SIL HIE Implementation Guide, published by Kathurima Kimathi. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/savannahghi/hie-fhir-ig-profile/ and changes regularly. See the Directory of published versions

• Content
• Detailed Descriptions
• Mappings
• Examples
• XML
• JSON
• TTL

Resource Profile: HIE Patient

R4B Patient constrained for HIE workflows.

Usages:

• Refer to this Profile: HIE AllergyIntolerance, HIE Appointment, HIE AppointmentResponse, HIE Claim... Show 10 more, HIE ClaimResponse, HIE Condition, HIE Consent, HIE DiagnosticReport, HIE DocumentReference, HIE MedicationDispense, HIE MedicationRequest, HIE Patient, HIE QuestionnaireResponse and HIE ServiceRequest
• Examples for this Profile: Patient/HIEPatient-example

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Patient		0..*	Patient	Information about an individual or animal receiving health care services
Patient.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Patient.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
Patient.identifier	Σ This element is included in summaries.	1..*	Identifier	An identifier for this patient
Patient.identifier.use	?! This element is a modifier element. Σ This element is included in summaries.	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
Patient.identifier.type	Σ This element is included in summaries. C	1..1	HIECodeableConcept	Description of identifier Binding: HIE Person Identifier Types (required) Constraints: cc-text-or-code
Patient.identifier.system	Σ This element is included in summaries.	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
Patient.identifier.value	S This element must be supported. Σ This element is included in summaries.	1..1	string	The value that is unique Example General: 123456
Patient.identifier.assigner	S This element must be supported. Σ This element is included in summaries.	0..1	HIEReference(HIE Organization)	Organization that issued id (may be just text)
Patient.active	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	boolean	Whether this patient's record is in active use
Patient.name	S This element must be supported. Σ This element is included in summaries.	1..1	HIEHumanName	A name associated with the patient
Patient.telecom	S This element must be supported. Σ This element is included in summaries.	0..*	HIEContactPoint	A contact detail for the individual
Patient.gender	Σ This element is included in summaries.	1..1	code	male | female | other | unknown Binding: AdministrativeGender (required)
Patient.birthDate	S This element must be supported. Σ This element is included in summaries.	0..1	date	The date of birth for the individual
Patient.deceased[x]	?! This element is a modifier element. Σ This element is included in summaries.	0..1		Indicates if the individual is deceased or not
Patient.deceased[x].deceasedBoolean			boolean
Patient.deceased[x].deceasedDateTime			dateTime
Patient.maritalStatus	S This element must be supported. C	0..1	HIECodeableConcept	Marital (civil) status of a patient Binding: Marital Status Codes (extensible) Constraints: cc-text-or-code
Patient.contact	S This element must be supported. C	0..*	BackboneElement	A contact party (e.g. guardian, partner, friend) for the patient Constraints: pat-1
Patient.contact.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Patient.contact.relationship	S This element must be supported. C	1..*	HIECodeableConcept	The kind of relationship Binding: PatientContactRelationship (extensible) Constraints: cc-text-or-code
Patient.contact.telecom		1..*	HIEContactPoint	A contact detail for the person
Patient.contact.organization	C	0..1	HIEReference(HIE Organization)	Organization that is associated with the contact
Patient.communication	S This element must be supported.	0..*	BackboneElement	A language which may be used to communicate with the patient about his or her health
Patient.communication.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Patient.communication.language	S This element must be supported. C	1..1	HIECodeableConcept	The language which can be used to communicate with the patient about his or her health Binding: AllLanguages (extensible) Constraints: cc-text-or-code
Patient.generalPractitioner	S This element must be supported.	0..*	HIEReference(HIE Practitioner | PractitionerRole | HIE Organization)	Patient's nominated primary care provider
Patient.managingOrganization	S This element must be supported. Σ This element is included in summaries.	1..1	HIEReference(HIE Organization)	Organization that is the custodian of the patient record
Patient.link	?! This element is a modifier element. Σ This element is included in summaries.	0..*	BackboneElement	Link to another patient resource that concerns the same actual person
Patient.link.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Patient.link.other	Σ This element is included in summaries.	1..1	HIEReference(HIE Patient)	The other patient or related person resource that the link refers to
Patient.link.type	Σ This element is included in summaries.	1..1	code	replaced-by | replaces | refer | seealso Binding: LinkType (required): The type of link between this patient resource and another patient resource.
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Patient.identifier.use	Base	required	IdentifierUse	📍4.3.0	FHIR Std.
Patient.identifier.type	Base	required	HIE Person Identifier Types	📦0.1.0	This IG
Patient.gender	Base	required	AdministrativeGender	📦4.3.0	FHIR Std.
Patient.maritalStatus	Base	extensible	MaritalStatus	📦4.3.0	FHIR Std.
Patient.contact.relationship	Base	extensible	Patient Contact Relationship	📦4.3.0	FHIR Std.
Patient.communication.​language	Base	extensible	All Languages	📦4.3.0	FHIR Std.
Patient.link.type	Base	required	LinkType	📍4.3.0	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
cc-text-or-code	warning	Patient.identifier.type, Patient.maritalStatus, Patient.contact.relationship, Patient.communication.language	Text is optional, coding is required	coding.exists()
dom-2	error	Patient	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Patient	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where(((id.exists() and ('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url)))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(uri) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Patient	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	error	Patient	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Patient	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
pat-1	error	Patient.contact	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()

