AU Base Implementation Guide
6.0.0-ci-build - CI Build

AU Base Implementation Guide, published by HL7 Australia. This guide is not an authorized publication; it is the continuous build for version 6.0.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7au/au-fhir-base/ and changes regularly. See the Directory of published versions

## Resource Profile: AUBasePatient - Detailed Descriptions

Page standards status: Trial-use | Maturity Level: 3

Definitions for the au-patient resource profile.

- Key Elements Table
- Differential Elements Table
- Snapshot Elements Table

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

0. Patient
Definition | Demographics and other administrative information about an individual receiving care or other health-related services. Demographics and other administrative information about an individual or animal receiving care or other health-related services.
Short | A patient in an Australian healthcare contextInformation about an individual or animal receiving health care services
Control | 0..*
Is Modifier | false
Summary | false
Alternate Names | SubjectOfCare Client Resident
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty()) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()) 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()) inv-pat-0: If present, birth time's date shall be the birth date (`birthDate.extension('http://hl7.org/fhir/StructureDefinition/patient-birthTime').exists() implies birthDate.extension('http://hl7.org/fhir/StructureDefinition/patient-birthTime').value.toString().substring(0,10) = birthDate.toString()`) inv-pat-1: Individual gender identity shall be a member of the Gender Identity Response value set if any codes within that value set can apply (`extension('http://hl7.org/fhir/StructureDefinition/individual-genderIdentity').extension('value').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-genderIdentity').extension('value').value.all(memberOf('https://healthterminologies.gov.au/fhir/ValueSet/gender-identity-response-1'))`) inv-pat-2: Individual pronouns shall be a member of the Australian Pronouns value set if any codes within that value set can apply (`extension('http://hl7.org/fhir/StructureDefinition/individual-pronouns').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-pronouns').extension('value').value.all(memberOf('https://healthterminologies.gov.au/fhir/ValueSet/australian-pronouns-1'))`) inv-pat-3: Recorded sex or gender type shall be a member of the AU Recorded Sex or Gender Type value set if any codes within that value set can apply (`extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('type').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('type').value.all(memberOf('http://terminology.hl7.org.au/ValueSet/rsg-type'))`) inv-pat-4: Recorded sex or gender source document type shall be a member of the AU Recorded Sex or Gender (RSG) Source Document Type value set if any codes within that value set can apply (`extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('sourceDocument').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('sourceDocument').value.ofType(CodeableConcept).all(memberOf('http://terminology.hl7.org.au/ValueSet/rsg-source-document-type'))`) inv-pat-5: Recorded sex or gender jurisdiction shall be a member of the Jurisdiction ValueSet - AU Extended value set if any codes within that value set can apply (`extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('jurisdiction').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('jurisdiction').value.all(memberOf('http://terminology.hl7.org.au/ValueSet/jurisdiction-extended'))`) inv-pat-6: Recorded sex or gender source shall be a member of the AU Recorded Sex or Gender (RSG) Source value set if any codes within that value set can apply (`extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('source').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('source').value.ofType(CodeableConcept).all(memberOf('http://terminology.hl7.org.au/ValueSet/rsg-source'))`)
2. Patient.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. 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.
Short | ExtensionAdditional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Patient.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
6. Patient.extension:birthPlace
Slice Name | birthPlace
Definition | The registered place of birth of the patient. A sytem may use the address.text if they don't store the birthPlace address in discrete elements.
Short | Place of Birth for patient
Control | 0..1
Type | Extension(Patient Birth Place) (Extension Type: Address)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) 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())
8. Patient.extension:indigenousStatus
Slice Name | indigenousStatus
Definition | National Health Data Dictionary (NHDD) based indigenous status for a person.
Short | Indigenous status
Comments | This concept is equivalent to Australian Institute of Health and Welfare data element 602543 Person—Indigenous status, code N.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Australian Indigenous Status) (Extension Type: Coding)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
10. Patient.extension:veteranStatus
Slice Name | veteranStatus
Definition | Veteran / Australian Defence Force (ADF) status for a person.
Short | Veteran / Australian Defence Force (ADF) status
Comments | This concept is equivalent to Australian Institute of Health and Welfare data element 737931 Person—ADF veteran status, code N.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(Australian Veteran Status) (Extension Type: Coding)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
12. Patient.extension:closingTheGapRegistration
Slice Name | closingTheGapRegistration
Definition | Indication of eligibility for the Closing the Gap co-payment.
Short | Closing the Gap co-payment eligibility indicator
Comments | This concept is equivalent to Australian Institute of Health and Welfare data element 603671 Patient—Closing the Gap co-payment eligibility indicator.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Closing the Gap Registration) (Extension Type: boolean)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
14. Patient.extension:mothersMaidenName
Slice Name | mothersMaidenName
Definition | Mother's maiden (unmarried) name, commonly collected to help verify patient identity.
Short | Mother's Maiden name
Control | 0..1
Type | Extension(Patient Mother's Maiden Name) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) 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:interpreterRequired
Slice Name | interpreterRequired
Definition | Indicates whether an interpreter is required to facilitate communication in a healthcare setting. While this extension is named patient-interpreterRequired for backwards compatibility, it may also be used on RelatedPerson, Practitioner, and Encounter.
Short | Whether an interpreter is required
Comments | The individual does not speak the default language of the organization, and hence requires an interpreter. If other languages are in the Communications list, then that would be the type of interpreter required. While this extension is named patient-interpreterRequired for backwards compatibility, it may also be used on RelatedPerson, Practitioner, and Encounter. When used on Patient, RelatedPerson, or Practitioner, it indicates a default or assumed need for an interpreter. When used on Encounter, it indicates that an interpreter is needed to facilitate communication between some participants in that Encounter. The encounter-level evaluation of whether an interpreter is needed might involve evaluating the language proficiencies of the participants.
