.3.0
      (required to http://hl7.org/fhir/ValueSet/identifier-use|4.3.0)
      Typecode
      Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      44. Patient.identifier:socialSecurityNumber
      Slice NamesocialSecurityNumber
      Definition

      Número de Identificação da Segurança Social


      An identifier for this patient.

      ShortNúmero de Identificação da Segurança SocialAn identifier for this patient
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..*
      TypeIdentifier
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      Patients are almost always assigned specific numerical identifiers.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      46. Patient.identifier:socialSecurityNumber.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..01
      Typeid
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      48. Patient.identifier:socialSecurityNumber.use
      Definition

      The purpose of this identifier.

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

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

      Control0..1
      BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.3.0
      (required to http://hl7.org/fhir/ValueSet/identifier-use|4.3.0)
      Typecode
      Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      50. Patient.identifier:healthCardNumber
      Slice NamehealthCardNumber
      Definition

      Número Nacional do Utente


      An identifier for this patient.

      ShortNúmero Nacional do UtenteAn identifier for this patient
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..*
      TypeIdentifier
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      Patients are almost always assigned specific numerical identifiers.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      52. Patient.identifier:healthCardNumber.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..01
      Typeid
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      54. Patient.identifier:healthCardNumber.use
      Definition

      The purpose of this identifier.

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

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

      Control0..1
      BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.3.0
      (required to http://hl7.org/fhir/ValueSet/identifier-use|4.3.0)
      Typecode
      Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      56. Patient.identifier:passportNumber
      Slice NamepassportNumber
      Definition

      Número do Passaporte


      An identifier for this patient.

      ShortNúmero do PassaporteAn identifier for this patient
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..*
      TypeIdentifier
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      Patients are almost always assigned specific numerical identifiers.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      58. Patient.identifier:passportNumber.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..01
      Typeid
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      60. Patient.identifier:passportNumber.use
      Definition

      The purpose of this identifier.

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

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

      Control0..1
      BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.3.0
      (required to http://hl7.org/fhir/ValueSet/identifier-use|4.3.0)
      Typecode
      Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      62. Patient.identifier:patientInternalIdentifier
      Slice NamepatientInternalIdentifier
      Definition

      Número Interno do Utente


      An identifier for this patient.

      ShortNúmero Interno do UtenteAn identifier for this patient
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..*
      TypeIdentifier
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      Patients are almost always assigned specific numerical identifiers.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      64. Patient.identifier:patientInternalIdentifier.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..01
      Typeid
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      66. Patient.identifier:patientInternalIdentifier.use
      Definition

      The purpose of this identifier.

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

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

      Control0..1
      BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.3.0
      (required to http://hl7.org/fhir/ValueSet/identifier-use|4.3.0)
      Typecode
      Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      68. Patient.identifier:militaryIDNumber
      Slice NamemilitaryIDNumber
      Definition

      Número da Cédula Militar


      An identifier for this patient.

      ShortNúmero da Cédula MilitarAn identifier for this patient
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..*
      TypeIdentifier
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      Patients are almost always assigned specific numerical identifiers.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      70. Patient.identifier:militaryIDNumber.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..01
      Typeid
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      72. Patient.identifier:militaryIDNumber.use
      Definition

      The purpose of this identifier.

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

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

      Control0..1
      BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.3.0
      (required to http://hl7.org/fhir/ValueSet/identifier-use|4.3.0)
      Typecode
      Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      74. Patient.identifier:medicalRecordNumber
      Slice NamemedicalRecordNumber
      Definition

      Numero de processo Clinico


      An identifier for this patient.

      ShortNumero de processo ClinicoAn identifier for this patient
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..*
      TypeIdentifier
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      Patients are almost always assigned specific numerical identifiers.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      76. Patient.identifier:medicalRecordNumber.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..01
      Typeid
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      78. Patient.identifier:medicalRecordNumber.use
      Definition

      The purpose of this identifier.

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

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

      Control0..1
      BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.3.0
      (required to http://hl7.org/fhir/ValueSet/identifier-use|4.3.0)
      Typecode
      Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      80. Patient.identifier:familyRecordNumber
      Slice NamefamilyRecordNumber
      Definition

      Numero de processo clinico familiar


      An identifier for this patient.

      ShortNumero de processo clinico familiarAn identifier for this patient
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..*
      TypeIdentifier
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      Patients are almost always assigned specific numerical identifiers.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      82. Patient.identifier:familyRecordNumber.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..01
      Typeid
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      84. Patient.identifier:familyRecordNumber.use
      Definition

      The purpose of this identifier.

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

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

      Control0..1
      BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.3.0
      (required to http://hl7.org/fhir/ValueSet/identifier-use|4.3.0)
      Typecode
      Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      86. Patient.identifier:birthRegistryNumber
      Slice NamebirthRegistryNumber
      Definition

      Cédula de Nascimento


      An identifier for this patient.

      ShortCédula de NascimentoAn identifier for this patient
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..*
      TypeIdentifier
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      Patients are almost always assigned specific numerical identifiers.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      88. Patient.identifier:birthRegistryNumber.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..01
      Typeid
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      90. Patient.identifier:birthRegistryNumber.use
      Definition

      The purpose of this identifier.

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

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

      Control0..1
      BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.3.0
      (required to http://hl7.org/fhir/ValueSet/identifier-use|4.3.0)
      Typecode
      Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

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

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

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

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

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

      ShortWhether this patient's record is in active use
      Comments

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

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

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

      Meaning if MissingThis resource is generally assumed to be active if no value is provided for the active element
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      94. Patient.name
      Definition

      A name associated with the individual.

      ShortA name associated with the patient
      Comments

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

      Control10..1*
      TypeHumanName
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

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

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

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

      ShortA contact detail for the individual
      Comments

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

      Control0..*
      TypeContactPoint
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

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

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

      Indicates if the individual is deceased or not.

      ShortIndicates if the individual is deceased or not
      Comments

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

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

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

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

      An address for the individual.

      ShortAn address for the individual
      Comments

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

      Control0..*
      TypeAddress
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Requirements

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

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

      An Extension

      ShortExtension
      Control0..*
      TypeExtension(PTAddressType) (Extension Type: Coding)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      104. Patient.address.extension:municipality
      Slice Namemunicipality
      Definition

      An Extension

      ShortCodigo do concelho
      Control0..*
      TypeExtension(PTAddressMunicipality) (Extension Type: CodeableConcept)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      106. Patient.address.extension:county
      Slice Namecounty
      Definition

      An Extension

      ShortCodigo do distrito
      Control0..*
      TypeExtension(PTAddressCounty) (Extension Type: CodeableConcept)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      108. Patient.address.extension:parish
      Slice Nameparish
      Definition

      An Extension

      ShortCódigo da Freguesia
      Control0..*
      TypeExtension(PTAddressParish) (Extension Type: CodeableConcept)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      110. Patient.address.extension:nuts
      Slice Namenuts
      Definition

      An Extension

      ShortExtension
      Control0..*
      TypeExtension(PTAddressNuts) (Complex Extension)
      Is Modifierfalse
      Must Supporttrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      112. Patient.address.use
      Definition

      The purpose of this address.

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

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

      Control0..1
      BindingThe codes SHALL be taken from AddressUsehttp://hl7.org/fhir/ValueSet/address-use|4.3.0
      (required to http://hl7.org/fhir/ValueSet/address-use|4.3.0)

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

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

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

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

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

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

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

      Control0..1*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Need to track people you can contact about the patient.

      Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
      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())
      116. Patient.contact.modifierExtension
      Definition

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

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

      ShortExtensions that cannot be ignored even if unrecognized
      Comments

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

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

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

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

      Patient's nominated care provider.

      ShortPatient's nominated primary care provider
      Comments

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

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

      Control0..*
      TypeReference(Organization, Practitioner, PractitionerRole)
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Alternate NamescareProvider
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      120. Patient.generalPractitioner.extension:patient-primary-care-period
      Slice Namepatient-primary-care-period
      Definition

      Optional Extension Element - found in all resources.

      ShortOptional Extensions Element
      Control0..*
      TypeExtension(PTPatientPrimaryCarePeriod) (Extension Type: Period)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      122. Patient.link
      Definition

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

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

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

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

      There are multiple use cases:

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

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

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

      ShortExtensions that cannot be ignored even if unrecognized
      Comments

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

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

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

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

      The other patient resource that the link refers to.

