Australian Base Profiles Implementation Guide

This page is part of the Australian Base IG (v0.1.0: AU Base 1 on STU3 Draft) based on FHIR R3. The current version which supercedes this version is 1.0.2. For a full list of available versions, see the Directory of published versions

D.4.1.4 StructureDefinition: - Detailed Descriptions

Definitions for the StructureDefinition-au-patient Profile.

Patient
Definition

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

Control0..*
Alternate NamesSubjectOfCare Client Resident
InvariantsDefined on this element
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (: contained.text.empty())
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (: contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (: contained.where(('#'+id in %resource.descendants().reference).not()).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
Patient.id
Definition

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

Control0..1
Typeid
Comments

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

Patient.meta
Definition

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

Control0..1
TypeMeta
Patient.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

Control0..1
Typeuri
Is Modifiertrue
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

Patient.language
Definition

The base language in which the resource is written.

Control0..1
BindingA human language.
The codes SHALL be taken from Common Languages; other codes may be used where these codes are not suitable
Typecode
Comments

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

Patient.text
Definition

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

Control0..1 This element is affected by the following invariants: dom-1
TypeNarrative
Alternate Namesnarrative, html, xhtml, display
Comments

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

Patient.contained
Definition

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

Control0..*
TypeResource
Alternate Namesinline resources, anonymous resources, contained resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.

Patient.extension
Definition

An Extension

Control0..*
TypeExtension
Patient.extension (http://hl7.org.au/fhir/StructureDefinition/indigenous-status)
Definition

NHDD based indigenous status for a patient

Control0..1 This element is affected by the following invariants: ele-1
Type (Extension Type: Coding)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
Patient.modifierExtension
Definition

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

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content
Comments

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

Patient.identifier
Definition

An identifier for this patient.

NoteThis is a business identifer, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Requirements

Patients are almost always assigned specific numerical identifiers.

Patient.identifier(IHI Number)
Definition

National identifier for the patient

NoteThis is a business identifer, not a resource identifier (see discussion)
Control0..1
TypeIdentifier
Requirements

Identifier as assigned and available via Health Identifiers service

InvariantsDefined on this element
inv-ihi-0: IHI is exactly 16 characters (: value.length() = 16)
inv-ihi-1: IHI prefix is 800360 (: value.startsWith('800360'))
Patient.identifier.id
Definition

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

Control0..1
Typestring
Patient.identifier.extension
Definition

An Extension

Control0..*
TypeExtension
Patient.identifier.extension (http://hl7.org.au/fhir/StructureDefinition/extension-au-ihi-status)
Definition

IHI value status associated with an IHI identifier

Control0..1 This element is affected by the following invariants: ele-1
Type (Extension Type: Coding)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
Patient.identifier.extension.id
Definition

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

Control0..1
Typestring
Patient.identifier.extension.extension
Definition

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

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

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

Patient.identifier.extension.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Patient.identifier.extension.value[x]
Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Control0..1
TypeChoice of: base64Binary, boolean, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, Meta
[x] NoteSee Choice of Data Types for further information about how to use [x]
Patient.identifier.extension (http://hl7.org.au/fhir/StructureDefinition/extension-au-ihi-record-status)
Definition

IHI value record status associated with an IHI identifier

Control0..1 This element is affected by the following invariants: ele-1
Type (Extension Type: Coding)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
Patient.identifier.extension.id
Definition

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

Control0..1
Typestring
Patient.identifier.extension.extension
Definition

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

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

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

Patient.identifier.extension.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Patient.identifier.extension.value[x]
Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Control0..1
TypeChoice of: base64Binary, boolean, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, Meta
[x] NoteSee Choice of Data Types for further information about how to use [x]
Patient.identifier.use
Definition

The purpose of this identifier.

Control0..1
BindingIdentifies the purpose for this identifier, if known .
The codes SHALL be taken from IdentifierUse
Typecode
Is Modifiertrue
Requirements

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

Comments

This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Patient.identifier.type
Definition

ihi

Control1..1
BindingA coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
The codes SHALL be taken from Identifier Type Codes; other codes may be used where these codes are not suitable
TypeCodeableConcept
Requirements

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

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage.

Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Patient.identifier.type.id
Definition

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

Control0..1
Typestring
Patient.identifier.type.extension
Definition

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

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

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

Patient.identifier.type.coding
Definition

ihi

Control0..1
TypeCoding
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

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

Fixed Value<valueCoding xmlns="http://hl7.org/fhir">
  <system value="http://hl7.org/fhir/v2/0203"/>
  <code value="NI"/>
  <display value="National unique individual identifier"/>
</valueCoding>
Patient.identifier.type.text
Definition

ihi

Control1..1
Typestring
Requirements

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

Comments

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

Fixed ValueIHI
Patient.identifier.system
Definition

National identifier for the patient

Control1..1
Typeuri
Requirements

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

Fixed Valuehttp://ns.electronichealth.net.au/id/hi/ihi/1.0
Example
General:http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri
Patient.identifier.value
Definition

The 16 digit unique identifier for consumers of healthcare services

Control1..1
Typestring
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension.

Max Length16
Example
General:123456
IHI number:8003608166690503
Patient.identifier.period
Definition

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

Control0..1
TypePeriod
Patient.identifier.assigner
Definition

Organization that issued/manages the identifier.

Control0..1
TypeReference(Organization)
Comments

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

Patient.identifier(Medicare Number)
Definition

Medicare Number assigned to a patient

NoteThis is a business identifer, not a resource identifier (see discussion)
Control0..1
TypeIdentifier
Requirements

Patients are almost always assigned specific numerical identifiers.

Patient.identifier.id
Definition

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

Control0..1
Typestring
Patient.identifier.extension
Definition

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

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

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

Patient.identifier.use
Definition

The purpose of this identifier.

Control0..1
BindingIdentifies the purpose for this identifier, if known .
The codes SHALL be taken from IdentifierUse
Typecode
Is Modifiertrue
Requirements

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

Comments

This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Patient.identifier.type
Definition

Medicare Number assigned to a patient

Control1..1
BindingA coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
The codes SHALL be taken from Identifier Type Codes; other codes may be used where these codes are not suitable
TypeCodeableConcept
Requirements

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

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage.

Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Patient.identifier.type.id
Definition

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

Control0..1
Typestring
Patient.identifier.type.extension
Definition

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

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

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

Patient.identifier.type.coding
Definition

Medicare Number assigned to a patient

Control0..1
TypeCoding
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

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

Fixed Value<valueCoding xmlns="http://hl7.org/fhir">
  <system value="http://hl7.org/fhir/v2/0203"/>
  <code value="MC"/>
  <display value="Patient&#39;s Medicare Number"/>
</valueCoding>
Patient.identifier.type.text
Definition

Medicare Number descriptive text

Control1..1
Typestring
Requirements

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

Comments

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

Fixed ValueMedicare Number
Patient.identifier.system
Definition

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

Control1..1
Typeuri
Requirements

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

Fixed Valuehttp://ns.electronichealth.net.au/id/medicare-number
Example
General:http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri
Patient.identifier.value
Definition

10 digit Medicare number with optional 11 digit individual reference number (IRN)

Control1..1
Typestring
Comments

10 digit Medicare Number and optional 1 digit Individual Reference Number

Max Length11
Example
General:123456
Medicare number:32788511952
Patient.identifier.period
Definition

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

Control1..1
TypePeriod
Patient.identifier.period.id
Definition

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

Control0..1
Typestring
Patient.identifier.period.extension
Definition

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

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

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

Patient.identifier.period.start
Definition

The start of the period. The boundary is inclusive.

Control0..1 This element is affected by the following invariants: per-1
TypedateTime
Comments

If the low element is missing, the meaning is that the low boundary is not known.

Patient.identifier.period.end
Definition

The end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

Control1..1 This element is affected by the following invariants: per-1
TypedateTime
Comments

The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.

Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
Patient.identifier.assigner
Definition

Organization that issued/manages the identifier.

Control0..1
TypeReference(Organization)
Comments

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

Patient.identifier(DVA Number)
Definition

Department of Veterans' Affairs number

NoteThis is a business identifer, not a resource identifier (see discussion)
Control0..1
TypeIdentifier
Requirements

Patients are almost always assigned specific numerical identifiers.

