ACT-NOW Implementation Guide
0.5.0 - ci-build

ACT-NOW Implementation Guide, published by Te aho o te kahu - Cancer Control Agency. This guide is not an authorized publication; it is the continuous build for version 0.5.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/tewhatuora/actnow/ and changes regularly. See the Directory of published versions

## Resource Profile: ACT-NOW patient

Official URL: http://canshare.co.nz/fhir/StructureDefinition/an-patient | Version: 0.5.0
Draft as of 2026-06-15 | Computable Name: AnPatient

ACT-NOW patient

Usages:

- Examples for this Profile: Patient/exPatient
- CapabilityStatements using this Profile: CapabilityStatement representing the server requirements for a FHIR server

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
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 1..* | Identifier | An identifier for this patient
active | ?!Σ | 0..1 | boolean | Whether this patient's record is in active use
deceased[x] | ?!Σ | 0..1 |  | Indicates if the individual is deceased or not
deceasedBoolean |  |  | boolean |
deceasedDateTime |  |  | dateTime |
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.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()`

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
identifier |  | 1..* | Identifier | An identifier for this patient
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Patient |  | 0..* | Patient | Information about an individual or animal receiving health care services
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | 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
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 1..* | Identifier | An identifier for this patient
active | ?!Σ | 0..1 | boolean | Whether this patient's record is in active use
name | Σ | 0..* | HumanName | A name associated with the patient
telecom | Σ | 0..* | ContactPoint | A contact detail for the individual
gender | Σ | 0..1 | code | male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
birthDate | Σ | 0..1 | date | The date of birth for the individual
deceased[x] | ?!Σ | 0..1 |  | Indicates if the individual is deceased or not
deceasedBoolean |  |  | boolean |
deceasedDateTime |  |  | dateTime |
address | Σ | 0..* | Address | An address for the individual
maritalStatus |  | 0..1 | CodeableConcept | Marital (civil) status of a patient Binding: Marital Status Codes (extensible): The domestic partnership status of a person.
multipleBirth[x] |  | 0..1 |  | Whether patient is part of a multiple birth
multipleBirthBoolean |  |  | boolean |
multipleBirthInteger |  |  | integer |
photo |  | 0..* | Attachment | Image of the patient
contact | C | 0..* | BackboneElement | A contact party (e.g. guardian, partner, friend) for the patient Constraints: pat-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
relationship |  | 0..* | CodeableConcept | The kind of relationship Binding: PatientContactRelationship (extensible): The nature of the relationship between a patient and a contact person for that patient.
name |  | 0..1 | HumanName | A name associated with the contact person
telecom |  | 0..* | ContactPoint | A contact detail for the person
address |  | 0..1 | Address | Address for the contact person
gender |  | 0..1 | code | male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
organization | C | 0..1 | Reference(Organization) | Organization that is associated with the contact
period |  | 0..1 | Period | The period during which this contact person or organization is valid to be contacted relating to this patient
communication |  | 0..* | BackboneElement | A language which may be used to communicate with the patient about his or her health
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
language |  | 1..1 | CodeableConcept | The language which can be used to communicate with the patient about his or her health Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
preferred |  | 0..1 | boolean | Language preference indicator
generalPractitioner |  | 0..* | Reference(Organization | Practitioner | PractitionerRole) | Patient's nominated primary care provider
managingOrganization | Σ | 0..1 | Reference(Organization) | Organization that is the custodian of the patient record
link | ?!Σ | 0..* | BackboneElement | Link to another patient resource that concerns the same actual person
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
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.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Patient.gender | Base | required | AdministrativeGender | 📍4.0.1 | FHIR Std.
Patient.maritalStatus | Base | extensible | MaritalStatus | 📍4.0.1 | FHIR Std.
Patient.contact.relationship | Base | extensible | Patient Contact Relationship | 📍4.0.1 | FHIR Std.
Patient.contact.gender | Base | required | AdministrativeGender | 📍4.0.1 | FHIR Std.
Patient.communication.​language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
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()`
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

Summary

Mandatory: 1 element

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
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 1..* | Identifier | An identifier for this patient
active | ?!Σ | 0..1 | boolean | Whether this patient's record is in active use
deceased[x] | ?!Σ | 0..1 |  | Indicates if the individual is deceased or not
deceasedBoolean |  |  | boolean |
deceasedDateTime |  |  | dateTime |
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.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()`

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
identifier |  | 1..* | Identifier | An identifier for this patient
Documentation for this format

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
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | 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
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 1..* | Identifier | An identifier for this patient
active | ?!Σ | 0..1 | boolean | Whether this patient's record is in active use
name | Σ | 0..* | HumanName | A name associated with the patient
telecom | Σ | 0..* | ContactPoint | A contact detail for the individual
gender | Σ | 0..1 | code | male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
birthDate | Σ | 0..1 | date | The date of birth for the individual
deceased[x] | ?!Σ | 0..1 |  | Indicates if the individual is deceased or not
deceasedBoolean |  |  | boolean |
deceasedDateTime |  |  | dateTime |
address | Σ | 0..* | Address | An address for the individual
maritalStatus |  | 0..1 | CodeableConcept | Marital (civil) status of a patient Binding: Marital Status Codes (extensible): The domestic partnership status of a person.
multipleBirth[x] |  | 0..1 |  | Whether patient is part of a multiple birth
multipleBirthBoolean |  |  | boolean |
multipleBirthInteger |  |  | integer |
photo |  | 0..* | Attachment | Image of the patient
contact | C | 0..* | BackboneElement | A contact party (e.g. guardian, partner, friend) for the patient Constraints: pat-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
relationship |  | 0..* | CodeableConcept | The kind of relationship Binding: PatientContactRelationship (extensible): The nature of the relationship between a patient and a contact person for that patient.
name |  | 0..1 | HumanName | A name associated with the contact person
telecom |  | 0..* | ContactPoint | A contact detail for the person
address |  | 0..1 | Address | Address for the contact person
gender |  | 0..1 | code | male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
organization | C | 0..1 | Reference(Organization) | Organization that is associated with the contact
period |  | 0..1 | Period | The period during which this contact person or organization is valid to be contacted relating to this patient
communication |  | 0..* | BackboneElement | A language which may be used to communicate with the patient about his or her health
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
language |  | 1..1 | CodeableConcept | The language which can be used to communicate with the patient about his or her health Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
preferred |  | 0..1 | boolean | Language preference indicator
generalPractitioner |  | 0..* | Reference(Organization | Practitioner | PractitionerRole) | Patient's nominated primary care provider
managingOrganization | Σ | 0..1 | Reference(Organization) | Organization that is the custodian of the patient record
link | ?!Σ | 0..* | BackboneElement | Link to another patient resource that concerns the same actual person
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
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.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Patient.gender | Base | required | AdministrativeGender | 📍4.0.1 | FHIR Std.
Patient.maritalStatus | Base | extensible | MaritalStatus | 📍4.0.1 | FHIR Std.
Patient.contact.relationship | Base | extensible | Patient Contact Relationship | 📍4.0.1 | FHIR Std.
Patient.contact.gender | Base | required | AdministrativeGender | 📍4.0.1 | FHIR Std.
Patient.communication.​language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
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()`
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

Summary

Mandatory: 1 element

Other representations of profile: CSV, Excel, Schematron