Fact of Death Decedent - Fact of Death Exchange FHIR Implementation Guide v0.2.0

Fact of Death Exchange FHIR Implementation Guide, published by HL7 International - Public Health Work Group. This guide is not an authorized publication; it is the continuous build for version 0.2.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/shpringman/fhir-fod/ and changes regularly. See the Directory of published versions

Resource Profile: Fact of Death Decedent

Official URL: http://example.org/fhir/us/fod/StructureDefinition/fod-decedent				Version: 0.2.0
Standards status: Informative			Maturity Level: 1	Computable Name: FODDecedent

The decedent whose death is being notified, carrying the demographics a receiving system needs in order to match the notification to an existing patient record. This profile derives from the VRDR Decedent (and therefore from VRCL Patient and US Core Patient) and adds must-support obligations on the elements that carry matching value. It does not define a matching algorithm; how a receiver matches, and what identity assurance it requires of the sender, are out of scope for this guide.

Usages:

Use this Profile: Fact of Death Notification Bundle
Refer to this Profile: Fact of Death Death Date

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	C	0..*	Decedent	Information about an individual or animal receiving health care services Constraints: us-core-6, fod-decedent-matchable
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension				Content/Rules for all slices
extension:race		0..1	(Complex)	US Core Race Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-race
extension:ethnicity		0..1	(Complex)	US Core ethnicity Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity
extension:birthsex		0..1	code	Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex Binding: Birth Sex (required): Code for sex assigned at birth
extension:genderIdentity		0..1	CodeableConcept	Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-genderIdentity Binding: Gender Identity (extensible)
extension:birthPlace		0..1	(Complex)	Decedent birthplace URL: http://hl7.org/fhir/StructureDefinition/patient-birthPlace
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/patient-birthPlace"
value[x]		1..1	Address	Value of extension
use	?!Σ	0..1	code	home \| work \| temp \| old \| billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
extension:parentReportedAgeAtDelivery		0..2	(Complex)	Extension - Reported Parent Age at Delivery - Vital Records URL: http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Extension-reported-parent-age-at-delivery-vr
extension:NVSS-SexAtDeath	S	0..1	CodeableConcept	Extension URL: http://hl7.org/fhir/us/vrdr/StructureDefinition/NVSS-SexAtDeath Binding: Administrative Gender ValueSet (preferred)
extension:Spouse-Alive		0..1	CodeableConcept	Spouse Alive? URL: http://hl7.org/fhir/us/vrdr/StructureDefinition/SpouseAlive Binding: Spouse Alive ValueSet (required)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	SΣ	1..*	Identifier	Identifiers for the decedent, including the SSN and any medical record number known to the sender Slice: Unordered, Open by pattern:type
identifier:MRN	SΣ	0..*	Identifier	Medical record number, if the sender happens to hold one for the receiving system
use	?!Σ	0..1	code	usual \| official \| temp \| secondary \| old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	1..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: MR
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique within the system. Example General: 123456
identifier:SSN	SΣ	0..1	Identifier	Social Security Number, the single highest-value matching element when available
use	?!Σ	0..1	code	usual \| official \| temp \| secondary \| old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	1..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: SS
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	SΣ	1..1	uri	The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-ssn
value	SΣ	1..1	string	The value that is unique within the system. Example General: 123456
identifier:SB	SΣ	0..1	Identifier	Deprecated Decedent's Social Security Number for Compatibility. Use SSN.
use	?!Σ	0..1	code	usual \| official \| temp \| secondary \| old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	1..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: SB
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
active	?!Σ	0..1	boolean	Whether this patient's record is in active use
Slices for name	SΣ	1..*	HumanName	A name associated with the patient Slice: Unordered, Open by value:use
name:currentLegalName	SΣ	1..1	HumanName	current legal name
use	?!Σ	1..1	code	usual \| official \| temp \| nickname \| anonymous \| old \| maiden Binding: NameUse (required): The use of a human name. Fixed Value: official
family	SΣC	0..1	string	Family name (often called 'Surname')
given	SΣC	0..*	string	Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name
name:namePriorToFirstMarriage	SΣ	0..1	HumanName	Maiden name, which materially improves matching for decedents whose name changed after their record was created
use	?!Σ	1..1	code	usual \| official \| temp \| nickname \| anonymous \| old \| maiden Binding: NameUse (required): The use of a human name. Fixed Value: maiden
family	SΣC	0..1	string	Family name (often called 'Surname')
given	SΣC	0..*	string	Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name
telecom	SΣ	0..*	ContactPoint	A contact detail for the individual
system	SΣC	1..1	code	phone \| fax \| email \| pager \| url \| sms \| other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value	SΣ	1..1	string	The actual contact point details
use	?!SΣ	0..1	code	home \| work \| temp \| old \| mobile - purpose of this contact point Binding: ContactPointUse (required)
gender	SΣ	1..1	code	male \| female \| other \| unknown Binding: AdministrativeGender (required)
birthDate	SΣ	0..1	date	Date of Birth
Slices for extension				Content/Rules for all slices
extension:partialDateTime		0..1	(Complex)	partialDateTIme URL: http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Extension-partial-date-time-vr
extension:birthTime		0..1	dateTime	Time of day of birth URL: http://hl7.org/fhir/StructureDefinition/patient-birthTime
extension:bypassEditFlag		0..1	(Complex)	BypassEditFlag Vital Records URL: http://hl7.org/fhir/us/vr-common-library/StructureDefinition/BypassEditFlag
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"http://hl7.org/fhir/us/vr-common-library/StructureDefinition/BypassEditFlag"