InvariantsDefined on this element
inv-dva-number-gold: DVA Number identifier type text must be 'DVA Number (Gold)' when colour coding is DVG (: type.coding.code='DVG' and type.text != 'DVA Number (Gold)')
inv-dva-number-orange: DVA Number identifier type text must be 'DVA Number (Orange)' when colour coding is DVO (: type.coding.code='DVO' and type.text != 'DVA Number (Orange)')
inv-dva-number-text: DVA Number identifier type text must be one of 'DVA Number', 'DVA Number (Gold)', 'DVA Number (White), 'DVA Number (Orange)' (: type.text = 'DVA Number' or type.text = 'DVA Number (Gold)' or type.text = 'DVA Number (White)' or type.text = 'DVA Number (Orange)')
inv-dva-number-unspecified: DVA Number identifier type text must be 'DVA Number' when colour is not specified (: exists(type.coding) and type.text != 'DVA Number')
inv-dva-number-white: DVA Number identifier type text must be 'DVA Number (White)' when colour coding is DVW (: type.coding.code='DVW' and type.text != 'DVA Number (White)')
Patient.identifier.id
Definition

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

Control0..1
Typestring
Patient.identifier.extension
Definition

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

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

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

Patient.identifier.use
Definition

The purpose of this identifier.

Control0..1
BindingIdentifies the purpose for this identifier, if known .
The codes SHALL be taken from IdentifierUse
Typecode
Is Modifiertrue
Requirements

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

Comments

This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Patient.identifier.type
Definition

DVA colour identifer type

Control1..1
BindingA coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
The codes SHALL be taken from Identifier Type Codes; other codes may be used where these codes are not suitable
TypeCodeableConcept
Requirements

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

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage.

Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Patient.identifier.type.id
Definition

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

Control0..1
Typestring
Patient.identifier.type.extension
Definition

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

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

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

Patient.identifier.type.coding
Definition

DVA colour coding

Control0..1
Bindingnull
The codes SHALL be taken from v2 Identifier Type - AU Extended - DVA Specifc Card Types
TypeCoding
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

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

Patient.identifier.type.text
Definition

DVA colour coding

Control1..1
Typestring
Requirements

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

Comments

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

Patient.identifier.system
Definition

DVA Number assigned uri

Control1..1
Typeuri
Requirements

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

Fixed Valuehttp://ns.electronichealth.net.au/id/dva
Example
General:http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri
Patient.identifier.value
Definition

Up to 9 digit value in the form AAXXNNNN[A]

Control1..1
Typestring
Comments

Reference: http://meteor.aihw.gov.au/content/index.phtml/itemId/339127

Max Length9
Example
General:123456
DVA number:NBUR9080
Patient.identifier.period
Definition

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

Control0..1
TypePeriod
Patient.identifier.assigner
Definition

Organization that issued/manages the identifier.

Control0..1
TypeReference(Organization)
Comments

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

Patient.identifier(Health Care Card)
Definition

Concesion Card Number assigned to a person by Centrelink, this can be Health Card Card, Pensioner Concession Card or Commonwealth Seniors Health Card Number

NoteThis is a business identifer, not a resource identifier (see discussion)
Control0..1
TypeIdentifier
Requirements

Patients are almost always assigned specific numerical identifiers.

Patient.identifier.id
Definition

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

Control0..1
Typestring
Patient.identifier.extension
Definition

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

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

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

Patient.identifier.use
Definition

The purpose of this identifier.

Control0..1
BindingIdentifies the purpose for this identifier, if known .
The codes SHALL be taken from IdentifierUse
Typecode
Is Modifiertrue
Requirements

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

Comments

This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Patient.identifier.type
Definition

Concesion Card Number assigned to a person by Centrelink, this can be Health Card Card, Pensioner Concession Card or Commonwealth Seniors Health Card Number

Control1..1
BindingA coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
The codes SHALL be taken from Identifier Type Codes; other codes may be used where these codes are not suitable
TypeCodeableConcept
Requirements

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

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage.

Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Fixed Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/v2/0203"/>
    <code value="HC"/>
    <display value="Health Card Number"/>
  </coding>
  <text value="Health Care Card Number"/>
</valueCodeableConcept>
Patient.identifier.system
Definition

namespace for CRN values

Control1..1
Typeuri
Requirements

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

Fixed Valuehttp://ns.electronichealth.net.au/id/crn
Example
General:http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri
Patient.identifier.value
Definition

10 character identifier NNNNNNNNNA

Control1..1
Typestring
Comments

A personal identifier assigned by Centrelink for the purposes of identifying people (and organisations) eligible for specific services.

Max Length10
Example
General:123456
DHS CRN:307111942H
Patient.identifier.period
Definition

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

Control0..1
TypePeriod
Patient.identifier.assigner
Definition

Organization that issued/manages the identifier.