Control | 0..1
Type | Extension(Interpreter Required) (Extension Type: boolean)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) 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())
18. Patient.extension:dateOfArrival
Slice Name | dateOfArrival
Definition | The date a person first arrived in Australia, from another country, with the intention of living in Australia for one year or more. This date is captured once for a person and is not subsequently updated with subsequent arrivals.
Short | The date a person first arrived in Australia, from another country, with the intention of living in Australia for one year or more
Comments | See Australian Bureau of Statics (ABS) 1200.0.55.007 - Year of Arrival Standard, 2014, Version 1.5 for further information. This concept is equivalent to Australian Institute of Health and Welfare data element 269447 Person—year of first arrival in Australia.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Date of Arrival in Australia) (Extension Type: date)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
20. Patient.extension:genderIdentity
Slice Name | genderIdentity
Definition | An individual's personal sense of being a man, woman, boy, girl, nonbinary, or something else.
Short | Gender identity shall be a member of the Gender Identity Response value set if any codes within that value set can apply
Comments | The individual's gender identity is populated in the `extension:value.value[x]` of the Individual Gender Identity extension and shall contain one of the codes from the Gender Identity Response value set if any of the codes within the value set can apply. See Australian Bureau of Statics (ABS) Standard for Sex, Gender, Variations of Sex Characteristics and Sexual Orientation Variables, 2020 for further materials.
Control | 0..* This element is affected by the following invariants: inv-pat-1
Type | Extension(Individual Gender Identity) (Complex Extension)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
22. Patient.extension:individualPronouns
Slice Name | individualPronouns
Definition | The pronouns to use when referring to an individual in verbal or written communication.
Short | Pronouns shall be a member of the Australian Pronouns value set if any codes within that value set can apply
Comments | The individual's pronouns are populated in the `extension:value.value[x]` of the Individual Pronouns extension and shall contain one of the codes from the Australian Pronouns value set if any of the codes within the value set can apply.
Control | 0..* This element is affected by the following invariants: inv-pat-2
Type | Extension(Individual Pronouns) (Complex Extension)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
24. Patient.extension:recordedSexOrGender
Slice Name | recordedSexOrGender
Definition | A sex or gender property for the individual from a document or other record
Short | Recorded sex or gender type shall be a member of the AU Recorded Sex or Gender Type value set if any codes within that value set can apply. Recorded sex or gender source document type shall be a member of the AU Recorded Sex or Gender (RSG) Source Document Type value set if any codes within that value set can apply. Recorded sex or gender jurisdiction shall be a member of the Jurisdiction - ValueSet AU Extended value set if any codes within that value set can apply. Recorded sex or gender source shall be a member of the AU Recorded Sex or Gender (RSG) Source value set if any codes within that value set can apply.
Comments | The type of recorded sex or gender is populated in the `extension:type.value[x]` of the Person Recorded Sex or Gender extension and shall contain one of the codes from the AU Recorded Sex or Gender Type value set if any of the codes within the value set can apply. The document from which the sex or gender property was acquired is populated in the `extension:sourceDocument.value[x]` of the Person Recorded Sex or Gender extension and shall contain one of the codes from the AU Recorded Sex or Gender (RSG) Source Document Type value set if any of the codes within the value set can apply. The jurisdiction that issued the document where the sex or gender was acquired is populated in the `extension:jurisdiction.value[x]` of the Person Recorded Sex or Gender extension and shall contain one of the codes from the Jurisdiction ValueSet - AU Extended value set if any of the codes within the value set can apply. The non-document source from which the sex or gender property was acquired is populated in the `extension:source.value[x]` of the Person Recorded Sex or Gender extension and shall contain one of the codes from the AU Recorded Sex or Gender (RSG) Source value set if any of the codes within the value set can apply.
Control | 0..* This element is affected by the following invariants: inv-pat-3, inv-pat-4, inv-pat-5, inv-pat-6
Type | Extension(Person Recorded Sex Or Gender) (Complex Extension)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
26. Patient.extension:sexParameterForClinicalUse
Slice Name | sexParameterForClinicalUse
Definition | A parameter that provides guidance on how a recipient should apply settings or reference ranges that are derived from observable information such as an organ inventory, recent hormone lab tests, genetic testing, menstrual status, obstetric history, etc..
Short | A context-specific sex parameter for clinical use
Control | 0..*
Type | Extension(Patient Sex Parameter For Clinical Use) (Complex Extension)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
28. Patient.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
30. Patient.identifier
Definition | An identifier for this patient.
Short | Identifies this patient across multiple systemsAn identifier for this patient
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier(Identifier, AU IHI, AU Medicare Card Number, AU DVA Number, AU Health Care Card Number, AU Pensioner Concession Card Number, AU Commonwealth Seniors Health Card Number, AU Medical Record Number, AU Insurance Member Number, AU Patient Internal Identifier)
Is Modifier | false
Summary | true
Requirements | Patients are almost always assigned specific numerical identifiers.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. Patient.active
Definition | Whether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules. It is often used to filter patient lists to exclude inactive patients Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death.
Short | Whether this patient's record is in active use
Comments | If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient.
Control | 0..1
Type | boolean
Is Modifier | true because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to be able to mark a patient record as not to be used because it was created in error.
Meaning if Missing | This resource is generally assumed to be active if no value is provided for the active element
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. Patient.birthDate
Definition | The date of birth for the individual.
Short | Date of birth extended for time and accuracy indicatorThe date of birth for the individual
Comments | At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternity/infant care systems).
Control | 0..1 This element is affected by the following invariants: inv-pat-0
Type | date
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Age of the individual drives many clinical processes. May include accuracy indicator and specific birth time. Age of the individual drives many clinical processes.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
LOINC Code | 21112-8
36. Patient.birthDate.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Patient.birthDate.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
38. Patient.birthDate.extension:accuracyIndicator
Slice Name | accuracyIndicator
Definition | General date accuracy indicator coding.