This structure is derived from Patient

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Patient		0..*	Patient	Information about an individual or animal receiving health care services
Patient.text
Patient.text.status		1..1	code	generated | extensions | additional | empty Required Pattern: generated (extensions allowed)
Patient.identifier		1..*	Identifier	An identifier for this patient
Patient.identifier.use		1..1	code	usual | official | temp | secondary | old (If known)
Patient.identifier.type		1..1	HIECodeableConcept	Description of identifier Binding: HIE Person Identifier Types (required)
Patient.identifier.system		1..1	uri	The namespace for the identifier value
Patient.identifier.value	S This element must be supported.	1..1	string	The value that is unique
Patient.identifier.assigner	S This element must be supported.	0..1	HIEReference(HIE Organization)	Organization that issued id (may be just text)
Patient.active	S This element must be supported.	1..1	boolean	Whether this patient's record is in active use
Patient.name	S This element must be supported.	1..1	HIEHumanName	A name associated with the patient
Patient.telecom	S This element must be supported.	0..*	HIEContactPoint	A contact detail for the individual
Patient.gender		1..1	code	male | female | other | unknown Binding: AdministrativeGender (required)
Patient.birthDate	S This element must be supported.	0..1	date	The date of birth for the individual
Patient.maritalStatus	S This element must be supported.	0..1	HIECodeableConcept	Marital (civil) status of a patient Binding: Marital Status Codes (extensible)
Patient.contact	S This element must be supported.	0..*	BackboneElement	A contact party (e.g. guardian, partner, friend) for the patient
Patient.contact.relationship	S This element must be supported.	1..*	HIECodeableConcept	The kind of relationship Binding: PatientContactRelationship (extensible)
Patient.contact.telecom		1..*	HIEContactPoint	A contact detail for the person
Patient.contact.organization		0..1	HIEReference(HIE Organization)	Organization that is associated with the contact
Patient.communication	S This element must be supported.	0..*	BackboneElement	A language which may be used to communicate with the patient about his or her health
Patient.communication.language	S This element must be supported.	1..1	HIECodeableConcept	The language which can be used to communicate with the patient about his or her health Binding: AllLanguages (extensible)
Patient.generalPractitioner	S This element must be supported.	0..*	HIEReference(HIE Practitioner | PractitionerRole | HIE Organization)	Patient's nominated primary care provider
Patient.managingOrganization	S This element must be supported.	1..1	HIEReference(HIE Organization)	Organization that is the custodian of the patient record
Patient.link
Patient.link.other		1..1	HIEReference(HIE Patient)	The other patient or related person resource that the link refers to
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Patient.identifier.type	Base	required	HIE Person Identifier Types	📦0.1.0	This IG
Patient.gender	Base	required	AdministrativeGender	📦4.3.0	FHIR Std.
Patient.maritalStatus	Base	extensible	MaritalStatus	📦4.3.0	FHIR Std.
Patient.contact.relationship	Base	extensible	Patient Contact Relationship	📦4.3.0	FHIR Std.
Patient.communication.​language	Base	extensible	All Languages	📦4.3.0	FHIR Std.