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

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

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

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

      Shortreplaced-by | replaces | refer | seealso
      Control1..1
      BindingThe codes SHALL be taken from LinkTypehttp://hl7.org/fhir/ValueSet/link-type|4.3.0
      (required to http://hl7.org/fhir/ValueSet/link-type|4.3.0)

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

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

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

      0. Patient
      2. Patient.id
      Control1..?
      Must Supporttrue
      4. Patient.extension
      SlicingThis element introduces a set of slices on Patient.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 6. Patient.extension:occupation
        Slice Nameoccupation
        Control0..*
        TypeExtension(PTPersonOccupation) (Complex Extension)
        Must Supporttrue
        8. Patient.extension:patient-record-type
        Slice Namepatient-record-type
        Control0..*
        TypeExtension(PTPersonRecordType) (Extension Type: boolean)
        10. Patient.extension:patient-enrollment-category-primarycare
        Slice Namepatient-enrollment-category-primarycare
        Control0..*
        TypeExtension(PTPatientEnrollmentCategoryPrimarycare) (Extension Type: CodeableConcept)
        12. Patient.extension:nationality
        Slice Namenationality
        Control0..*
        TypeExtension(PTNationality) (Extension Type: CodeableConcept)
        Must Supporttrue
        14. Patient.extension:birthplace
        Slice Namebirthplace
        Control0..1
        TypeExtension(PTPersonBirthplace) (Complex Extension)
        16. Patient.identifier
        NoteThis is a business identifier, not a resource identifier (see discussion)
        SlicingThis element introduces a set of slices on Patient.identifier. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
        • type @ type
        • 18. Patient.identifier.id
          Control0..0
          20. Patient.identifier.type
          22. Patient.identifier.type.id
          Control0..0
          24. Patient.identifier.type.extension
          Control0..0
          26. Patient.identifier.type.coding
          BindingUnless not suitable, these codes SHALL be taken from Tipos de Identificadores de Paciente
          (extensible to http://example.com/fhir/example/ValueSet/patient-identifier-type)
          28. Patient.identifier:residentCardNumber
          Slice NameresidentCardNumber
          Definition

          Número do Título de Residência

          ShortNúmero do Título de Residência
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..*
          Must Supporttrue
          30. Patient.identifier:residentCardNumber.type
          32. Patient.identifier:residentCardNumber.type.coding
          Pattern Value{
            "system" : "http://hl7.pt/fhir/identifier-type",
            "code" : "PRC",
            "display" : "Número do Título de Residência"
          }
          34. Patient.identifier:residentCardNumber.type.text
          Pattern ValueNúmero do Título de Residência
          36. Patient.identifier:citizenshipCardNumber
          Slice NamecitizenshipCardNumber
          Definition

          Número de Identificação Civil

          ShortNúmero de Identificação Civil
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..*
          Must Supporttrue
          38. Patient.identifier:citizenshipCardNumber.type
          40. Patient.identifier:citizenshipCardNumber.type.coding
          Pattern Value{
            "system" : "http://hl7.pt/fhir/identifier-type",
            "code" : "CZ",
            "display" : "Número de Identificação Civil"
          }
          42. Patient.identifier:citizenshipCardNumber.type.text
          Pattern ValueNúmero de Identificação Civil
          44. Patient.identifier:taxIdNumber
          Slice NametaxIdNumber
          Definition

          Número de Identificação Fiscal

          ShortNúmero de Identificação Fiscal
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..*
          Must Supporttrue
          46. Patient.identifier:taxIdNumber.type
          48. Patient.identifier:taxIdNumber.type.coding
          Pattern Value{
            "system" : "http://hl7.pt/fhir/identifier-type",
            "code" : "TAX",
            "display" : "Número de Identificação Fiscal"
          }
          50. Patient.identifier:taxIdNumber.type.text
          Pattern ValueNúmero de Identificação Fiscal
          52. Patient.identifier:socialSecurityNumber
          Slice NamesocialSecurityNumber
          Definition

          Número de Identificação da Segurança Social

          ShortNúmero de Identificação da Segurança Social
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..*
          Must Supporttrue
          54. Patient.identifier:socialSecurityNumber.type
          56. Patient.identifier:socialSecurityNumber.type.coding
          Pattern Value{
            "system" : "http://hl7.pt/fhir/identifier-type",
            "code" : "SS",
            "display" : "Número de Segurança Social"
          }
          58. Patient.identifier:socialSecurityNumber.type.text
          Pattern ValueNúmero de Identificação da Segurança Social
          60. Patient.identifier:healthCardNumber
          Slice NamehealthCardNumber
          Definition

          Número Nacional do Utente

          ShortNúmero Nacional do Utente
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..*
          Must Supporttrue
          62. Patient.identifier:healthCardNumber.type
          64. Patient.identifier:healthCardNumber.type.coding
          Pattern Value{
            "system" : "http://hl7.pt/fhir/identifier-type",
            "code" : "HC",
            "display" : "Número Nacional do Utente"
          }
          66. Patient.identifier:healthCardNumber.type.text
          Pattern ValueNúmero Nacional do Utente
          68. Patient.identifier:passportNumber
          Slice NamepassportNumber
          Definition

          Número do Passaporte

          ShortNúmero do Passaporte
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..*
          Must Supporttrue
          70. Patient.identifier:passportNumber.type
          72. Patient.identifier:passportNumber.type.coding
          Pattern Value{
            "system" : "http://hl7.pt/fhir/identifier-type",
            "code" : "PPN",
            "display" : "Número de Passaporte"
          }
          74. Patient.identifier:passportNumber.type.text
          Pattern ValueNúmero do Passaporte
          76. Patient.identifier:patientInternalIdentifier
          Slice NamepatientInternalIdentifier
          Definition

          Número Interno do Utente

          ShortNúmero Interno do Utente
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..*
          Must Supporttrue
          78. Patient.identifier:patientInternalIdentifier.type
          80. Patient.identifier:patientInternalIdentifier.type.coding
          Pattern Value{
            "system" : "http://hl7.pt/fhir/identifier-type",
            "code" : "PI",
            "display" : "Número Interno do Utente"
          }
          82. Patient.identifier:patientInternalIdentifier.type.text
          Pattern ValueNúmero Interno do Utente
          84. Patient.identifier:militaryIDNumber
          Slice NamemilitaryIDNumber
          Definition

          Número da Cédula Militar

          ShortNúmero da Cédula Militar
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..*
          Must Supporttrue
          86. Patient.identifier:militaryIDNumber.type
          88. Patient.identifier:militaryIDNumber.type.coding
          Pattern Value{
            "system" : "http://hl7.pt/fhir/identifier-type",
            "code" : "MI",
            "display" : "Número da Cédula Militar"
          }
          90. Patient.identifier:militaryIDNumber.type.text
          Pattern ValueNúmero da Cédula Militar
          92. Patient.identifier:medicalRecordNumber
          Slice NamemedicalRecordNumber
          Definition

          Numero de processo Clinico

          ShortNumero de processo Clinico
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..*
          Must Supporttrue
          94. Patient.identifier:medicalRecordNumber.type
          96. Patient.identifier:medicalRecordNumber.type.coding
          Pattern Value{
            "system" : "http://hl7.pt/fhir/identifier-type",
            "code" : "MR",
            "display" : "Numero de processo Clinico"
          }
          98. Patient.identifier:medicalRecordNumber.type.text
          Pattern ValueNumero de processo Clinico
          100. Patient.identifier:familyRecordNumber
          Slice NamefamilyRecordNumber
          Definition

          Numero de processo clinico familiar

          ShortNumero de processo clinico familiar
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..*
          Must Supporttrue
          102. Patient.identifier:familyRecordNumber.type
          104. Patient.identifier:familyRecordNumber.type.coding
          Pattern Value{
            "system" : "http://hl7.pt/fhir/identifier-type",
            "code" : "MR",
            "display" : "Numero de processo clinico familiar"
          }
          106. Patient.identifier:familyRecordNumber.type.text
          Pattern ValueNumero de processo clinico familiar
          108. Patient.identifier:birthRegistryNumber
          Slice NamebirthRegistryNumber
          Definition