Short | Birth date accuracy indicator
Comments | In some circumstances, systems may only have date or datetime data that has unknown or estimated parts. This coding establishes the accuracy of the day, month and year parts.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Date Accuracy Indicator) (Extension Type: Coding)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
40. Patient.birthDate.extension:birthTime
Slice Name | birthTime
Definition | The time of day that the patient was born. This includes the date to ensure that the timezone information can be communicated effectively.
Short | Birth time
Comments | The patient prefix on the extension was retained to ensure backward compatibility with existing data (the content itself is provided to assist in sharing data across patient resources effectively)
Control | 0..1 This element is affected by the following invariants: inv-pat-0
Type | Extension(Patient/Person/RelatedPerson/Practitioner Birth Time) (Extension Type: dateTime)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) 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())
42. Patient.deceased[x]
Definition | Indicates if the individual is deceased or not. Deceased date accuracy indicator is optional. Indicates if the individual is deceased or not.
Short | Indicates if the individual is deceased or not
Comments | If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.
Control | 0..1
Type | Choice of: boolean, dateTime
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | true because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Patient.deceased[x]`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: type @ $this
44. Patient.deceased[x]:deceasedBoolean
Slice Name | deceasedBoolean
Definition | Boolean indicator if the individual is deceased or not. Indicates if the individual is deceased or not.
Short | Deceased indicatorIndicates if the individual is deceased or not
Comments | If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.
Control | 0..1
Type | boolean, dateTime
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | true because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
46. Patient.deceased[x]:deceasedDateTime
Slice Name | deceasedDateTime
Definition | Individual deceased date-time with optional accuracy indicator. Indicates if the individual is deceased or not.
Short | Deceased date timeIndicates if the individual is deceased or not
Comments | If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.
Control | 0..1
Type | dateTime, boolean
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | true because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
48. Patient.deceased[x]:deceasedDateTime.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Patient.deceased[x].extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
50. Patient.deceased[x]:deceasedDateTime.extension:accuracyIndicator
Slice Name | accuracyIndicator
Definition | General date accuracy indicator coding.
Short | Deceased date accuracy indicator
Comments | In some circumstances, systems may only have date or datetime data that has unknown or estimated parts. This coding establishes the accuracy of the day, month and year parts.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Date Accuracy Indicator) (Extension Type: Coding)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
52. Patient.address
Definition | An address for the individual.
Short | An address for the individual
Comments | The address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource). Patient may have multiple addresses with different uses or applicable periods.
Control | 0..*
Type | Address(Australian Address, Address)
Is Modifier | false
Summary | true
Requirements | May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
54. Patient.link
Definition | Link to a Patient or RelatedPerson resource that concerns the same actual person. Link to another patient resource that concerns the same actual patient.
Short | Link to a Patient or RelatedPerson resource that concerns the same actual personLink to another patient resource that concerns the same actual person
Comments | There is no assumption that linked patient records have mutual links.
Control | 0..*
Type | BackboneElement
Is Modifier | true because This element is labeled as a modifier because it might not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'
Summary | true
Requirements | There are multiple use cases: Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and Distribution of patient information across multiple servers.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
56. 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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
58. Patient.link.other
Definition | The other patient resource that the link refers to.
Short | The other patient or related person resource that the link refers to
Comments | Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.
Control | 1..1
Type | Reference(Patient, RelatedPerson)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
60. Patient.link.type
Definition | The type of link between this patient resource and another patient resource.
Short | replaced-by | replaces | refer | seealso
Control | 1..1
Binding | The codes SHALL be taken from LinkType http://hl7.org/fhir/ValueSet/link-type|4.0.1 (required to `http://hl7.org/fhir/ValueSet/link-type|4.0.1` ) The type of link between this patient resource and another patient resource.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

0. Patient
Definition | Demographics and other administrative information about an individual receiving care or other health-related services.
Short | A patient in an Australian healthcare context
Invariants | inv-pat-0: If present, birth time's date shall be the birth date (`birthDate.extension('http://hl7.org/fhir/StructureDefinition/patient-birthTime').exists() implies birthDate.extension('http://hl7.org/fhir/StructureDefinition/patient-birthTime').value.toString().substring(0,10) = birthDate.toString()`) inv-pat-1: Individual gender identity shall be a member of the Gender Identity Response value set if any codes within that value set can apply ( Changed:`extension('http://hl7.org/fhir/StructureDefinition/individual-genderIdentity').extension('value').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-genderIdentity').extension('value').value.all(memberOf('https://healthterminologies.gov.au/fhir/ValueSet/gender-identity-response-1'))`) inv-pat-2: Individual pronouns shall be a member of the Australian Pronouns value set if any codes within that value set can apply ( Changed:`extension('http://hl7.org/fhir/StructureDefinition/individual-pronouns').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-pronouns').extension('value').value.all(memberOf('https://healthterminologies.gov.au/fhir/ValueSet/australian-pronouns-1'))`) inv-pat-3: Recorded sex or gender type shall be a member of the AU Recorded Sex or Gender Type value set if any codes within that value set can apply ( Changed:`extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('type').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('type').value.all(memberOf('http://terminology.hl7.org.au/ValueSet/rsg-type'))`) inv-pat-4: Recorded sex or gender source document type shall be a member of the AU Recorded Sex or Gender (RSG) Source Document Type value set if any codes within that value set can apply ( Changed:`extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('sourceDocument').