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Patient		0..*	Patient	Information about an individual or animal receiving health care services
Patient.id	Σ This element is included in summaries.	0..1	id	Logical id of this artifact
Patient.meta	Σ This element is included in summaries.	0..1	Meta	Metadata about the resource
Patient.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Patient.language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): IETF language tag Additional Bindings Purpose AllLanguages Max Binding
Patient.text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
Patient.text.id		0..1	id	Unique id for inter-element referencing
Patient.text.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Patient.text.status		1..1	code	generated | extensions | additional | empty Binding: NarrativeStatus (required) Required Pattern: generated (extensions allowed)
Patient.text.div	C	1..1	xhtml	Limited xhtml content Constraints: txt-1, txt-2
Patient.contained		0..*	Resource	Contained, inline Resources Constraints: dom-r4b
Patient.extension		0..*	Extension	Additional content defined by implementations
Patient.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
Patient.identifier	Σ This element is included in summaries.	1..*	Identifier	An identifier for this patient
Patient.identifier.id		0..1	id	Unique id for inter-element referencing
Patient.identifier.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Patient.identifier.use	?! This element is a modifier element. Σ This element is included in summaries.	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
Patient.identifier.type	Σ This element is included in summaries. C	1..1	HIECodeableConcept	Description of identifier Binding: HIE Person Identifier Types (required) Constraints: cc-text-or-code
Patient.identifier.system	Σ This element is included in summaries.	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
Patient.identifier.value	S This element must be supported. Σ This element is included in summaries.	1..1	string	The value that is unique Example General: 123456
Patient.identifier.period	Σ This element is included in summaries.	0..1	Period	Time period when id is/was valid for use
Patient.identifier.assigner	S This element must be supported. Σ This element is included in summaries.	0..1	HIEReference(HIE Organization)	Organization that issued id (may be just text)
Patient.active	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	boolean	Whether this patient's record is in active use
Patient.name	S This element must be supported. Σ This element is included in summaries.	1..1	HIEHumanName	A name associated with the patient
Patient.telecom	S This element must be supported. Σ This element is included in summaries.	0..*	HIEContactPoint	A contact detail for the individual
Patient.gender	Σ This element is included in summaries.	1..1	code	male | female | other | unknown Binding: AdministrativeGender (required)
Patient.birthDate	S This element must be supported. Σ This element is included in summaries.	0..1	date	The date of birth for the individual
Patient.deceased[x]	?! This element is a modifier element. Σ This element is included in summaries.	0..1		Indicates if the individual is deceased or not
Patient.deceased[x].deceasedBoolean			boolean
Patient.deceased[x].deceasedDateTime			dateTime
Patient.address	Σ This element is included in summaries.	0..*	Address	An address for the individual
Patient.maritalStatus	S This element must be supported. C	0..1	HIECodeableConcept	Marital (civil) status of a patient Binding: Marital Status Codes (extensible) Constraints: cc-text-or-code
Patient.multipleBirth[x]		0..1		Whether patient is part of a multiple birth
Patient.multipleBirth[x].multipleBirthBoolean			boolean
Patient.multipleBirth[x].multipleBirthInteger			integer
Patient.photo		0..*	Attachment	Image of the patient
Patient.contact	S This element must be supported. C	0..*	BackboneElement	A contact party (e.g. guardian, partner, friend) for the patient Constraints: pat-1
Patient.contact.id		0..1	string	Unique id for inter-element referencing
Patient.contact.extension		0..*	Extension	Additional content defined by implementations
Patient.contact.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Patient.contact.relationship	S This element must be supported. C	1..*	HIECodeableConcept	The kind of relationship Binding: PatientContactRelationship (extensible) Constraints: cc-text-or-code