Control0..1
TypeReference(Organization)
Comments

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

Patient.identifier(Pensioner Concession Card)
Definition

Concesion Card Number assigned to a person by Centrelink, this can be Health Card Card, Pensioner Concession Card or Commonwealth Seniors Health Card Number

NoteThis is a business identifer, not a resource identifier (see discussion)
Control0..1
TypeIdentifier
Requirements

Patients are almost always assigned specific numerical identifiers.

Patient.identifier.id
Definition

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

Control0..1
Typestring
Patient.identifier.extension
Definition

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

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

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

Patient.identifier.use
Definition

The purpose of this identifier.

Control0..1
BindingIdentifies the purpose for this identifier, if known .
The codes SHALL be taken from IdentifierUse
Typecode
Is Modifiertrue
Requirements

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

Comments

This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Patient.identifier.type
Definition

Concesion Card Number assigned to a person by Centrelink, this can be Health Card Card, Pensioner Concession Card or Commonwealth Seniors Health Card Number

Control1..1
BindingA coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
The codes SHALL be taken from Identifier Type Codes; other codes may be used where these codes are not suitable
TypeCodeableConcept
Requirements

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

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage.

Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Fixed Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/v2/0203"/>
    <code value="PEN"/>
    <display value="Pension Number"/>
  </coding>
  <text value="Pensioner Concession Card Number"/>
</valueCodeableConcept>
Patient.identifier.system
Definition

namespace for CRN values

Control1..1
Typeuri
Requirements

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

Fixed Valuehttp://ns.electronichealth.net.au/id/crn
Example
General:http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri
Patient.identifier.value
Definition

10 character identifier NNNNNNNNNA

Control1..1
Typestring
Comments

A personal identifier assigned by Centrelink for the purposes of identifying people (and organisations) eligible for specific services.

Max Length10
Example
General:123456
DHS CRN:307111942H
Patient.identifier.period
Definition

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

Control0..1
TypePeriod
Patient.identifier.assigner
Definition

Organization that issued/manages the identifier.

Control0..1
TypeReference(Organization)
Comments

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

Patient.identifier(Commonwealth Seniors Health Card)
Definition

Concesion Card Number assigned to a person by Centrelink, this can be Health Card Card, Pensioner Concession Card or Commonwealth Seniors Health Card Number

NoteThis is a business identifer, not a resource identifier (see discussion)
Control0..1
TypeIdentifier
Requirements

Patients are almost always assigned specific numerical identifiers.

Patient.identifier.id
Definition

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

Control0..1
Typestring
Patient.identifier.extension
Definition

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

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

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

Patient.identifier.use
Definition

The purpose of this identifier.

Control0..1
BindingIdentifies the purpose for this identifier, if known .
The codes SHALL be taken from IdentifierUse
Typecode
Is Modifiertrue
Requirements

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

Comments

This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Patient.identifier.type
Definition

Concesion Card Number assigned to a person by Centrelink, this can be Health Card Card, Pensioner Concession Card or Commonwealth Seniors Health Card Number

Control1..1
BindingA coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
The codes SHALL be taken from Identifier Type Codes; other codes may be used where these codes are not suitable
TypeCodeableConcept
Requirements

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

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage.

Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Fixed Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org.au/fhir/v2/0203"/>
    <code value="SEN"/>
    <display value="Commonwealth Seniors Health Card"/>
  </coding>
  <text value="Commonwealth Seniors Health Card"/>
</valueCodeableConcept>
Patient.identifier.system
Definition

namespace for CRN values

Control1..1
Typeuri
Requirements

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

Fixed Valuehttp://ns.electronichealth.net.au/id/crn
Example
General:http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri
Patient.identifier.value
Definition

10 character identifier NNNNNNNNNA

Control1..1
Typestring
Comments

A personal identifier assigned by Centrelink for the purposes of identifying people (and organisations) eligible for specific services.

Max Length10
Example
General:123456
DHS CRN:307111942H
Patient.identifier.period
Definition

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

Control0..1
TypePeriod
Patient.identifier.assigner
Definition

Organization that issued/manages the identifier.

Control0..1
TypeReference(Organization)
Comments

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

Patient.active
Definition

Whether this patient record is in active use.

Control0..1
Typeboolean
Is Modifiertrue
Requirements

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

Comments

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

This element is labeled as a modifier because when the patient record is marked as not active it is not expected to be used/referenced without being changed back to active.

Default Valuetrue
Patient.name
Definition

A name associated with the individual.