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('sourceDocument').value.ofType(CodeableConcept).all(memberOf('http://terminology.hl7.org.au/ValueSet/rsg-source-document-type'))`) inv-pat-5: Recorded sex or gender jurisdiction shall be a member of the Jurisdiction ValueSet - AU Extended value set if any codes within that value set can apply ( Changed:`extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('jurisdiction').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('jurisdiction').value.all(memberOf('http://terminology.hl7.org.au/ValueSet/jurisdiction-extended'))`) Added:inv-pat-6: Recorded sex or gender source shall be a member of the AU Recorded Sex or Gender (RSG) Source value set if any codes within that value set can apply (`extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('source').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('source').value.ofType(CodeableConcept).all(memberOf('http://terminology.hl7.org.au/ValueSet/rsg-source'))`)
2. Patient.extension
Slicing | This element introduces a set of slices on `Patient.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
4. Patient.extension:birthPlace
Slice Name | birthPlace
Type | Extension(Patient Birth Place) (Extension Type: Address)
6. Patient.extension:indigenousStatus
Slice Name | indigenousStatus
Type | Extension(Australian Indigenous Status) (Extension Type: Coding)
8. Patient.extension:veteranStatus
Slice Name | veteranStatus
Type | Extension(Australian Veteran Status) (Extension Type: Coding)
10. Patient.extension:closingTheGapRegistration
Slice Name | closingTheGapRegistration
Type | Extension(Closing the Gap Registration) (Extension Type: boolean)
12. Patient.extension:mothersMaidenName
Slice Name | mothersMaidenName
Type | Extension(Patient Mother's Maiden Name) (Extension Type: string)
14. Patient.extension:interpreterRequired
Slice Name | interpreterRequired
Type | Extension(Interpreter Required) (Extension Type: boolean)
16. Patient.extension:dateOfArrival
Slice Name | dateOfArrival
Type | Extension(Date of Arrival in Australia) (Extension Type: date)
18. Patient.extension:genderIdentity
Slice Name | genderIdentity
Short | Gender identity shall be a member of the Gender Identity Response value set if any codes within that value set can apply
Comments | The individual's gender identity is populated in the `extension:value.value[x]` of the Individual Gender Identity extension and shall contain one of the codes from the Gender Identity Response value set if any of the codes within the value set can apply. See Australian Bureau of Statics (ABS) Standard for Sex, Gender, Variations of Sex Characteristics and Sexual Orientation Variables, 2020 for further materials.
Type | Extension(Individual Gender Identity) (Complex Extension)
20. Patient.extension:individualPronouns
Slice Name | individualPronouns
Short | Pronouns shall be a member of the Australian Pronouns value set if any codes within that value set can apply
Comments | The individual's pronouns are populated in the `extension:value.value[x]` of the Individual Pronouns extension and shall contain one of the codes from the Australian Pronouns value set if any of the codes within the value set can apply.
Type | Extension(Individual Pronouns) (Complex Extension)
22. Patient.extension:recordedSexOrGender
Slice Name | recordedSexOrGender
Short | Changed:Recorded sex or gender type shall be a member of the AU Recorded Sex or Gender Type value set if any codes within that value set can apply. Recorded sex or gender source document type shall be a member of the AU Recorded Sex or Gender (RSG) Source Document Type value set if any codes within that value set can apply. Recorded sex or gender jurisdiction shall be a member of the Jurisdiction - ValueSet AU Extended value set if any codes within that value set can apply. Recorded sex or gender source shall be a member of the AU Recorded Sex or Gender (RSG) Source value set if any codes within that value set can apply.
Comments | Changed: The type of recorded sex or gender is populated in the `extension:type.value[x]` of the Person Recorded Sex or Gender extension and shall contain one of the codes from the AU Recorded Sex or Gender Type value set if any of the codes within the value set can apply. The document from which the sex or gender property was acquired is populated in the `extension:sourceDocument.value[x]` of the Person Recorded Sex or Gender extension and shall contain one of the codes from the AU Recorded Sex or Gender (RSG) Source Document Type value set if any of the codes within the value set can apply. The jurisdiction that issued the document where the sex or gender was acquired is populated in the `extension:jurisdiction.value[x]` of the Person Recorded Sex or Gender extension and shall contain one of the codes from the Jurisdiction ValueSet - AU Extended value set if any of the codes within the value set can apply. The non-document source from which the sex or gender property was acquired is populated in the `extension:source.value[x]` of the Person Recorded Sex or Gender extension and shall contain one of the codes from the AU Recorded Sex or Gender (RSG) Source value set if any of the codes within the value set can apply.
Type | Extension(Person Recorded Sex Or Gender) (Complex Extension)
Added: 24. Patient.extension:sexParameterForClinicalUse
Slice Name | sexParameterForClinicalUse
Type | Extension(Patient Sex Parameter For Clinical Use) (Complex Extension)
26. Patient.identifier
Short | Identifies this patient across multiple systems
Note | This is a business identifier, not a resource identifier (see discussion)
Type | Identifier(Identifier, AU IHI, AU Medicare Card Number, AU DVA Number, AU Health Care Card Number, AU Pensioner Concession Card Number, AU Commonwealth Seniors Health Card Number, AU Medical Record Number, AU Insurance Member Number, AU Patient Internal Identifier)
28. Patient.birthDate
Short | Date of birth extended for time and accuracy indicator
Requirements | Age of the individual drives many clinical processes. May include accuracy indicator and specific birth time.
LOINC Code |
30. Patient.birthDate.extension
Slicing | This element introduces a set of slices on `Patient.birthDate.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
32. Patient.birthDate.extension:accuracyIndicator
Slice Name | accuracyIndicator
Short | Birth date accuracy indicator
Comments | In some circumstances, systems may only have date or datetime data that has unknown or estimated parts. This coding establishes the accuracy of the day, month and year parts.
Type | Extension(Date Accuracy Indicator) (Extension Type: Coding)
34. Patient.birthDate.extension:birthTime
Slice Name | birthTime
Definition | The time of day that the patient was born. This includes the date to ensure that the timezone information can be communicated effectively.
Short | Birth time
Type | Extension(Patient/Person/RelatedPerson/Practitioner Birth Time) (Extension Type: dateTime)
36. Patient.deceased[x]
Definition | Indicates if the individual is deceased or not. Deceased date accuracy indicator is optional.