Patient.contact.name		0..1	HumanName	A name associated with the contact person
Patient.contact.telecom		1..*	HIEContactPoint	A contact detail for the person
Patient.contact.address		0..1	Address	Address for the contact person
Patient.contact.gender		0..1	code	male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
Patient.contact.organization	C	0..1	HIEReference(HIE Organization)	Organization that is associated with the contact
Patient.contact.period		0..1	Period	The period during which this contact person or organization is valid to be contacted relating to this patient
Patient.communication	S This element must be supported.	0..*	BackboneElement	A language which may be used to communicate with the patient about his or her health
Patient.communication.id		0..1	string	Unique id for inter-element referencing
Patient.communication.extension		0..*	Extension	Additional content defined by implementations
Patient.communication.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Patient.communication.language	S This element must be supported. C	1..1	HIECodeableConcept	The language which can be used to communicate with the patient about his or her health Binding: AllLanguages (extensible) Constraints: cc-text-or-code
Patient.communication.preferred		0..1	boolean	Language preference indicator
Patient.generalPractitioner	S This element must be supported.	0..*	HIEReference(HIE Practitioner | PractitionerRole | HIE Organization)	Patient's nominated primary care provider
Patient.managingOrganization	S This element must be supported. Σ This element is included in summaries.	1..1	HIEReference(HIE Organization)	Organization that is the custodian of the patient record
Patient.link	?! This element is a modifier element. Σ This element is included in summaries.	0..*	BackboneElement	Link to another patient resource that concerns the same actual person
Patient.link.id		0..1	string	Unique id for inter-element referencing
Patient.link.extension		0..*	Extension	Additional content defined by implementations
Patient.link.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Patient.link.other	Σ This element is included in summaries.	1..1	HIEReference(HIE Patient)	The other patient or related person resource that the link refers to
Patient.link.type	Σ This element is included in summaries.	1..1	code	replaced-by | replaces | refer | seealso Binding: LinkType (required): The type of link between this patient resource and another patient resource.
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Patient.language	Base	preferred	Common Languages	📍4.3.0	FHIR Std.
Patient.text.status	Base	required	NarrativeStatus	📍4.3.0	FHIR Std.
Patient.identifier.use	Base	required	IdentifierUse	📍4.3.0	FHIR Std.
Patient.identifier.type	Base	required	HIE Person Identifier Types	📦0.1.0	This IG
Patient.gender	Base	required	AdministrativeGender	📦4.3.0	FHIR Std.
Patient.maritalStatus	Base	extensible	MaritalStatus	📦4.3.0	FHIR Std.
Patient.contact.relationship	Base	extensible	Patient Contact Relationship	📦4.3.0	FHIR Std.
Patient.contact.gender	Base	required	AdministrativeGender	📍4.3.0	FHIR Std.
Patient.communication.​language	Base	extensible	All Languages	📦4.3.0	FHIR Std.
Patient.link.type	Base	required	LinkType	📍4.3.0	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
cc-text-or-code	warning	Patient.identifier.type, Patient.maritalStatus, Patient.contact.relationship, Patient.communication.language	Text is optional, coding is required	coding.exists()
dom-2	error	Patient	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Patient	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where(((id.exists() and ('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url)))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(uri) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Patient	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	error	Patient	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Patient	A resource should have narrative for robust management	text.`div`.exists()
dom-r4b	warning	Patient.contained	Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems	($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic)
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
pat-1	error	Patient.contact	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()
txt-1	error	Patient.text.div	The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes	htmlChecks()
txt-2	error	Patient.text.div	The narrative SHALL have some non-whitespace content	htmlChecks()