          Cédula de Nascimento

          ShortCédula de Nascimento
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..*
          Must Supporttrue
          110. Patient.identifier:birthRegistryNumber.type
          112. Patient.identifier:birthRegistryNumber.type.coding
          Pattern Value{
            "system" : "http://hl7.pt/fhir/identifier-type",
            "code" : "BR",
            "display" : "Cédula de Nascimento"
          }
          114. Patient.identifier:birthRegistryNumber.type.text
          Pattern ValueCédula de Nascimento
          116. Patient.name
          Control1..1
          Must Supporttrue
          118. Patient.telecom
          Must Supporttrue
          120. Patient.address
          122. Patient.address.extension:addressType
          Slice NameaddressType
          Control0..*
          TypeExtension(PTAddressType) (Extension Type: Coding)
          Must Supporttrue
          124. Patient.address.extension:municipality
          Slice Namemunicipality
          Control0..*
          TypeExtension(PTAddressMunicipality) (Extension Type: CodeableConcept)
          Must Supporttrue
          126. Patient.address.extension:county
          Slice Namecounty
          Control0..*
          TypeExtension(PTAddressCounty) (Extension Type: CodeableConcept)
          Must Supporttrue
          128. Patient.address.extension:parish
          Slice Nameparish
          Control0..*
          TypeExtension(PTAddressParish) (Extension Type: CodeableConcept)
          Must Supporttrue
          130. Patient.address.extension:nuts
          Slice Namenuts
          Control0..*
          TypeExtension(PTAddressNuts) (Complex Extension)
          Must Supporttrue
          132. Patient.contact
          Control0..1
          Must Supporttrue
          134. Patient.contact.address
          136. Patient.contact.address.extension:addressType
          Slice NameaddressType
          Control0..*
          TypeExtension(PTAddressType) (Extension Type: Coding)
          138. Patient.contact.address.extension:municipality
          Slice Namemunicipality
          Control0..*
          TypeExtension(PTAddressMunicipality) (Extension Type: CodeableConcept)
          140. Patient.contact.address.extension:county
          Slice Namecounty
          Control0..*
          TypeExtension(PTAddressCounty) (Extension Type: CodeableConcept)
          142. Patient.contact.address.extension:parish
          Slice Nameparish
          Control0..*
          TypeExtension(PTAddressParish) (Extension Type: CodeableConcept)
          144. Patient.contact.address.extension:nuts
          Slice Namenuts
          Control0..*
          TypeExtension(PTAddressNuts) (Complex Extension)
          146. Patient.generalPractitioner
          148. Patient.generalPractitioner.extension:patient-primary-care-period
          Slice Namepatient-primary-care-period
          Control0..*
          TypeExtension(PTPatientPrimaryCarePeriod) (Extension Type: Period)
          Must Supporttrue

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

          0. Patient
          Definition

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

          ShortInformation about an individual or animal receiving health care services
          Control0..*
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Alternate NamesSubjectOfCare Client Resident
          Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
          dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where(((id.exists() and ('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url)))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(uri) = '#').exists()).not()).trace('unmatched', id).empty())
          dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
          dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
          dom-6: A resource should have narrative for robust management (text.`div`.exists())
          2. Patient.id
          Definition

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

          ShortLogical id of this artifact
          Comments

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

          Control1..1
          Typeid
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          4. Patient.meta
          Definition

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

          ShortMetadata about the resource
          Control0..1
          TypeMeta
          Is Modifierfalse
          Must Supportfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          6. Patient.implicitRules
          Definition

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

          ShortA set of rules under which this content was created
          Comments

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

          Control0..1
          Typeuri
          Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          8. Patient.language
          Definition

          The base language in which the resource is written.

          ShortLanguage of the resource content
          Comments

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

          Control0..1
          BindingThe codes SHOULD be taken from CommonLanguages
          (preferred to http://hl7.org/fhir/ValueSet/languages|4.3.0)

          IETF language tag

          Additional BindingsPurpose
          AllLanguagesMax Binding
          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          10. Patient.text
          Definition

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

          ShortText summary of the resource, for human interpretation
          Comments

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

          Control0..1
          TypeNarrative
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Alternate Namesnarrative, html, xhtml, display
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          12. Patient.contained
          Definition

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

          ShortContained, inline Resources
          Comments

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

          Control0..*
          TypeResource
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Alternate Namesinline resources, anonymous resources, contained resources
          Invariantsdom-r4b: Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems (($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic))
          14. Patient.extension
          Definition

          An Extension

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

            Optional Extension Element - found in all resources.

            ShortOptional Extensions Element
            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension(PTPersonOccupation) (Complex Extension)
            Is Modifierfalse
            Must Supporttrue
            Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            18. Patient.extension:patient-record-type
            Slice Namepatient-record-type
            Definition

            Optional Extension Element - found in all resources.

            ShortOptional Extensions Element
            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension(PTPersonRecordType) (Extension Type: boolean)
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            20. Patient.extension:patient-enrollment-category-primarycare
            Slice Namepatient-enrollment-category-primarycare
            Definition

            Optional Extension Element - found in all resources.

            ShortOptional Extensions Element
            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension(PTPatientEnrollmentCategoryPrimarycare) (Extension Type: CodeableConcept)
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            22. Patient.extension:nationality
            Slice Namenationality
            Definition

            An Extension

            ShortExtension
            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension(PTNationality) (Extension Type: CodeableConcept)
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            24. Patient.extension:birthplace
            Slice Namebirthplace
            Definition

            Optional Extension Element - found in all resources.

            ShortOptional Extensions Element
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(PTPersonBirthplace) (Complex Extension)
            Is Modifierfalse
            Must Supportfalse
            Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            26. Patient.modifierExtension
            Definition

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

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

            ShortExtensions that cannot be ignored
            Comments

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

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
            Must Supportfalse
            Summaryfalse
            Requirements

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

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

            An identifier for this patient.

            ShortAn identifier for this patient
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..*
            TypeIdentifier
            Is Modifierfalse
            Must Supportfalse
            Summarytrue
            Requirements

            Patients are almost always assigned specific numerical identifiers.

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

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

              ShortUnique id for inter-element referencing
              Control0..0
              Typeid
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              32. 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.

              ShortAdditional content defined by implementations
              Comments

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

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

                The purpose of this identifier.

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

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

                Control0..1
                BindingThe codes SHALL be taken from IdentifierUse
                (required to http://hl7.org/fhir/ValueSet/identifier-use|4.3.0)
                Typecode
                Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

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

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

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

                ShortDescription of identifier
                Comments

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

                Control0..1
                BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.3.0)
                TypeCodeableConcept
                Is Modifierfalse
                Summarytrue
                Requirements

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

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                38. Patient.identifier.type.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..0
                Typeid
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                40. Patient.identifier.type.extension
                Definition

                An Extension

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

                  A reference to a code defined by a terminology system.

                  ShortCode defined by a terminology system
                  Comments

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

                  Control0..*
                  BindingUnless not suitable, these codes SHALL be taken from Tipos de Identificadores de Paciente
                  (extensible to http://example.com/fhir/example/ValueSet/patient-identifier-type)
                  TypeCoding
                  Is Modifierfalse
                  Summarytrue
                  Requirements

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

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

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

                  ShortPlain text representation of the concept
                  Comments

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

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

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

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

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

                  ShortThe namespace for the identifier value
                  Comments

                  Identifier.system is always case sensitive.

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

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

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

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

                  ShortThe value that is unique
                  Comments

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

                  Control0..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  ExampleGeneral: 123456
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  50. Patient.identifier.period
                  Definition

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

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

                  Organization that issued/manages the identifier.

                  ShortOrganization that issued id (may be just text)
                  Comments

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

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

                  Número do Título de Residência

                  ShortNúmero do Título de Residência
                  NoteThis is a business identifier, not a resource identifier (see discussion)
                  Control0..*
                  TypeIdentifier
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Requirements

                  Patients are almost always assigned specific numerical identifiers.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  56. Patient.identifier:residentCardNumber.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..0
                  Typeid
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  58. Patient.identifier:residentCardNumber.extension
                  Definition

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

                  ShortAdditional content defined by implementations
                  Comments

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

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

                    The purpose of this identifier.

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

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

                    Control0..1
                    BindingThe codes SHALL be taken from IdentifierUse
                    (required to http://hl7.org/fhir/ValueSet/identifier-use|4.3.0)
                    Typecode
                    Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

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

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

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

                    ShortDescription of identifier
                    Comments

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

                    Control0..1
                    BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                    (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.3.0)
                    TypeCodeableConcept
                    Is Modifierfalse
                    Summarytrue
                    Requirements

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

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    64. Patient.identifier:residentCardNumber.type.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..0
                    Typeid
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    66. Patient.identifier:residentCardNumber.type.extension
                    Definition

                    An Extension

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

                      A reference to a code defined by a terminology system.