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Slicing | This element introduces a set of slices on `Patient.deceased[x]`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: type @ $this
38. Patient.deceased[x]:deceasedBoolean
Slice Name | deceasedBoolean
Definition | Boolean indicator if the individual is deceased or not.
Short | Deceased indicator
Type | boolean
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
40. Patient.deceased[x]:deceasedDateTime
Slice Name | deceasedDateTime
Definition | Individual deceased date-time with optional accuracy indicator.
Short | Deceased date time
Type | dateTime
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
42. Patient.deceased[x]:deceasedDateTime.extension
Slicing | This element introduces a set of slices on `Patient.deceased[x].extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
44. Patient.deceased[x]:deceasedDateTime.extension:accuracyIndicator
Slice Name | accuracyIndicator
Short | Deceased date accuracy indicator
Comments | In some circumstances, systems may only have date or datetime data that has unknown or estimated parts. This coding establishes the accuracy of the day, month and year parts.
Type | Extension(Date Accuracy Indicator) (Extension Type: Coding)
46. Patient.address
Short | Changed:An address for the individual
Comments | The address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource).
Type | Address(Australian Address, Address)
48. Patient.contact
50. Patient.contact.relationship
Binding | Unless not suitable, these codes SHALL be taken from https://healthterminologies.gov.au/fhir/ValueSet/contact-relationship-type-3 (extensible to `https://healthterminologies.gov.au/fhir/ValueSet/contact-relationship-type-3` )
Added: 52. Patient.contact.address
Short | Address for the contact person
Comments | The address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource).
Type | Address(Address, Australian Address)
54. Patient.communication
56. Patient.communication.language
Binding | Unless not suitable, these codes SHALL be taken from https://healthterminologies.gov.au/fhir/ValueSet/common-languages-australia-2 (extensible to `https://healthterminologies.gov.au/fhir/ValueSet/common-languages-australia-2` )
58. Patient.link
Definition | Link to a Patient or RelatedPerson resource that concerns the same actual person.
Short | Link to a Patient or RelatedPerson resource that concerns the same actual person

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

0. Patient
Definition | Demographics and other administrative information about an individual receiving care or other health-related services.
Short | A patient in an Australian healthcare context
Control | 0..*
Is Modifier | false
Summary | false
Alternate Names | SubjectOfCare Client Resident
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (`contained.contained.empty()`) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (`contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`) 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()`) inv-pat-0: If present, birth time's date shall be the birth date (`birthDate.extension('http://hl7.org/fhir/StructureDefinition/patient-birthTime').exists() implies birthDate.extension('http://hl7.org/fhir/StructureDefinition/patient-birthTime').value.toString().substring(0,10) = birthDate.toString()`) inv-pat-1: Individual gender identity shall be a member of the Gender Identity Response value set if any codes within that value set can apply (`extension('http://hl7.org/fhir/StructureDefinition/individual-genderIdentity').extension('value').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-genderIdentity').extension('value').value.all(memberOf('https://healthterminologies.gov.au/fhir/ValueSet/gender-identity-response-1'))`) inv-pat-2: Individual pronouns shall be a member of the Australian Pronouns value set if any codes within that value set can apply (`extension('http://hl7.org/fhir/StructureDefinition/individual-pronouns').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-pronouns').extension('value').value.all(memberOf('https://healthterminologies.gov.au/fhir/ValueSet/australian-pronouns-1'))`) inv-pat-3: Recorded sex or gender type shall be a member of the AU Recorded Sex or Gender Type value set if any codes within that value set can apply (`extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('type').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('type').value.all(memberOf('http://terminology.hl7.org.au/ValueSet/rsg-type'))`) inv-pat-4: Recorded sex or gender source document type shall be a member of the AU Recorded Sex or Gender (RSG) Source Document Type value set if any codes within that value set can apply (`extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('sourceDocument').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('sourceDocument').value.ofType(CodeableConcept).all(memberOf('http://terminology.hl7.org.au/ValueSet/rsg-source-document-type'))`) inv-pat-5: Recorded sex or gender jurisdiction shall be a member of the Jurisdiction ValueSet - AU Extended value set if any codes within that value set can apply (`extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('jurisdiction').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('jurisdiction').value.all(memberOf('http://terminology.hl7.org.au/ValueSet/jurisdiction-extended'))`) inv-pat-6: Recorded sex or gender source shall be a member of the AU Recorded Sex or Gender (RSG) Source value set if any codes within that value set can apply (`extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('source').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('source').value.ofType(CodeableConcept).all(memberOf('http://terminology.hl7.org.au/ValueSet/rsg-source'))`)
2. Patient.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Short | Logical 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.
Control | 0..1
Type | id
Is Modifier | false
Summary | true
4. Patient.meta
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Short | Metadata about the resource
Control | 0..1
Type | Meta
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
6. Patient.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
8. Patient.language
Definition | The base language in which the resource is written.
Short | Language of the resource content
Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Control | 0..1
Binding | The codes SHOULD be taken from CommonLanguages (preferred to `http://hl7.org/fhir/ValueSet/languages|4.0.1` ) A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
10. Patient.text
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Short | Text summary of the resource, for human interpretation
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Control | 0..1
Type | Narrative
Is Modifier | false
Summary | false
Alternate Names | narrative, html, xhtml, display
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
12. Patient.contained
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Short | Contained, inline Resources
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Control | 0..*
Type | Resource
Is Modifier | false
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
14. Patient.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Patient.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
16. Patient.extension:birthPlace
Slice Name | birthPlace
Definition | The registered place of birth of the patient. A sytem may use the address.text if they don't store the birthPlace address in discrete elements.