This structure is derived from Patient

Summary

Mandatory: 9 elements(2 nested mandatory elements)
Must-Support: 13 elements

Structures

This structure refers to these other structures:

• HIE CodeableConcept (https://nshr.dha.go.ke/fhir/StructureDefinition/codeable-concept)
• HIE Reference (https://nshr.dha.go.ke/fhir/StructureDefinition/reference)
• HIE Organization (https://nshr.dha.go.ke/fhir/StructureDefinition/organization)
• HIE HumanName (https://nshr.dha.go.ke/fhir/StructureDefinition/human-name)
• HIE ContactPoint (https://nshr.dha.go.ke/fhir/StructureDefinition/contact-point)
• HIE Practitioner (https://nshr.dha.go.ke/fhir/StructureDefinition/practitioner)
• HIE Patient (https://nshr.dha.go.ke/fhir/StructureDefinition/patient)

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Patient		0..*	Patient	Information about an individual or animal receiving health care services
Patient.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Patient.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
Patient.identifier	Σ This element is included in summaries.	1..*	Identifier	An identifier for this patient
Patient.identifier.use	?! This element is a modifier element. Σ This element is included in summaries.	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
Patient.identifier.type	Σ This element is included in summaries. C	1..1	HIECodeableConcept	Description of identifier Binding: HIE Person Identifier Types (required) Constraints: cc-text-or-code
Patient.identifier.system	Σ This element is included in summaries.	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
Patient.identifier.value	S This element must be supported. Σ This element is included in summaries.	1..1	string	The value that is unique Example General: 123456
Patient.identifier.assigner	S This element must be supported. Σ This element is included in summaries.	0..1	HIEReference(HIE Organization)	Organization that issued id (may be just text)
Patient.active	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	boolean	Whether this patient's record is in active use
Patient.name	S This element must be supported. Σ This element is included in summaries.	1..1	HIEHumanName	A name associated with the patient
Patient.telecom	S This element must be supported. Σ This element is included in summaries.	0..*	HIEContactPoint	A contact detail for the individual
Patient.gender	Σ This element is included in summaries.	1..1	code	male | female | other | unknown Binding: AdministrativeGender (required)
Patient.birthDate	S This element must be supported. Σ This element is included in summaries.	0..1	date	The date of birth for the individual
Patient.deceased[x]	?! This element is a modifier element. Σ This element is included in summaries.	0..1		Indicates if the individual is deceased or not
Patient.deceased[x].deceasedBoolean			boolean
Patient.deceased[x].deceasedDateTime			dateTime
Patient.maritalStatus	S This element must be supported. C	0..1	HIECodeableConcept	Marital (civil) status of a patient Binding: Marital Status Codes (extensible) Constraints: cc-text-or-code
Patient.contact	S This element must be supported. C	0..*	BackboneElement	A contact party (e.g. guardian, partner, friend) for the patient Constraints: pat-1
Patient.contact.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Patient.contact.relationship	S This element must be supported. C	1..*	HIECodeableConcept	The kind of relationship Binding: PatientContactRelationship (extensible) Constraints: cc-text-or-code
Patient.contact.telecom		1..*	HIEContactPoint	A contact detail for the person
Patient.contact.organization	C	0..1	HIEReference(HIE Organization)	Organization that is associated with the contact
Patient.communication	S This element must be supported.	0..*	BackboneElement	A language which may be used to communicate with the patient about his or her health
Patient.communication.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Patient.communication.language	S This element must be supported. C	1..1	HIECodeableConcept	The language which can be used to communicate with the patient about his or her health Binding: AllLanguages (extensible) Constraints: cc-text-or-code
Patient.generalPractitioner	S This element must be supported.	0..*	HIEReference(HIE Practitioner | PractitionerRole | HIE Organization)	Patient's nominated primary care provider
Patient.managingOrganization	S This element must be supported. Σ This element is included in summaries.	1..1	HIEReference(HIE Organization)	Organization that is the custodian of the patient record
Patient.link	?! This element is a modifier element. Σ This element is included in summaries.	0..*	BackboneElement	Link to another patient resource that concerns the same actual person
Patient.link.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Patient.link.other	Σ This element is included in summaries.	1..1	HIEReference(HIE Patient)	The other patient or related person resource that the link refers to
Patient.link.type	Σ This element is included in summaries.	1..1	code	replaced-by | replaces | refer | seealso Binding: LinkType (required): The type of link between this patient resource and another patient resource.
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Patient.identifier.use	Base	required	IdentifierUse	📍4.3.0	FHIR Std.
Patient.identifier.type	Base	required	HIE Person Identifier Types	📦0.1.0	This IG
Patient.gender	Base	required	AdministrativeGender	📦4.3.0	FHIR Std.
Patient.maritalStatus	Base	extensible	MaritalStatus	📦4.3.0	FHIR Std.
Patient.contact.relationship	Base	extensible	Patient Contact Relationship	📦4.3.0	FHIR Std.
Patient.communication.​language	Base	extensible	All Languages	📦4.3.0	FHIR Std.
Patient.link.type	Base	required	LinkType	📍4.3.0	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
cc-text-or-code	warning	Patient.identifier.type, Patient.maritalStatus, Patient.contact.relationship, Patient.communication.language	Text is optional, coding is required	coding.exists()
dom-2	error	Patient	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Patient	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where(((id.exists() and ('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url)))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(uri) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Patient	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	error	Patient	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Patient	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
pat-1	error	Patient.contact	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()