                      ShortCode defined by a terminology system
                      Comments

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

                      Control0..*
                      BindingUnless not suitable, these codes SHALL be taken from Tipos de Identificadores de Paciente
                      (extensible to http://example.com/fhir/example/ValueSet/patient-identifier-type)
                      TypeCoding
                      Is Modifierfalse
                      Summarytrue
                      Requirements

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

                      Pattern Value{
                        "system" : "http://hl7.pt/fhir/identifier-type",
                        "code" : "PRC",
                        "display" : "Número do Título de Residência"
                      }
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      70. Patient.identifier:residentCardNumber.type.text
                      Definition

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

                      ShortPlain text representation of the concept
                      Comments

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

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

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

                      Pattern ValueNúmero do Título de Residência
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      72. Patient.identifier:residentCardNumber.system
                      Definition

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

                      ShortThe namespace for the identifier value
                      Comments

                      Identifier.system is always case sensitive.

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

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

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

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

                      ShortThe value that is unique
                      Comments

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

                      Control0..1
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      ExampleGeneral: 123456
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      76. Patient.identifier:residentCardNumber.period
                      Definition

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

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

                      Organization that issued/manages the identifier.

                      ShortOrganization that issued id (may be just text)
                      Comments

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

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

                      Número de Identificação Civil

                      ShortNúmero de Identificação Civil
                      NoteThis is a business identifier, not a resource identifier (see discussion)
                      Control0..*
                      TypeIdentifier
                      Is Modifierfalse
                      Must Supporttrue
                      Summarytrue
                      Requirements

                      Patients are almost always assigned specific numerical identifiers.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      82. Patient.identifier:citizenshipCardNumber.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..0
                      Typeid
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      84. Patient.identifier:citizenshipCardNumber.extension
                      Definition

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

                      ShortAdditional content defined by implementations
                      Comments

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

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

                        The purpose of this identifier.

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

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

                        Control0..1
                        BindingThe codes SHALL be taken from IdentifierUse
                        (required to http://hl7.org/fhir/ValueSet/identifier-use|4.3.0)
                        Typecode
                        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

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

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

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

                        ShortDescription of identifier
                        Comments

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

                        Control0..1
                        BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                        (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.3.0)
                        TypeCodeableConcept
                        Is Modifierfalse
                        Summarytrue
                        Requirements

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

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        90. Patient.identifier:citizenshipCardNumber.type.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..0
                        Typeid
                        Is Modifierfalse
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Summaryfalse
                        92. Patient.identifier:citizenshipCardNumber.type.extension
                        Definition

                        An Extension

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

                          A reference to a code defined by a terminology system.

                          ShortCode defined by a terminology system
                          Comments

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

                          Control0..*
                          BindingUnless not suitable, these codes SHALL be taken from Tipos de Identificadores de Paciente
                          (extensible to http://example.com/fhir/example/ValueSet/patient-identifier-type)
                          TypeCoding
                          Is Modifierfalse
                          Summarytrue
                          Requirements

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

                          Pattern Value{
                            "system" : "http://hl7.pt/fhir/identifier-type",
                            "code" : "CZ",
                            "display" : "Número de Identificação Civil"
                          }
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          96. Patient.identifier:citizenshipCardNumber.type.text
                          Definition

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

                          ShortPlain text representation of the concept
                          Comments

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

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

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

                          Pattern ValueNúmero de Identificação Civil
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          98. Patient.identifier:citizenshipCardNumber.system
                          Definition

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

                          ShortThe namespace for the identifier value
                          Comments

                          Identifier.system is always case sensitive.

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

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

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

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

                          ShortThe value that is unique
                          Comments

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

                          Control0..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          ExampleGeneral: 123456
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          102. Patient.identifier:citizenshipCardNumber.period
                          Definition

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

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

                          Organization that issued/manages the identifier.

                          ShortOrganization that issued id (may be just text)
                          Comments

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

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

                          Número de Identificação Fiscal

                          ShortNúmero de Identificação Fiscal
                          NoteThis is a business identifier, not a resource identifier (see discussion)
                          Control0..*
                          TypeIdentifier
                          Is Modifierfalse
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          Patients are almost always assigned specific numerical identifiers.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          108. Patient.identifier:taxIdNumber.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..0
                          Typeid
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          110. Patient.identifier:taxIdNumber.extension
                          Definition

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

                          ShortAdditional content defined by implementations
                          Comments

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

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

                            The purpose of this identifier.

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

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

                            Control0..1
                            BindingThe codes SHALL be taken from IdentifierUse
                            (required to http://hl7.org/fhir/ValueSet/identifier-use|4.3.0)
                            Typecode
                            Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

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

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

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

                            ShortDescription of identifier
                            Comments

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

                            Control0..1
                            BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                            (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.3.0)
                            TypeCodeableConcept
                            Is Modifierfalse
                            Summarytrue
                            Requirements

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

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            116. Patient.identifier:taxIdNumber.type.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..0
                            Typeid
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            118. Patient.identifier:taxIdNumber.type.extension
                            Definition

                            An Extension

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

                              A reference to a code defined by a terminology system.

                              ShortCode defined by a terminology system
                              Comments

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

                              Control0..*
                              BindingUnless not suitable, these codes SHALL be taken from Tipos de Identificadores de Paciente
                              (extensible to http://example.com/fhir/example/ValueSet/patient-identifier-type)
                              TypeCoding
                              Is Modifierfalse
                              Summarytrue
                              Requirements

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

                              Pattern Value{
                                "system" : "http://hl7.pt/fhir/identifier-type",
                                "code" : "TAX",
                                "display" : "Número de Identificação Fiscal"
                              }
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              122. Patient.identifier:taxIdNumber.type.text
                              Definition

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

                              ShortPlain text representation of the concept
                              Comments

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

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

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

                              Pattern ValueNúmero de Identificação Fiscal
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              124. Patient.identifier:taxIdNumber.system
                              Definition

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

                              ShortThe namespace for the identifier value
                              Comments

                              Identifier.system is always case sensitive.

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

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

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

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

                              ShortThe value that is unique
                              Comments

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

                              Control0..1
                              Typestring
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              ExampleGeneral: 123456
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              128. Patient.identifier:taxIdNumber.period
                              Definition

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

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

                              Organization that issued/manages the identifier.

                              ShortOrganization that issued id (may be just text)
                              Comments

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

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

                              Número de Identificação da Segurança Social

                              ShortNúmero de Identificação da Segurança Social
                              NoteThis is a business identifier, not a resource identifier (see discussion)
                              Control0..*
                              TypeIdentifier
                              Is Modifierfalse
                              Must Supporttrue
                              Summarytrue
                              Requirements

                              Patients are almost always assigned specific numerical identifiers.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              134. Patient.identifier:socialSecurityNumber.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..0
                              Typeid
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              136. Patient.identifier:socialSecurityNumber.extension
                              Definition

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

                              ShortAdditional content defined by implementations
                              Comments

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

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

                                The purpose of this identifier.

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

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

                                Control0..1
                                BindingThe codes SHALL be taken from IdentifierUse
                                (required to http://hl7.org/fhir/ValueSet/identifier-use|4.3.0)
                                Typecode
                                Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Requirements

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

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

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

                                ShortDescription of identifier
                                Comments

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

                                Control0..1
                                BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.3.0)
                                TypeCodeableConcept
                                Is Modifierfalse
                                Summarytrue
                                Requirements

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

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                142. Patient.identifier:socialSecurityNumber.type.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..0
                                Typeid
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                144. Patient.identifier:socialSecurityNumber.type.extension
                                Definition

                                An Extension

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

                                  A reference to a code defined by a terminology system.

                                  ShortCode defined by a terminology system
                                  Comments

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

                                  Control0..*
                                  BindingUnless not suitable, these codes SHALL be taken from Tipos de Identificadores de Paciente
                                  (extensible to http://example.com/fhir/example/ValueSet/patient-identifier-type)
                                  TypeCoding
                                  Is Modifierfalse
                                  Summarytrue
                                  Requirements

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

                                  Pattern Value{
                                    "system" : "http://hl7.pt/fhir/identifier-type",
                                    "code" : "SS",
                                    "display" : "Número de Segurança Social"
                                  }
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  148. Patient.identifier:socialSecurityNumber.type.text
                                  Definition

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

                                  ShortPlain text representation of the concept
                                  Comments

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

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

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

                                  Pattern ValueNúmero de Identificação da Segurança Social
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  150. Patient.identifier:socialSecurityNumber.system
                                  Definition

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

                                  ShortThe namespace for the identifier value
                                  Comments

                                  Identifier.system is always case sensitive.

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

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

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

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

                                  ShortThe value that is unique
                                  Comments

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

                                  Control0..1
                                  Typestring
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  ExampleGeneral: 123456
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  154. Patient.identifier:socialSecurityNumber.period
                                  Definition

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

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

                                  Organization that issued/manages the identifier.