value[x]		1..1	CodeableConcept	To reflect the relevant edit possibilities for date of birth. Binding: Value Set - Date of Birth Edit Flags (NCHS) Vital Records (required): Date of Birth Edit Flags (NCHS)
Slices for deceased[x]	?!Σ	0..1	boolean	Indicates if the individual is deceased or not Slice: Unordered, Closed by type:$this
deceased[x]:deceasedBoolean	?!SΣC	1..1	boolean	SHALL be true. The date and time of death are carried by the Fact of Death Death Date observation, which is the authoritative source for them. Constraints: fetalDeathOnlyIfDeceased Required Pattern: true
Slices for extension				Content/Rules for all slices
extension:fetalDeath		0..1	boolean	Boolean indicator. True if the Patient died as a fetus. URL: http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Extension-patient-fetal-death-vr
address	SΣ	0..*	Address	Residence address of the decedent, used for matching
Slices for extension				Content/Rules for all slices
extension:withinCityLimitsIndicator		0..1	Coding	indicates whether or not an address is within city limits URL: http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Extension-within-city-limits-indicator-vr Binding: Value Set - Yes No Unknown Vital Records (required): Yes No Unknown (YNU)
extension:predir		0..1	string	Predirectional URL: http://hl7.org/fhir/us/vr-common-library/StructureDefinition/PreDirectional
extension:stnum		0..1	string	Street Number URL: http://hl7.org/fhir/us/vr-common-library/StructureDefinition/StreetNumber
extension:stname		0..1	string	Street Name URL: http://hl7.org/fhir/us/vr-common-library/StructureDefinition/StreetName
extension:stdesig		0..1	string	Street Designator URL: http://hl7.org/fhir/us/vr-common-library/StructureDefinition/StreetDesignator
extension:postdir		0..1	string	Postdirectional URL: http://hl7.org/fhir/us/vr-common-library/StructureDefinition/PostDirectional
extension:unitnumber		0..1	string	Unit Number URL: http://hl7.org/fhir/us/vr-common-library/StructureDefinition/UnitOrAptNumber
use	?!Σ	0..1	code	home \| work \| temp \| old \| billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
line	SΣ	0..*	string	Street Address This repeating element order: The order in which lines should appear in an address label Example General: 137 Nowhere Street
city	SΣ	0..1	string	City Example General: Erewhon
Slices for extension				Content/Rules for all slices
extension:cityCode		0..1	positiveInt	City Code URL: http://hl7.org/fhir/us/vr-common-library/StructureDefinition/CityCode
state	SΣ	0..1	string	State/Jurisdiction of residence. Provide both state and jurisdiction if different. Binding: Value Set - States, Territories and Provinces Vital Records (required)
Slices for extension				Content/Rules for all slices
extension:residenceJurisdictionId		0..1	string	Location Jurisdiction Id Vital Records URL: http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Extension-jurisdiction-id-vr Binding: Value Set - Jurisdictions Vital Records (required)
postalCode	SΣ	0..1	string	Postal Code Example General: 9132
period	SΣ	0..1	Period	Time period when address was/is in use Example General: {"start":"2010-03-23","end":"2010-07-01"}
communication		0..*	BackboneElement	A language which may be used to communicate with the patient about his or her health
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
language	S	1..1	CodeableConcept	The language which can be used to communicate with the patient about his or her health Binding: Language codes with language and optionally a region modifier (extensible)
link	?!Σ	0..*	BackboneElement	Link to another patient resource that concerns the same actual person
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
other	Σ	1..1	Reference(Patient \| RelatedPerson)	The other patient or related person resource that the link refers to
type	Σ	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.extension:birthPlace.value[x].use	Base	required	AddressUse	📍4.0.1	FHIR Std.
Patient.identifier:MRN.use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Patient.identifier:MRN.type	Base	extensible	IdentifierType	📦4.0.1	FHIR Std.
Patient.identifier:SSN.use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Patient.identifier:SSN.type	Base	extensible	IdentifierType	📦4.0.1	FHIR Std.
Patient.identifier:SB.use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Patient.identifier:SB.type	Base	extensible	IdentifierType	📦4.0.1	FHIR Std.
Patient.name:currentLegalName.use	Base	required	NameUse	📍4.0.1	FHIR Std.
Patient.name:namePriorToFirstMarriage.use	Base	required	NameUse	📍4.0.1	FHIR Std.
Patient.telecom.system	Base	required	ContactPointSystem	📦4.0.1	FHIR Std.
Patient.telecom.use	Base	required	ContactPointUse	📦4.0.1	FHIR Std.
Patient.gender	Base	required	AdministrativeGender	📦4.0.1	FHIR Std.
Patient.birthDate.extension:bypassEditFlag.value[x]	Base	required	Value Set - Date of Birth Edit Flags (NCHS) Vital Records	📦2.0.0	Vital Records Common Library v2.0
Patient.address.use	Base	required	AddressUse	📍4.0.1	FHIR Std.
Patient.address.state	Base	required	Value Set - States, Territories and Provinces Vital Records	📦2.0.0	Vital Records Common Library v2.0
Patient.communication.language	Base	extensible	Language codes with language and optionally a region modifier	📦5.0.1	US Core v5.0
Patient.link.type	Base	required	LinkType	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
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 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	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()`
fetalDeathOnlyIfDeceased	error	Patient.deceased[x]:deceasedBoolean	Fetal death should only be indicated if Patient is deceased.	`(extension.where(url = 'http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Extension-patient-fetal-death-vr').exists(value.exists() and value = 'true')) implies (value.exists() and value = 'true')`
fod-decedent-matchable	error	Patient	A decedent SHALL carry either a Social Security Number, or a birth date together with an address or a telecom, so that a receiving system has enough demographic breadth to match safely.	`identifier.where(type.coding.where(system = 'http://terminology.hl7.org/CodeSystem/v2-0203' and code = 'SS').exists()).exists() or (birthDate.exists() and (address.exists() or telecom.exists()))`
us-core-6	error	Patient	Either Patient.name.given and/or Patient.name.family SHALL be present or a Data Absent Reason Extension SHALL be present.	`(name.family.exists() or name.given.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()`