Short | Place of Birth for patient
Control | 0..1
Type | Extension(Patient Birth Place) (Extension Type: Address)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
18. Patient.extension:indigenousStatus
Slice Name | indigenousStatus
Definition | National Health Data Dictionary (NHDD) based indigenous status for a person.
Short | Indigenous status
Comments | This concept is equivalent to Australian Institute of Health and Welfare data element 602543 Person—Indigenous status, code N.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Australian Indigenous Status) (Extension Type: Coding)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
20. Patient.extension:veteranStatus
Slice Name | veteranStatus
Definition | Veteran / Australian Defence Force (ADF) status for a person.
Short | Veteran / Australian Defence Force (ADF) status
Comments | This concept is equivalent to Australian Institute of Health and Welfare data element 737931 Person—ADF veteran status, code N.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(Australian Veteran Status) (Extension Type: Coding)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
22. Patient.extension:closingTheGapRegistration
Slice Name | closingTheGapRegistration
Definition | Indication of eligibility for the Closing the Gap co-payment.
Short | Closing the Gap co-payment eligibility indicator
Comments | This concept is equivalent to Australian Institute of Health and Welfare data element 603671 Patient—Closing the Gap co-payment eligibility indicator.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Closing the Gap Registration) (Extension Type: boolean)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
24. Patient.extension:mothersMaidenName
Slice Name | mothersMaidenName
Definition | Mother's maiden (unmarried) name, commonly collected to help verify patient identity.
Short | Mother's Maiden name
Control | 0..1
Type | Extension(Patient Mother's Maiden Name) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
26. Patient.extension:interpreterRequired
Slice Name | interpreterRequired
Definition | Indicates whether an interpreter is required to facilitate communication in a healthcare setting. While this extension is named patient-interpreterRequired for backwards compatibility, it may also be used on RelatedPerson, Practitioner, and Encounter.
Short | Whether an interpreter is required
Comments | The individual does not speak the default language of the organization, and hence requires an interpreter. If other languages are in the Communications list, then that would be the type of interpreter required. While this extension is named patient-interpreterRequired for backwards compatibility, it may also be used on RelatedPerson, Practitioner, and Encounter. When used on Patient, RelatedPerson, or Practitioner, it indicates a default or assumed need for an interpreter. When used on Encounter, it indicates that an interpreter is needed to facilitate communication between some participants in that Encounter. The encounter-level evaluation of whether an interpreter is needed might involve evaluating the language proficiencies of the participants.
Control | 0..1
Type | Extension(Interpreter Required) (Extension Type: boolean)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
28. Patient.extension:dateOfArrival
Slice Name | dateOfArrival
Definition | The date a person first arrived in Australia, from another country, with the intention of living in Australia for one year or more. This date is captured once for a person and is not subsequently updated with subsequent arrivals.
Short | The date a person first arrived in Australia, from another country, with the intention of living in Australia for one year or more
Comments | See Australian Bureau of Statics (ABS) 1200.0.55.007 - Year of Arrival Standard, 2014, Version 1.5 for further information. This concept is equivalent to Australian Institute of Health and Welfare data element 269447 Person—year of first arrival in Australia.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Date of Arrival in Australia) (Extension Type: date)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
30. Patient.extension:genderIdentity
Slice Name | genderIdentity
Definition | An individual's personal sense of being a man, woman, boy, girl, nonbinary, or something else.
Short | Gender identity shall be a member of the Gender Identity Response value set if any codes within that value set can apply
Comments | The individual's gender identity is populated in the `extension:value.value[x]` of the Individual Gender Identity extension and shall contain one of the codes from the Gender Identity Response value set if any of the codes within the value set can apply. See Australian Bureau of Statics (ABS) Standard for Sex, Gender, Variations of Sex Characteristics and Sexual Orientation Variables, 2020 for further materials.
Control | 0..* This element is affected by the following invariants: inv-pat-1
Type | Extension(Individual Gender Identity) (Complex Extension)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
32. Patient.extension:individualPronouns
Slice Name | individualPronouns
Definition | The pronouns to use when referring to an individual in verbal or written communication.
Short | Pronouns shall be a member of the Australian Pronouns value set if any codes within that value set can apply
Comments | The individual's pronouns are populated in the `extension:value.value[x]` of the Individual Pronouns extension and shall contain one of the codes from the Australian Pronouns value set if any of the codes within the value set can apply.
Control | 0..* This element is affected by the following invariants: inv-pat-2
Type | Extension(Individual Pronouns) (Complex Extension)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
34. Patient.extension:recordedSexOrGender
Slice Name | recordedSexOrGender
Definition | A sex or gender property for the individual from a document or other record
Short | Recorded sex or gender type shall be a member of the AU Recorded Sex or Gender Type value set if any codes within that value set can apply. Recorded sex or gender source document type shall be a member of the AU Recorded Sex or Gender (RSG) Source Document Type value set if any codes within that value set can apply. Recorded sex or gender jurisdiction shall be a member of the Jurisdiction - ValueSet AU Extended value set if any codes within that value set can apply. Recorded sex or gender source shall be a member of the AU Recorded Sex or Gender (RSG) Source value set if any codes within that value set can apply.
Comments | The type of recorded sex or gender is populated in the `extension:type.value[x]` of the Person Recorded Sex or Gender extension and shall contain one of the codes from the AU Recorded Sex or Gender Type value set if any of the codes within the value set can apply. The document from which the sex or gender property was acquired is populated in the `extension:sourceDocument.value[x]` of the Person Recorded Sex or Gender extension and shall contain one of the codes from the AU Recorded Sex or Gender (RSG) Source Document Type value set if any of the codes within the value set can apply. The jurisdiction that issued the document where the sex or gender was acquired is populated in the `extension:jurisdiction.value[x]` of the Person Recorded Sex or Gender extension and shall contain one of the codes from the Jurisdiction ValueSet - AU Extended value set if any of the codes within the value set can apply. The non-document source from which the sex or gender property was acquired is populated in the `extension:source.value[x]` of the Person Recorded Sex or Gender extension and shall contain one of the codes from the AU Recorded Sex or Gender (RSG) Source value set if any of the codes within the value set can apply.