                                  ShortOrganization that issued id (may be just text)
                                  Comments

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

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

                                  Número Nacional do Utente

                                  ShortNúmero Nacional do Utente
                                  NoteThis is a business identifier, not a resource identifier (see discussion)
                                  Control0..*
                                  TypeIdentifier
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summarytrue
                                  Requirements

                                  Patients are almost always assigned specific numerical identifiers.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  160. Patient.identifier:healthCardNumber.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..0
                                  Typeid
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  162. Patient.identifier:healthCardNumber.extension
                                  Definition

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

                                  ShortAdditional content defined by implementations
                                  Comments

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

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

                                    The purpose of this identifier.

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

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

                                    Control0..1
                                    BindingThe codes SHALL be taken from IdentifierUse
                                    (required to http://hl7.org/fhir/ValueSet/identifier-use|4.3.0)
                                    Typecode
                                    Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Requirements

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

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

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

                                    ShortDescription of identifier
                                    Comments

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

                                    Control0..1
                                    BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                    (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.3.0)
                                    TypeCodeableConcept
                                    Is Modifierfalse
                                    Summarytrue
                                    Requirements

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

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    168. Patient.identifier:healthCardNumber.type.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..0
                                    Typeid
                                    Is Modifierfalse
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    Summaryfalse
                                    170. Patient.identifier:healthCardNumber.type.extension
                                    Definition

                                    An Extension

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

                                      A reference to a code defined by a terminology system.

                                      ShortCode defined by a terminology system
                                      Comments

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

                                      Control0..*
                                      BindingUnless not suitable, these codes SHALL be taken from Tipos de Identificadores de Paciente
                                      (extensible to http://example.com/fhir/example/ValueSet/patient-identifier-type)
                                      TypeCoding
                                      Is Modifierfalse
                                      Summarytrue
                                      Requirements

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

                                      Pattern Value{
                                        "system" : "http://hl7.pt/fhir/identifier-type",
                                        "code" : "HC",
                                        "display" : "Número Nacional do Utente"
                                      }
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      174. Patient.identifier:healthCardNumber.type.text
                                      Definition

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

                                      ShortPlain text representation of the concept
                                      Comments

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

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

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

                                      Pattern ValueNúmero Nacional do Utente
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      176. Patient.identifier:healthCardNumber.system
                                      Definition

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

                                      ShortThe namespace for the identifier value
                                      Comments

                                      Identifier.system is always case sensitive.

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

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

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

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

                                      ShortThe value that is unique
                                      Comments

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

                                      Control0..1
                                      Typestring
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      ExampleGeneral: 123456
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      180. Patient.identifier:healthCardNumber.period
                                      Definition

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

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

                                      Organization that issued/manages the identifier.

                                      ShortOrganization that issued id (may be just text)
                                      Comments

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

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

                                      Número do Passaporte

                                      ShortNúmero do Passaporte
                                      NoteThis is a business identifier, not a resource identifier (see discussion)
                                      Control0..*
                                      TypeIdentifier
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summarytrue
                                      Requirements

                                      Patients are almost always assigned specific numerical identifiers.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      186. Patient.identifier:passportNumber.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..0
                                      Typeid
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      188. Patient.identifier:passportNumber.extension
                                      Definition

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

                                      ShortAdditional content defined by implementations
                                      Comments

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

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

                                        The purpose of this identifier.

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

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

                                        Control0..1
                                        BindingThe codes SHALL be taken from IdentifierUse
                                        (required to http://hl7.org/fhir/ValueSet/identifier-use|4.3.0)
                                        Typecode
                                        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Requirements

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

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

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

                                        ShortDescription of identifier
                                        Comments

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

                                        Control0..1
                                        BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                        (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.3.0)
                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Summarytrue
                                        Requirements

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

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        194. Patient.identifier:passportNumber.type.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..0
                                        Typeid
                                        Is Modifierfalse
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        Summaryfalse
                                        196. Patient.identifier:passportNumber.type.extension
                                        Definition

                                        An Extension

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

                                          A reference to a code defined by a terminology system.

                                          ShortCode defined by a terminology system
                                          Comments

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

                                          Control0..*
                                          BindingUnless not suitable, these codes SHALL be taken from Tipos de Identificadores de Paciente
                                          (extensible to http://example.com/fhir/example/ValueSet/patient-identifier-type)
                                          TypeCoding
                                          Is Modifierfalse
                                          Summarytrue
                                          Requirements

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

                                          Pattern Value{
                                            "system" : "http://hl7.pt/fhir/identifier-type",
                                            "code" : "PPN",
                                            "display" : "Número de Passaporte"
                                          }
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          200. Patient.identifier:passportNumber.type.text
                                          Definition

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

                                          ShortPlain text representation of the concept
                                          Comments

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

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

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

                                          Pattern ValueNúmero do Passaporte
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          202. Patient.identifier:passportNumber.system
                                          Definition

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

                                          ShortThe namespace for the identifier value
                                          Comments

                                          Identifier.system is always case sensitive.

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

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

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

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

                                          ShortThe value that is unique
                                          Comments

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

                                          Control0..1
                                          Typestring
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summarytrue
                                          ExampleGeneral: 123456
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          206. Patient.identifier:passportNumber.period
                                          Definition

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

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

                                          Organization that issued/manages the identifier.

                                          ShortOrganization that issued id (may be just text)
                                          Comments

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

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

                                          Número Interno do Utente

                                          ShortNúmero Interno do Utente
                                          NoteThis is a business identifier, not a resource identifier (see discussion)
                                          Control0..*
                                          TypeIdentifier
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Summarytrue
                                          Requirements

                                          Patients are almost always assigned specific numerical identifiers.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          212. Patient.identifier:patientInternalIdentifier.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..0
                                          Typeid
                                          Is Modifierfalse
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          Summaryfalse
                                          214. Patient.identifier:patientInternalIdentifier.extension
                                          Definition

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

                                          ShortAdditional content defined by implementations
                                          Comments

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

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

                                            The purpose of this identifier.

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

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

                                            Control0..1
                                            BindingThe codes SHALL be taken from IdentifierUse
                                            (required to http://hl7.org/fhir/ValueSet/identifier-use|4.3.0)
                                            Typecode
                                            Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summarytrue
                                            Requirements

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

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

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

                                            ShortDescription of identifier
                                            Comments

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

                                            Control0..1
                                            BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                            (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.3.0)
                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Summarytrue
                                            Requirements

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

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            220. Patient.identifier:patientInternalIdentifier.type.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..0
                                            Typeid
                                            Is Modifierfalse
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            Summaryfalse
                                            222. Patient.identifier:patientInternalIdentifier.type.extension
                                            Definition

                                            An Extension

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

                                              A reference to a code defined by a terminology system.

                                              ShortCode defined by a terminology system
                                              Comments

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

                                              Control0..*
                                              BindingUnless not suitable, these codes SHALL be taken from Tipos de Identificadores de Paciente
                                              (extensible to http://example.com/fhir/example/ValueSet/patient-identifier-type)
                                              TypeCoding
                                              Is Modifierfalse
                                              Summarytrue
                                              Requirements

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

                                              Pattern Value{
                                                "system" : "http://hl7.pt/fhir/identifier-type",
                                                "code" : "PI",
                                                "display" : "Número Interno do Utente"
                                              }
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              226. Patient.identifier:patientInternalIdentifier.type.text
                                              Definition

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

                                              ShortPlain text representation of the concept
                                              Comments

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

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

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

                                              Pattern ValueNúmero Interno do Utente
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              228. Patient.identifier:patientInternalIdentifier.system
                                              Definition

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

                                              ShortThe namespace for the identifier value
                                              Comments

                                              Identifier.system is always case sensitive.

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

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

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

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

                                              ShortThe value that is unique
                                              Comments

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

                                              Control0..1
                                              Typestring
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summarytrue
                                              ExampleGeneral: 123456
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              232. Patient.identifier:patientInternalIdentifier.period
                                              Definition

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

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

                                              Organization that issued/manages the identifier.

                                              ShortOrganization that issued id (may be just text)
                                              Comments

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

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

                                              Número da Cédula Militar

                                              ShortNúmero da Cédula Militar
                                              NoteThis is a business identifier, not a resource identifier (see discussion)
                                              Control0..*
                                              TypeIdentifier
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summarytrue
                                              Requirements

                                              Patients are almost always assigned specific numerical identifiers.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              238. Patient.identifier:militaryIDNumber.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..0
                                              Typeid
                                              Is Modifierfalse
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              Summaryfalse
                                              240. Patient.identifier:militaryIDNumber.extension
                                              Definition

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

                                              ShortAdditional content defined by implementations
                                              Comments

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

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

                                                The purpose of this identifier.