Differential View

This structure is derived from Patient

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Patient		0..*	Patient	Information about an individual or animal receiving health care services
Patient.text
Patient.text.status		1..1	code	generated | extensions | additional | empty Required Pattern: generated (extensions allowed)
Patient.identifier		1..*	Identifier	An identifier for this patient
Patient.identifier.use		1..1	code	usual | official | temp | secondary | old (If known)
Patient.identifier.type		1..1	HIECodeableConcept	Description of identifier Binding: HIE Person Identifier Types (required)
Patient.identifier.system		1..1	uri	The namespace for the identifier value
Patient.identifier.value	S This element must be supported.	1..1	string	The value that is unique
Patient.identifier.assigner	S This element must be supported.	0..1	HIEReference(HIE Organization)	Organization that issued id (may be just text)
Patient.active	S This element must be supported.	1..1	boolean	Whether this patient's record is in active use
Patient.name	S This element must be supported.	1..1	HIEHumanName	A name associated with the patient
Patient.telecom	S This element must be supported.	0..*	HIEContactPoint	A contact detail for the individual
Patient.gender		1..1	code	male | female | other | unknown Binding: AdministrativeGender (required)
Patient.birthDate	S This element must be supported.	0..1	date	The date of birth for the individual
Patient.maritalStatus	S This element must be supported.	0..1	HIECodeableConcept	Marital (civil) status of a patient Binding: Marital Status Codes (extensible)
Patient.contact	S This element must be supported.	0..*	BackboneElement	A contact party (e.g. guardian, partner, friend) for the patient
Patient.contact.relationship	S This element must be supported.	1..*	HIECodeableConcept	The kind of relationship Binding: PatientContactRelationship (extensible)
Patient.contact.telecom		1..*	HIEContactPoint	A contact detail for the person
Patient.contact.organization		0..1	HIEReference(HIE Organization)	Organization that is associated with the contact
Patient.communication	S This element must be supported.	0..*	BackboneElement	A language which may be used to communicate with the patient about his or her health
Patient.communication.language	S This element must be supported.	1..1	HIECodeableConcept	The language which can be used to communicate with the patient about his or her health Binding: AllLanguages (extensible)
Patient.generalPractitioner	S This element must be supported.	0..*	HIEReference(HIE Practitioner | PractitionerRole | HIE Organization)	Patient's nominated primary care provider
Patient.managingOrganization	S This element must be supported.	1..1	HIEReference(HIE Organization)	Organization that is the custodian of the patient record
Patient.link
Patient.link.other		1..1	HIEReference(HIE Patient)	The other patient or related person resource that the link refers to
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Patient.identifier.type	Base	required	HIE Person Identifier Types	📦0.1.0	This IG
Patient.gender	Base	required	AdministrativeGender	📦4.3.0	FHIR Std.
Patient.maritalStatus	Base	extensible	MaritalStatus	📦4.3.0	FHIR Std.
Patient.contact.relationship	Base	extensible	Patient Contact Relationship	📦4.3.0	FHIR Std.
Patient.communication.​language	Base	extensible	All Languages	📦4.3.0	FHIR Std.