This structure is derived from Decedent

Name	Flags	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
Patient	C	0..*	Decedent	Information about an individual or animal receiving health care services Constraints: fod-decedent-matchable
Slices for extension				Content/Rules for all slices
extension:NVSS-SexAtDeath	S	0..1	NVSSSexAtDeath	Extension
identifier	S	1..*	Identifier	Identifiers for the decedent, including the SSN and any medical record number known to the sender
Slices for identifier				Content/Rules for all slices
identifier:MRN	S	0..*	Identifier	Medical record number, if the sender happens to hold one for the receiving system
identifier:SSN	S	0..1	Identifier	Social Security Number, the single highest-value matching element when available
name	S	1..*	HumanName	A name associated with the patient
Slices for name				Content/Rules for all slices
name:currentLegalName	S	1..1	HumanName	current legal name
name:namePriorToFirstMarriage	S	0..1	HumanName	Maiden name, which materially improves matching for decedents whose name changed after their record was created
telecom	S	0..*	ContactPoint	A contact detail for the individual
gender	S	1..1	code	male \| female \| other \| unknown
birthDate	S	0..1	date	Date of Birth
Slices for deceased[x]				Content/Rules for all slices
deceased[x]:deceasedBoolean	S	1..1	boolean	SHALL be true. The date and time of death are carried by the Fact of Death Death Date observation, which is the authoritative source for them.
address	S	0..*	Address	Residence address of the decedent, used for matching
Documentation for this format

Constraints

Id	Grade	Path(s)	Description	Expression
fod-decedent-matchable	error	Patient	A decedent SHALL carry either a Social Security Number, or a birth date together with an address or a telecom, so that a receiving system has enough demographic breadth to match safely.	`identifier.where(type.coding.where(system = 'http://terminology.hl7.org/CodeSystem/v2-0203' and code = 'SS').exists()).exists() or (birthDate.exists() and (address.exists() or telecom.exists()))`

Description & Constraints Filter: Filters

Patient

0..*

Decedent

Information about an individual or animal receiving health care services
Constraints: us-core-6, fod-decedent-matchable

0..1

Logical id of this artifact

Meta

Metadata about the resource

implicitRules

?!Σ

0..1

uri

A set of rules under which this content was created

language

0..1

code

Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional Bindings

Purpose

AllLanguages

Max Binding

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

contained

0..*

Resource

Contained, inline Resources

Slices for extension

0..*

Extension

Extension
Slice: Unordered, Open by value:url

extension:race

0..1

(Complex)

US Core Race Extension
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-race