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

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

                                                Control0..1
                                                BindingThe codes SHALL be taken from IdentifierUse
                                                (required to http://hl7.org/fhir/ValueSet/identifier-use|4.3.0)
                                                Typecode
                                                Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Summarytrue
                                                Requirements

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

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

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

                                                ShortDescription of identifier
                                                Comments

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

                                                Control0..1
                                                BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                                (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.3.0)
                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Summarytrue
                                                Requirements

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

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                246. Patient.identifier:militaryIDNumber.type.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..0
                                                Typeid
                                                Is Modifierfalse
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                Summaryfalse
                                                248. Patient.identifier:militaryIDNumber.type.extension
                                                Definition

                                                An Extension

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

                                                  A reference to a code defined by a terminology system.

                                                  ShortCode defined by a terminology system
                                                  Comments

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

                                                  Control0..*
                                                  BindingUnless not suitable, these codes SHALL be taken from Tipos de Identificadores de Paciente
                                                  (extensible to http://example.com/fhir/example/ValueSet/patient-identifier-type)
                                                  TypeCoding
                                                  Is Modifierfalse
                                                  Summarytrue
                                                  Requirements

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

                                                  Pattern Value{
                                                    "system" : "http://hl7.pt/fhir/identifier-type",
                                                    "code" : "MI",
                                                    "display" : "Número da Cédula Militar"
                                                  }
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  252. Patient.identifier:militaryIDNumber.type.text
                                                  Definition

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

                                                  ShortPlain text representation of the concept
                                                  Comments

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

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

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

                                                  Pattern ValueNúmero da Cédula Militar
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  254. Patient.identifier:militaryIDNumber.system
                                                  Definition

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

                                                  ShortThe namespace for the identifier value
                                                  Comments

                                                  Identifier.system is always case sensitive.

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

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

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

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

                                                  ShortThe value that is unique
                                                  Comments

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

                                                  Control0..1
                                                  Typestring
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  ExampleGeneral: 123456
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  258. Patient.identifier:militaryIDNumber.period
                                                  Definition

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

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

                                                  Organization that issued/manages the identifier.

                                                  ShortOrganization that issued id (may be just text)
                                                  Comments

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

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

                                                  Numero de processo Clinico

                                                  ShortNumero de processo Clinico
                                                  NoteThis is a business identifier, not a resource identifier (see discussion)
                                                  Control0..*
                                                  TypeIdentifier
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summarytrue
                                                  Requirements

                                                  Patients are almost always assigned specific numerical identifiers.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  264. Patient.identifier:medicalRecordNumber.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..0
                                                  Typeid
                                                  Is Modifierfalse
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  Summaryfalse
                                                  266. Patient.identifier:medicalRecordNumber.extension
                                                  Definition

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

                                                  ShortAdditional content defined by implementations
                                                  Comments

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

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

                                                    The purpose of this identifier.

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

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

                                                    Control0..1
                                                    BindingThe codes SHALL be taken from IdentifierUse
                                                    (required to http://hl7.org/fhir/ValueSet/identifier-use|4.3.0)
                                                    Typecode
                                                    Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Summarytrue
                                                    Requirements

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

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

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

                                                    ShortDescription of identifier
                                                    Comments

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

                                                    Control0..1
                                                    BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                                    (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.3.0)
                                                    TypeCodeableConcept
                                                    Is Modifierfalse
                                                    Summarytrue
                                                    Requirements

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

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    272. Patient.identifier:medicalRecordNumber.type.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..0
                                                    Typeid
                                                    Is Modifierfalse
                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                    Summaryfalse
                                                    274. Patient.identifier:medicalRecordNumber.type.extension
                                                    Definition

                                                    An Extension

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

                                                      A reference to a code defined by a terminology system.

                                                      ShortCode defined by a terminology system
                                                      Comments

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

                                                      Control0..*
                                                      BindingUnless not suitable, these codes SHALL be taken from Tipos de Identificadores de Paciente
                                                      (extensible to http://example.com/fhir/example/ValueSet/patient-identifier-type)
                                                      TypeCoding
                                                      Is Modifierfalse
                                                      Summarytrue
                                                      Requirements

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

                                                      Pattern Value{
                                                        "system" : "http://hl7.pt/fhir/identifier-type",
                                                        "code" : "MR",
                                                        "display" : "Numero de processo Clinico"
                                                      }
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      278. Patient.identifier:medicalRecordNumber.type.text
                                                      Definition

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

                                                      ShortPlain text representation of the concept
                                                      Comments

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

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

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

                                                      Pattern ValueNumero de processo Clinico
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      280. Patient.identifier:medicalRecordNumber.system
                                                      Definition

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

                                                      ShortThe namespace for the identifier value
                                                      Comments

                                                      Identifier.system is always case sensitive.

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

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

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

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

                                                      ShortThe value that is unique
                                                      Comments

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

                                                      Control0..1
                                                      Typestring
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Summarytrue
                                                      ExampleGeneral: 123456
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      284. Patient.identifier:medicalRecordNumber.period
                                                      Definition

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

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

                                                      Organization that issued/manages the identifier.

                                                      ShortOrganization that issued id (may be just text)
                                                      Comments

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

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

                                                      Numero de processo clinico familiar

                                                      ShortNumero de processo clinico familiar
                                                      NoteThis is a business identifier, not a resource identifier (see discussion)
                                                      Control0..*
                                                      TypeIdentifier
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Summarytrue
                                                      Requirements

                                                      Patients are almost always assigned specific numerical identifiers.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      290. Patient.identifier:familyRecordNumber.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..0
                                                      Typeid
                                                      Is Modifierfalse
                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                      Summaryfalse
                                                      292. Patient.identifier:familyRecordNumber.extension
                                                      Definition

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

                                                      ShortAdditional content defined by implementations
                                                      Comments

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

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

                                                        The purpose of this identifier.

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

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

                                                        Control0..1
                                                        BindingThe codes SHALL be taken from IdentifierUse
                                                        (required to http://hl7.org/fhir/ValueSet/identifier-use|4.3.0)
                                                        Typecode
                                                        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Summarytrue
                                                        Requirements

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

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

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

                                                        ShortDescription of identifier
                                                        Comments

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

                                                        Control0..1
                                                        BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                                        (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.3.0)
                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Summarytrue
                                                        Requirements

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

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        298. Patient.identifier:familyRecordNumber.type.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..0
                                                        Typeid
                                                        Is Modifierfalse
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        Summaryfalse
                                                        300. Patient.identifier:familyRecordNumber.type.extension
                                                        Definition

                                                        An Extension

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

                                                          A reference to a code defined by a terminology system.

                                                          ShortCode defined by a terminology system
                                                          Comments

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

                                                          Control0..*
                                                          BindingUnless not suitable, these codes SHALL be taken from Tipos de Identificadores de Paciente
                                                          (extensible to http://example.com/fhir/example/ValueSet/patient-identifier-type)
                                                          TypeCoding
                                                          Is Modifierfalse
                                                          Summarytrue
                                                          Requirements

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

                                                          Pattern Value{
                                                            "system" : "http://hl7.pt/fhir/identifier-type",
                                                            "code" : "MR",
                                                            "display" : "Numero de processo clinico familiar"
                                                          }
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          304. Patient.identifier:familyRecordNumber.type.text
                                                          Definition

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

                                                          ShortPlain text representation of the concept
                                                          Comments

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

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

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

                                                          Pattern ValueNumero de processo clinico familiar
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          306. Patient.identifier:familyRecordNumber.system
                                                          Definition

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

                                                          ShortThe namespace for the identifier value
                                                          Comments

                                                          Identifier.system is always case sensitive.

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

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

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

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

                                                          ShortThe value that is unique
                                                          Comments

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

                                                          Control0..1
                                                          Typestring
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summarytrue
                                                          ExampleGeneral: 123456
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          310. Patient.identifier:familyRecordNumber.period
                                                          Definition

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

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

                                                          Organization that issued/manages the identifier.