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Patient		0..*	Patient	Information about an individual or animal receiving health care services
Patient.id	Σ This element is included in summaries.	0..1	id	Logical id of this artifact
Patient.meta	Σ This element is included in summaries.	0..1	Meta	Metadata about the resource
Patient.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Patient.language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): IETF language tag Additional Bindings Purpose AllLanguages Max Binding
Patient.text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
Patient.text.id		0..1	id	Unique id for inter-element referencing
Patient.text.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Patient.text.status		1..1	code	generated | extensions | additional | empty Binding: NarrativeStatus (required) Required Pattern: generated (extensions allowed)
Patient.text.div	C	1..1	xhtml	Limited xhtml content Constraints: txt-1, txt-2
Patient.contained		0..*	Resource	Contained, inline Resources Constraints: dom-r4b
Patient.extension		0..*	Extension	Additional content defined by implementations
Patient.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
Patient.identifier	Σ This element is included in summaries.	1..*	Identifier	An identifier for this patient
Patient.identifier.id		0..1	id	Unique id for inter-element referencing
Patient.identifier.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Patient.identifier.use	?! This element is a modifier element. Σ This element is included in summaries.	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
Patient.identifier.type	Σ This element is included in summaries. C	1..1	HIECodeableConcept	Description of identifier Binding: HIE Person Identifier Types (required) Constraints: cc-text-or-code
Patient.identifier.system	Σ This element is included in summaries.	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
Patient.identifier.value	S This element must be supported. Σ This element is included in summaries.	1..1	string	The value that is unique Example General: 123456
Patient.identifier.period	Σ This element is included in summaries.	0..1	Period	Time period when id is/was valid for use
Patient.identifier.assigner	S This element must be supported. Σ This element is included in summaries.	0..1	HIEReference(HIE Organization)	Organization that issued id (may be just text)
Patient.active	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	boolean	Whether this patient's record is in active use
Patient.name	S This element must be supported. Σ This element is included in summaries.	1..1	HIEHumanName	A name associated with the patient
Patient.telecom	S This element must be supported. Σ This element is included in summaries.	0..*	HIEContactPoint	A contact detail for the individual
Patient.gender	Σ This element is included in summaries.	1..1	code	male | female | other | unknown Binding: AdministrativeGender (required)
Patient.birthDate	S This element must be supported. Σ This element is included in summaries.	0..1	date	The date of birth for the individual
Patient.deceased[x]	?! This element is a modifier element. Σ This element is included in summaries.	0..1		Indicates if the individual is deceased or not
Patient.deceased[x].deceasedBoolean			boolean
Patient.deceased[x].deceasedDateTime			dateTime
Patient.address	Σ This element is included in summaries.	0..*	Address	An address for the individual
Patient.maritalStatus	S This element must be supported. C	0..1	HIECodeableConcept	Marital (civil) status of a patient Binding: Marital Status Codes (extensible) Constraints: cc-text-or-code
Patient.multipleBirth[x]		0..1		Whether patient is part of a multiple birth
Patient.multipleBirth[x].multipleBirthBoolean			boolean
Patient.multipleBirth[x].multipleBirthInteger			integer
Patient.photo		0..*	Attachment	Image of the patient
Patient.contact	S This element must be supported. C	0..*	BackboneElement	A contact party (e.g. guardian, partner, friend) for the patient Constraints: pat-1
Patient.contact.id		0..1	string	Unique id for inter-element referencing
Patient.contact.extension		0..*	Extension	Additional content defined by implementations
Patient.contact.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Patient.contact.relationship	S This element must be supported. C	1..*	HIECodeableConcept	The kind of relationship Binding: PatientContactRelationship (extensible) Constraints: cc-text-or-code
Patient.contact.name		0..1	HumanName	A name associated with the contact person
Patient.contact.telecom		1..*	HIEContactPoint	A contact detail for the person
Patient.contact.address		0..1	Address	Address for the contact person
Patient.contact.gender		0..1	code	male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
Patient.contact.organization	C	0..1	HIEReference(HIE Organization)	Organization that is associated with the contact