Control | 0..* This element is affected by the following invariants: inv-pat-3, inv-pat-4, inv-pat-5, inv-pat-6
Type | Extension(Person Recorded Sex Or Gender) (Complex Extension)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
36. Patient.extension:sexParameterForClinicalUse
Slice Name | sexParameterForClinicalUse
Definition | A parameter that provides guidance on how a recipient should apply settings or reference ranges that are derived from observable information such as an organ inventory, recent hormone lab tests, genetic testing, menstrual status, obstetric history, etc..
Short | A context-specific sex parameter for clinical use
Control | 0..*
Type | Extension(Patient Sex Parameter For Clinical Use) (Complex Extension)
Is Modifier | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
38. Patient.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
40. Patient.identifier
Definition | An identifier for this patient.
Short | Identifies this patient across multiple systems
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier(Identifier, AU IHI, AU Medicare Card Number, AU DVA Number, AU Health Care Card Number, AU Pensioner Concession Card Number, AU Commonwealth Seniors Health Card Number, AU Medical Record Number, AU Insurance Member Number, AU Patient Internal Identifier)
Is Modifier | false
Summary | true
Requirements | Patients are almost always assigned specific numerical identifiers.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
42. Patient.active
Definition | Whether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules. It is often used to filter patient lists to exclude inactive patients Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death.
Short | Whether this patient's record is in active use
Comments | If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient.
Control | 0..1
Type | boolean
Is Modifier | true because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to be able to mark a patient record as not to be used because it was created in error.
Meaning if Missing | This resource is generally assumed to be active if no value is provided for the active element
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
44. Patient.name
Definition | A name associated with the individual.
Short | A 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.
Control | 0..*
Type | HumanName
Is Modifier | false
Summary | true
Requirements | Need to be able to track the patient by multiple names. Examples are your official name and a partner name.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
46. Patient.telecom
Definition | A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted.
Short | A contact detail for the individual
Comments | A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).
Control | 0..*
Type | ContactPoint
Is Modifier | false
Summary | true
Requirements | People have (primary) ways to contact them in some way such as phone, email.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
48. Patient.gender
Definition | Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes.
Short | male | female | other | unknown
Comments | The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex.
Control | 0..1
Binding | The codes SHALL be taken from AdministrativeGender (required to `http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1` ) The gender of a person used for administrative purposes.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Needed for identification of the individual, in combination with (at least) name and birth date.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
50. Patient.birthDate
Definition | The date of birth for the individual.
Short | Date of birth extended for time and accuracy indicator
Comments | At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternity/infant care systems).
Control | 0..1 This element is affected by the following invariants: inv-pat-0
Type | date
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Age of the individual drives many clinical processes. May include accuracy indicator and specific birth time.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
LOINC Code | 21112-8
52. Patient.birthDate.id
Definition | unique id for the element within a resource (for internal references)
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
54. Patient.birthDate.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Patient.birthDate.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
56. Patient.birthDate.extension:accuracyIndicator
Slice Name | accuracyIndicator
Definition | General date accuracy indicator coding.
Short | Birth date accuracy indicator
Comments | In some circumstances, systems may only have date or datetime data that has unknown or estimated parts. This coding establishes the accuracy of the day, month and year parts.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Date Accuracy Indicator) (Extension Type: Coding)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
58. Patient.birthDate.extension:birthTime
Slice Name | birthTime
Definition | The time of day that the patient was born. This includes the date to ensure that the timezone information can be communicated effectively.
Short | Birth time
Comments | The patient prefix on the extension was retained to ensure backward compatibility with existing data (the content itself is provided to assist in sharing data across patient resources effectively)
Control | 0..1 This element is affected by the following invariants: inv-pat-0
Type | Extension(Patient/Person/RelatedPerson/Practitioner Birth Time) (Extension Type: dateTime)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
60. Patient.birthDate.value
Definition | The actual value
Short | Primitive value for date
Control | 0..1
Type | date
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
62. Patient.deceased[x]
Definition | Indicates if the individual is deceased or not. Deceased date accuracy indicator is optional.
Short | Indicates if the individual is deceased or not
Comments | If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.
Control | 0..1
Type | Choice of: boolean, dateTime
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | true because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Patient.deceased[x]`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: type @ $this
64. Patient.deceased[x]:deceasedBoolean
Slice Name | deceasedBoolean
Definition | Boolean indicator if the individual is deceased or not.
Short | Deceased indicator
Comments | If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.
Control | 0..1
Type | boolean
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | true because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
66. Patient.deceased[x]:deceasedDateTime
Slice Name | deceasedDateTime
Definition | Individual deceased date-time with optional accuracy indicator.
Short | Deceased date time
Comments | If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.
Control | 0..1
Type | dateTime
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | true because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
68. Patient.deceased[x]:deceasedDateTime.id
Definition | unique id for the element within a resource (for internal references)
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
70. Patient.deceased[x]:deceasedDateTime.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Patient.deceased[x].extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
72. Patient.deceased[x]:deceasedDateTime.extension:accuracyIndicator
Slice Name | accuracyIndicator
Definition | General date accuracy indicator coding.
Short | Deceased date accuracy indicator
Comments | In some circumstances, systems may only have date or datetime data that has unknown or estimated parts. This coding establishes the accuracy of the day, month and year parts.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Date Accuracy Indicator) (Extension Type: Coding)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
74. Patient.deceased[x]:deceasedDateTime.value
Definition | The actual value
Short | Primitive value for dateTime
Control | 0..1
Type | dateTime
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
76. Patient.address
Definition | An address for the individual.
Short | An address for the individual
Comments | The address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource).