                                                          ShortOrganization that issued id (may be just text)
                                                          Comments

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

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

                                                          Cédula de Nascimento

                                                          ShortCédula de Nascimento
                                                          NoteThis is a business identifier, not a resource identifier (see discussion)
                                                          Control0..*
                                                          TypeIdentifier
                                                          Is Modifierfalse
                                                          Must Supporttrue
                                                          Summarytrue
                                                          Requirements

                                                          Patients are almost always assigned specific numerical identifiers.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          316. Patient.identifier:birthRegistryNumber.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..0
                                                          Typeid
                                                          Is Modifierfalse
                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                          Summaryfalse
                                                          318. Patient.identifier:birthRegistryNumber.extension
                                                          Definition

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

                                                          ShortAdditional content defined by implementations
                                                          Comments

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

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

                                                            The purpose of this identifier.

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

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

                                                            Control0..1
                                                            BindingThe codes SHALL be taken from IdentifierUse
                                                            (required to http://hl7.org/fhir/ValueSet/identifier-use|4.3.0)
                                                            Typecode
                                                            Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Summarytrue
                                                            Requirements

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

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

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

                                                            ShortDescription of identifier
                                                            Comments

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

                                                            Control0..1
                                                            BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                                            (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.3.0)
                                                            TypeCodeableConcept
                                                            Is Modifierfalse
                                                            Summarytrue
                                                            Requirements

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

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            324. Patient.identifier:birthRegistryNumber.type.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..0
                                                            Typeid
                                                            Is Modifierfalse
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            Summaryfalse
                                                            326. Patient.identifier:birthRegistryNumber.type.extension
                                                            Definition

                                                            An Extension

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

                                                              A reference to a code defined by a terminology system.

                                                              ShortCode defined by a terminology system
                                                              Comments

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

                                                              Control0..*
                                                              BindingUnless not suitable, these codes SHALL be taken from Tipos de Identificadores de Paciente
                                                              (extensible to http://example.com/fhir/example/ValueSet/patient-identifier-type)
                                                              TypeCoding
                                                              Is Modifierfalse
                                                              Summarytrue
                                                              Requirements

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

                                                              Pattern Value{
                                                                "system" : "http://hl7.pt/fhir/identifier-type",
                                                                "code" : "BR",
                                                                "display" : "Cédula de Nascimento"
                                                              }
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              330. Patient.identifier:birthRegistryNumber.type.text
                                                              Definition

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

                                                              ShortPlain text representation of the concept
                                                              Comments

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

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

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

                                                              Pattern ValueCédula de Nascimento
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              332. Patient.identifier:birthRegistryNumber.system
                                                              Definition

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

                                                              ShortThe namespace for the identifier value
                                                              Comments

                                                              Identifier.system is always case sensitive.

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

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

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

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

                                                              ShortThe value that is unique
                                                              Comments

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

                                                              Control0..1
                                                              Typestring
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Summarytrue
                                                              ExampleGeneral: 123456
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              336. Patient.identifier:birthRegistryNumber.period
                                                              Definition

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

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

                                                              Organization that issued/manages the identifier.

                                                              ShortOrganization that issued id (may be just text)
                                                              Comments

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

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

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

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

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

                                                              ShortWhether this patient's record is in active use
                                                              Comments

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

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

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

                                                              Meaning if MissingThis resource is generally assumed to be active if no value is provided for the active element
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              342. Patient.name
                                                              Definition

                                                              A name associated with the individual.

                                                              ShortA name associated with the patient
                                                              Comments

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

                                                              Control1..1
                                                              TypeHumanName
                                                              Is Modifierfalse
                                                              Must Supporttrue
                                                              Summarytrue
                                                              Requirements

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

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

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

                                                              ShortA contact detail for the individual
                                                              Comments

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

                                                              Control0..*
                                                              TypeContactPoint
                                                              Is Modifierfalse
                                                              Must Supporttrue
                                                              Summarytrue
                                                              Requirements

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

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

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

                                                              Shortmale | female | other | unknown
                                                              Comments

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

                                                              Control0..1
                                                              BindingThe codes SHALL be taken from AdministrativeGender
                                                              (required to http://hl7.org/fhir/ValueSet/administrative-gender|4.3.0)

                                                              The gender of a person used for administrative purposes.

                                                              Typecode
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Must Supportfalse
                                                              Summarytrue
                                                              Requirements

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

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

                                                              The date of birth for the individual.

                                                              ShortThe date of birth for the individual
                                                              Comments

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

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

                                                              Age of the individual drives many clinical processes.

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

                                                              Indicates if the individual is deceased or not.

                                                              ShortIndicates if the individual is deceased or not
                                                              Comments

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

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

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

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

                                                              An address for the individual.

                                                              ShortAn address for the individual
                                                              Comments

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

                                                              Control0..*
                                                              TypeAddress
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summarytrue
                                                              Requirements

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

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

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

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

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

                                                              ShortAdditional content defined by implementations
                                                              Comments

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

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

                                                                An Extension

                                                                ShortExtension
                                                                Control0..*
                                                                TypeExtension(PTAddressType) (Extension Type: Coding)
                                                                Is Modifierfalse
                                                                Must Supporttrue
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                360. Patient.address.extension:municipality
                                                                Slice Namemunicipality
                                                                Definition

                                                                An Extension

                                                                ShortCodigo do concelho
                                                                Control0..*
                                                                TypeExtension(PTAddressMunicipality) (Extension Type: CodeableConcept)
                                                                Is Modifierfalse
                                                                Must Supporttrue
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                362. Patient.address.extension:county
                                                                Slice Namecounty
                                                                Definition

                                                                An Extension

                                                                ShortCodigo do distrito
                                                                Control0..*
                                                                TypeExtension(PTAddressCounty) (Extension Type: CodeableConcept)
                                                                Is Modifierfalse
                                                                Must Supporttrue
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                364. Patient.address.extension:parish
                                                                Slice Nameparish
                                                                Definition

                                                                An Extension

                                                                ShortCódigo da Freguesia
                                                                Control0..*
                                                                TypeExtension(PTAddressParish) (Extension Type: CodeableConcept)
                                                                Is Modifierfalse
                                                                Must Supporttrue
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                366. Patient.address.extension:nuts
                                                                Slice Namenuts
                                                                Definition

                                                                An Extension

                                                                ShortExtension
                                                                Control0..*
                                                                TypeExtension(PTAddressNuts) (Complex Extension)
                                                                Is Modifierfalse
                                                                Must Supporttrue
                                                                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())
                                                                368. Patient.address.use
                                                                Definition

                                                                The purpose of this address.

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

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

                                                                Control0..1
                                                                BindingThe codes SHALL be taken from AddressUse
                                                                (required to http://hl7.org/fhir/ValueSet/address-use|4.3.0)

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

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

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

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

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

                                                                Shortpostal | physical | both
                                                                Comments

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

                                                                Control0..1
                                                                BindingThe codes SHALL be taken from AddressType
                                                                (required to http://hl7.org/fhir/ValueSet/address-type|4.3.0)

                                                                The type of an address (physical / postal).

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

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

                                                                ShortText representation of the address
                                                                Comments

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

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

                                                                A renderable, unencoded form.

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

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

                                                                ShortStreet name, number, direction & P.O. Box etc.
                                                                Control0..*
                                                                Typestring
                                                                Is Modifierfalse
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Summarytrue
                                                                ExampleGeneral: 137 Nowhere Street
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                376. Patient.address.city
                                                                Definition

                                                                The name of the city, town, suburb, village or other community or delivery center.

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

                                                                The name of the administrative area (county).

                                                                ShortDistrict name (aka county)
                                                                Comments

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

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

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

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

                                                                A postal code designating a region defined by the postal service.

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

                                                                Country - a nation as commonly understood or generally accepted.

                                                                ShortCountry (e.g. can be ISO 3166 2 or 3 letter code)
                                                                Comments

                                                                ISO 3166 3 letter codes can be used in place of a human readable country name.

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

                                                                Time period when address was/is in use.

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

                                                                Allows addresses to be placed in historical context.

                                                                ExampleGeneral: { "start" : "2010-03-23", "end" : "2010-07-01" }
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                388. Patient.maritalStatus
                                                                Definition

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

                                                                ShortMarital (civil) status of a patient
                                                                Control0..1
                                                                BindingUnless not suitable, these codes SHALL be taken from Marital Status Codes
                                                                (extensible to http://hl7.org/fhir/ValueSet/marital-status|4.3.0)

                                                                The domestic partnership status of a person.

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Most, if not all systems capture it.

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

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

                                                                ShortWhether patient is part of a multiple birth
                                                                Comments

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

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

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

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

                                                                Image of the patient.

                                                                ShortImage of the patient
                                                                Comments

                                                                Guidelines:

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

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

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

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

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

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

                                                                Control0..1
                                                                TypeBackboneElement
                                                                Is Modifierfalse
                                                                Must Supporttrue
                                                                Summaryfalse
                                                                Requirements

                                                                Need to track people you can contact about the patient.