Patient.contact.period		0..1	Period	The period during which this contact person or organization is valid to be contacted relating to this patient
Patient.communication	S This element must be supported.	0..*	BackboneElement	A language which may be used to communicate with the patient about his or her health
Patient.communication.id		0..1	string	Unique id for inter-element referencing
Patient.communication.extension		0..*	Extension	Additional content defined by implementations
Patient.communication.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Patient.communication.language	S This element must be supported. C	1..1	HIECodeableConcept	The language which can be used to communicate with the patient about his or her health Binding: AllLanguages (extensible) Constraints: cc-text-or-code
Patient.communication.preferred		0..1	boolean	Language preference indicator
Patient.generalPractitioner	S This element must be supported.	0..*	HIEReference(HIE Practitioner | PractitionerRole | HIE Organization)	Patient's nominated primary care provider
Patient.managingOrganization	S This element must be supported. Σ This element is included in summaries.	1..1	HIEReference(HIE Organization)	Organization that is the custodian of the patient record
Patient.link	?! This element is a modifier element. Σ This element is included in summaries.	0..*	BackboneElement	Link to another patient resource that concerns the same actual person
Patient.link.id		0..1	string	Unique id for inter-element referencing
Patient.link.extension		0..*	Extension	Additional content defined by implementations
Patient.link.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Patient.link.other	Σ This element is included in summaries.	1..1	HIEReference(HIE Patient)	The other patient or related person resource that the link refers to
Patient.link.type	Σ This element is included in summaries.	1..1	code	replaced-by | replaces | refer | seealso Binding: LinkType (required): The type of link between this patient resource and another patient resource.
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Patient.language	Base	preferred	Common Languages	📍4.3.0	FHIR Std.
Patient.text.status	Base	required	NarrativeStatus	📍4.3.0	FHIR Std.
Patient.identifier.use	Base	required	IdentifierUse	📍4.3.0	FHIR Std.
Patient.identifier.type	Base	required	HIE Person Identifier Types	📦0.1.0	This IG
Patient.gender	Base	required	AdministrativeGender	📦4.3.0	FHIR Std.
Patient.maritalStatus	Base	extensible	MaritalStatus	📦4.3.0	FHIR Std.
Patient.contact.relationship	Base	extensible	Patient Contact Relationship	📦4.3.0	FHIR Std.
Patient.contact.gender	Base	required	AdministrativeGender	📍4.3.0	FHIR Std.
Patient.communication.​language	Base	extensible	All Languages	📦4.3.0	FHIR Std.
Patient.link.type	Base	required	LinkType	📍4.3.0	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
cc-text-or-code	warning	Patient.identifier.type, Patient.maritalStatus, Patient.contact.relationship, Patient.communication.language	Text is optional, coding is required	coding.exists()
dom-2	error	Patient	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Patient	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where(((id.exists() and ('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url)))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(uri) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Patient	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	error	Patient	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Patient	A resource should have narrative for robust management	text.`div`.exists()
dom-r4b	warning	Patient.contained	Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems	($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic)
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
pat-1	error	Patient.contact	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()
txt-1	error	Patient.text.div	The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes	htmlChecks()
txt-2	error	Patient.text.div	The narrative SHALL have some non-whitespace content	htmlChecks()

This structure is derived from Patient

Summary

Mandatory: 9 elements(2 nested mandatory elements)
Must-Support: 13 elements

Structures

This structure refers to these other structures:

• HIE CodeableConcept (https://nshr.dha.go.ke/fhir/StructureDefinition/codeable-concept)
• HIE Reference (https://nshr.dha.go.ke/fhir/StructureDefinition/reference)
• HIE Organization (https://nshr.dha.go.ke/fhir/StructureDefinition/organization)
• HIE HumanName (https://nshr.dha.go.ke/fhir/StructureDefinition/human-name)
• HIE ContactPoint (https://nshr.dha.go.ke/fhir/StructureDefinition/contact-point)
• HIE Practitioner (https://nshr.dha.go.ke/fhir/StructureDefinition/practitioner)
• HIE Patient (https://nshr.dha.go.ke/fhir/StructureDefinition/patient)

Other representations of profile: CSV, Excel, Schematron