Control | 0..*
Type | Address(Australian Address, Address)
Is Modifier | false
Summary | true
Requirements | May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
78. Patient.maritalStatus
Definition | This field contains a patient's most recent marital (civil) status.
Short | Marital (civil) status of a patient
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from Marital Status Codes (extensible to `http://hl7.org/fhir/ValueSet/marital-status|4.0.1` ) The domestic partnership status of a person.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Most, if not all systems capture it.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
80. Patient.multipleBirth[x]
Definition | Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer).
Short | Whether patient is part of a multiple birth
Comments | Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in triplets would be valueInteger=2 and the third born would have valueInteger=3 If a boolean value was provided for this triplets example, then all 3 patient records would have valueBoolean=true (the ordering is not indicated).
Control | 0..1
Type | Choice of: boolean, integer
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
82. Patient.photo
Definition | Image of the patient.
Short | Image of the patient
Comments | Guidelines: Use id photos, not clinical photos. Limit dimensions to thumbnail. Keep byte count low to ease resource updates.
Control | 0..*
Type | Attachment
Is Modifier | false
Summary | false
Requirements | Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
84. Patient.contact
Definition | A contact party (e.g. guardian, partner, friend) for the patient.
Short | A contact party (e.g. guardian, partner, friend) for the patient
Comments | Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | Need to track people you can contact about the patient.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) pat-1: SHALL at least contain a contact's details or a reference to an organization (`name.exists() or telecom.exists() or address.exists() or organization.exists()`)
86. Patient.contact.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
88. 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
90. Patient.contact.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
92. Patient.contact.relationship
Definition | The nature of the relationship between the patient and the contact person.
Short | The kind of relationship
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from https://healthterminologies.gov.au/fhir/ValueSet/contact-relationship-type-3 (extensible to `https://healthterminologies.gov.au/fhir/ValueSet/contact-relationship-type-3` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Used to determine which contact person is the most relevant to approach, depending on circumstances.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
94. Patient.contact.name
Definition | A name associated with the contact person.
Short | A name associated with the contact person
Control | 0..1
Type | HumanName
Is Modifier | false
Summary | false
Requirements | Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
96. Patient.contact.telecom
Definition | A contact detail for the person, e.g. a telephone number or an email address.
Short | A contact detail for the person
Comments | Contact may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification.
Control | 0..*
Type | ContactPoint
Is Modifier | false
Summary | false
Requirements | People have (primary) ways to contact them in some way such as phone, email.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
98. Patient.contact.address
Definition | Address for the contact person.
Short | Address for the contact person
Comments | The address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource).
Control | 0..1
Type | Address(Address, Australian Address)
Is Modifier | false
Summary | false
Requirements | Need to keep track where the contact person can be contacted per postal mail or visited.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
100. Patient.contact.gender
Definition | Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes.
Short | male | female | other | unknown
Control | 0..1
Binding | The codes SHALL be taken from AdministrativeGender (required to `http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1` ) The gender of a person used for administrative purposes.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Needed to address the person correctly.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
102. Patient.contact.organization
Definition | Organization on behalf of which the contact is acting or for which the contact is working.
Short | Organization that is associated with the contact
Control | 0..1 This element is affected by the following invariants: pat-1
Type | Reference(Organization)
Is Modifier | false
Summary | false
Requirements | For guardians or business related contacts, the organization is relevant.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
104. Patient.contact.period
Definition | The period during which this contact person or organization is valid to be contacted relating to this patient.
Short | The period during which this contact person or organization is valid to be contacted relating to this patient
Control | 0..1
Type | Period
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
106. Patient.communication
Definition | A language which may be used to communicate with the patient about his or her health.
Short | A language which may be used to communicate with the patient about his or her health
Comments | If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
108. Patient.communication.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
110. 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
112. 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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
114. Patient.communication.language
Definition | The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English.
Short | The language which can be used to communicate with the patient about his or her health
Comments | The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from https://healthterminologies.gov.au/fhir/ValueSet/common-languages-australia-2 (extensible to `https://healthterminologies.gov.au/fhir/ValueSet/common-languages-australia-2` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
116. Patient.communication.preferred
Definition | Indicates whether or not the patient prefers this language (over other languages he masters up a certain level).
Short | Language preference indicator
Comments | This language is specifically identified for communicating healthcare information.
Control | 0..1
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
118. Patient.generalPractitioner
Definition | Patient's nominated care provider.
Short | Patient'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.
Control | 0..*
Type | Reference(Organization, Practitioner, PractitionerRole)
Is Modifier | false
Summary | false
Alternate Names | careProvider
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
120. Patient.managingOrganization
Definition | Organization that is the custodian of the patient record.
Short | Organization 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).
Control | 0..1
Type | Reference(Organization)
Is Modifier | false
Summary | true
Requirements | Need to know who recognizes this patient record, manages and updates it.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
122. Patient.link
Definition | Link to a Patient or RelatedPerson resource that concerns the same actual person.
Short | Link to a Patient or RelatedPerson resource that concerns the same actual person
Comments | There is no assumption that linked patient records have mutual links.
Control | 0..*
Type | BackboneElement
Is Modifier | true because This element is labeled as a modifier because it might not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'
Summary | true
Requirements | There are multiple use cases: Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and Distribution of patient information across multiple servers.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
124. Patient.link.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
126. 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
128. 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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
130. Patient.link.other
Definition | The other patient resource that the link refers to.
Short | The other patient or related person resource that the link refers to
Comments | Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.
Control | 1..1
Type | Reference(Patient, RelatedPerson)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
132. Patient.link.type
Definition | The type of link between this patient resource and another patient resource.
Short | replaced-by | replaces | refer | seealso
Control | 1..1
Binding | The codes SHALL be taken from LinkType (required to `http://hl7.org/fhir/ValueSet/link-type|4.0.1` ) The type of link between this patient resource and another patient resource.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)