                                                                Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
                                                                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())
                                                                396. Patient.contact.id
                                                                Definition

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

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

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

                                                                ShortAdditional content defined by implementations
                                                                Comments

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

                                                                Control0..*
                                                                TypeExtension
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Alternate Namesextensions, user content
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                400. Patient.contact.modifierExtension
                                                                Definition

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

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

                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                Comments

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

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

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

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

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

                                                                ShortThe kind of relationship
                                                                Control0..*
                                                                BindingUnless not suitable, these codes SHALL be taken from PatientContactRelationship
                                                                (extensible to http://hl7.org/fhir/ValueSet/patient-contactrelationship|4.3.0)

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

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

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

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

                                                                A name associated with the contact person.

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

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

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

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

                                                                ShortA contact detail for the person
                                                                Comments

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

                                                                Control0..*
                                                                TypeContactPoint
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

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

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

                                                                Address for the contact person.

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

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

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

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

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

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

                                                                ShortAdditional content defined by implementations
                                                                Comments

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

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

                                                                  An Extension

                                                                  ShortExtension
                                                                  Control0..*
                                                                  TypeExtension(PTAddressType) (Extension Type: Coding)
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  416. Patient.contact.address.extension:municipality
                                                                  Slice Namemunicipality
                                                                  Definition

                                                                  An Extension

                                                                  ShortCodigo do concelho
                                                                  Control0..*
                                                                  TypeExtension(PTAddressMunicipality) (Extension Type: CodeableConcept)
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  418. Patient.contact.address.extension:county
                                                                  Slice Namecounty
                                                                  Definition

                                                                  An Extension

                                                                  ShortCodigo do distrito
                                                                  Control0..*
                                                                  TypeExtension(PTAddressCounty) (Extension Type: CodeableConcept)
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  420. Patient.contact.address.extension:parish
                                                                  Slice Nameparish
                                                                  Definition

                                                                  An Extension

                                                                  ShortCódigo da Freguesia
                                                                  Control0..*
                                                                  TypeExtension(PTAddressParish) (Extension Type: CodeableConcept)
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  422. Patient.contact.address.extension:nuts
                                                                  Slice Namenuts
                                                                  Definition

                                                                  An Extension

                                                                  ShortExtension
                                                                  Control0..*
                                                                  TypeExtension(PTAddressNuts) (Complex Extension)
                                                                  Is Modifierfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  424. Patient.contact.address.use
                                                                  Definition

                                                                  The purpose of this address.

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

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

                                                                  Control0..1
                                                                  BindingThe codes SHALL be taken from AddressUse
                                                                  (required to http://hl7.org/fhir/ValueSet/address-use|4.3.0)

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

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

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

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

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

                                                                  Shortpostal | physical | both
                                                                  Comments

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

                                                                  Control0..1
                                                                  BindingThe codes SHALL be taken from AddressType
                                                                  (required to http://hl7.org/fhir/ValueSet/address-type|4.3.0)

                                                                  The type of an address (physical / postal).

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

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

                                                                  ShortText representation of the address
                                                                  Comments

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

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

                                                                  A renderable, unencoded form.

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

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

                                                                  ShortStreet name, number, direction & P.O. Box etc.
                                                                  Control0..*
                                                                  Typestring
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Summarytrue
                                                                  ExampleGeneral: 137 Nowhere Street
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  432. Patient.contact.address.city
                                                                  Definition

                                                                  The name of the city, town, suburb, village or other community or delivery center.

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

                                                                  The name of the administrative area (county).

                                                                  ShortDistrict name (aka county)
                                                                  Comments

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

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

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

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

                                                                  A postal code designating a region defined by the postal service.

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

                                                                  Country - a nation as commonly understood or generally accepted.

                                                                  ShortCountry (e.g. can be ISO 3166 2 or 3 letter code)
                                                                  Comments

                                                                  ISO 3166 3 letter codes can be used in place of a human readable country name.

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

                                                                  Time period when address was/is in use.

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

                                                                  Allows addresses to be placed in historical context.

                                                                  ExampleGeneral: { "start" : "2010-03-23", "end" : "2010-07-01" }
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  444. Patient.contact.gender
                                                                  Definition

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

                                                                  Shortmale | female | other | unknown
                                                                  Control0..1
                                                                  BindingThe codes SHALL be taken from AdministrativeGender
                                                                  (required to http://hl7.org/fhir/ValueSet/administrative-gender|4.3.0)

                                                                  The gender of a person used for administrative purposes.

                                                                  Typecode
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Needed to address the person correctly.

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

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

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

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

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

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

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

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

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

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

                                                                  Control0..*
                                                                  TypeBackboneElement
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

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

                                                                  Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
                                                                  452. Patient.communication.id
                                                                  Definition

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

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

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

                                                                  ShortAdditional content defined by implementations
                                                                  Comments

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

                                                                  Control0..*
                                                                  TypeExtension
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Alternate Namesextensions, user content
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  456. Patient.communication.modifierExtension
                                                                  Definition

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

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

                                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                                  Comments

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

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

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

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

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

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

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

                                                                  Control1..1
                                                                  BindingThe codes SHOULD be taken from CommonLanguages
                                                                  (preferred to http://hl7.org/fhir/ValueSet/languages|4.3.0)

                                                                  IETF language tag

                                                                  Additional BindingsPurpose
                                                                  AllLanguagesMax Binding
                                                                  TypeCodeableConcept
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

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

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

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

                                                                  ShortLanguage preference indicator
                                                                  Comments

                                                                  This language is specifically identified for communicating healthcare information.

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

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

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

                                                                  Patient's nominated care provider.

                                                                  ShortPatient's nominated primary care provider
                                                                  Comments

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

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

                                                                  Control0..*
                                                                  TypeReference(Organization, Practitioner, PractitionerRole)
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Alternate NamescareProvider
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  464. Patient.generalPractitioner.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
                                                                  Typeid
                                                                  Is Modifierfalse
                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                  Summaryfalse
                                                                  466. Patient.generalPractitioner.extension
                                                                  Definition

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

                                                                  ShortAdditional content defined by implementations
                                                                  Comments

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

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

                                                                    Optional Extension Element - found in all resources.

                                                                    ShortOptional Extensions Element
                                                                    Control0..*
                                                                    TypeExtension(PTPatientPrimaryCarePeriod) (Extension Type: Period)
                                                                    Is Modifierfalse
                                                                    Must Supporttrue
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                    470. Patient.generalPractitioner.reference
                                                                    Definition

                                                                    A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                    ShortLiteral reference, Relative, internal or absolute URL
                                                                    Comments

                                                                    Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                    Control0..1
                                                                    This element is affected by the following invariants: ref-1
                                                                    Typestring
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summarytrue
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    472. Patient.generalPractitioner.type
                                                                    Definition

                                                                    The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                                    The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                                    ShortType the reference refers to (e.g. "Patient")
                                                                    Comments

                                                                    This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                                    Control0..1
                                                                    BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                                    (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.3.0)
                                                                    Typeuri
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summarytrue
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    474. Patient.generalPractitioner.identifier
                                                                    Definition

                                                                    An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                    ShortLogical reference, when literal reference is not known
                                                                    Comments

                                                                    When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                    When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                    Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                    Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                                    NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                    Control0..1
                                                                    TypeIdentifier
                                                                    Is Modifierfalse
                                                                    Summarytrue
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    476. Patient.generalPractitioner.display
                                                                    Definition

                                                                    Plain text narrative that identifies the resource in addition to the resource reference.

                                                                    ShortText alternative for the resource
                                                                    Comments

                                                                    This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

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

                                                                    Organization that is the custodian of the patient record.

                                                                    ShortOrganization that is the custodian of the patient record
                                                                    Comments

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

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

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

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

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

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

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

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

                                                                    There are multiple use cases:

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

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

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

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

                                                                    ShortAdditional content defined by implementations
                                                                    Comments

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

                                                                    Control0..*
                                                                    TypeExtension
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Alternate Namesextensions, user content
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                    486. Patient.link.modifierExtension
                                                                    Definition

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

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

                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                    Comments

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

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

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

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

                                                                    The other patient resource that the link refers to.

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

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

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

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

                                                                    Shortreplaced-by | replaces | refer | seealso
                                                                    Control1..1
                                                                    BindingThe codes SHALL be taken from LinkType
                                                                    (required to http://hl7.org/fhir/ValueSet/link-type|4.3.0)

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

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