Control0..*
TypeHumanName
Requirements

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

Comments

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

Patient.telecom
Definition

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

Control0..*
TypeContactPoint
Requirements

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

Comments

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

Patient.gender
Definition

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

Control0..1
BindingThe gender of a person used for administrative purposes.
The codes SHALL be taken from AdministrativeGender
Typecode
Requirements

Needed for identification of the individual, in combination with (at least) name and birth date. Gender of individual drives many clinical processes.

Comments

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

Patient.birthDate
Definition

The date of birth for the individual.

Control0..1
Typedate
Requirements

Age of the individual drives many clinical processes.

Comments

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

LOINC Code21112-8
Patient.deceased[x]
Definition

Indicates if the individual is deceased or not.

Control0..1
TypeChoice of: boolean, dateTime
[x] NoteSee Choice of Data Types for further information about how to use [x]
Is Modifiertrue
Requirements

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

Comments

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

This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.

Patient.address
Definition

Addresses for the individual.

Control0..*
TypeAddress
Requirements

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

Comments

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

Patient.maritalStatus
Definition

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

Control0..1
BindingThe domestic partnership status of a person.
The codes SHALL be taken from Marital Status Codes; other codes may be used where these codes are not suitable
TypeCodeableConcept
Requirements

Most, if not all systems capture it.

Patient.multipleBirth[x]
Definition

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

Control0..1
TypeChoice of: boolean, integer
[x] NoteSee Choice of Data Types for further information about how to use [x]
Requirements

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

Comments

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

Patient.photo
Definition

Image of the patient.

Control0..*
TypeAttachment
Requirements

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

Patient.contact
Definition

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

Control0..*
TypeBackboneElement
Requirements

Need to track people you can contact about the patient.

Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
pat-1: SHALL at least contain a contact's details or a reference to an organization (: name.exists() or telecom.exists() or address.exists() or organization.exists())
Patient.contact.id
Definition

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

Control0..1
Typestring
Patient.contact.extension
Definition

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

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

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

Patient.contact.modifierExtension
Definition

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

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
Comments

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

Patient.contact.relationship
Definition

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

Control0..*
BindingThe nature of the relationship between a patient and a contact person for that patient.
The codes SHALL be taken from v2 Contact Role; other codes may be used where these codes are not suitable
TypeCodeableConcept
Requirements

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

Patient.contact.name
Definition

A name associated with the contact person.

Control0..1
TypeHumanName
Requirements

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

Patient.contact.telecom
Definition

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

Control0..*
TypeContactPoint
Requirements

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

Comments

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

Patient.contact.address
Definition

Address for the contact person.

Control0..1
TypeAddress
Requirements

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

Patient.contact.gender
Definition

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

Control0..1
BindingThe gender of a person used for administrative purposes.
The codes SHALL be taken from AdministrativeGender
Typecode
Requirements

Needed to address the person correctly.

Patient.contact.organization
Definition

Organization on behalf of which the contact is acting or for which the contact is working.

Control0..1 This element is affected by the following invariants: pat-1
TypeReference(Organization)
Requirements

For guardians or business related contacts, the organization is relevant.

Patient.contact.period
Definition

The period during which this contact person or organization is valid to be contacted relating to this patient.

Control0..1
TypePeriod
Patient.animal
Definition

Profile only for human patients

Control0..0
TypeBackboneElement
Is Modifiertrue
Requirements

Many clinical systems are extended to care for animal patients as well as human.

Comments

The animal element is labeled "Is Modifier" since patients may be non-human. Systems SHALL either handle patient details appropriately (e.g. inform users patient is not human) or reject declared animal records. The absense of the animal element does not imply that the patient is a human. If a system requires such a positive assertion that the patient is human, an extension will be required. (Do not use a species of homo-sapiens in animal species, as this would incorrectly infer that the patient is an animal).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
Patient.animal.id
Definition

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

Control0..1
Typestring
Patient.animal.extension
Definition

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

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

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

Patient.animal.modifierExtension
Definition

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

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
Comments

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

Patient.animal.species
Definition

Identifies the high level taxonomic categorization of the kind of animal.

Control1..1
BindingThe species of an animal.
For example codes, see AnimalSpecies
TypeCodeableConcept
Requirements

Need to know what kind of animal.

Comments

If the patient is non-human, at least a species SHALL be specified. Species SHALL be a widely recognised taxonomic classification. It may or may not be Linnaean taxonomy and may or may not be at the level of species. If the level is finer than species--such as a breed code--the code system used SHALL allow inference of the species. (The common example is that the word "Hereford" does not allow inference of the species Bos taurus, because there is a Hereford pig breed, but the SNOMED CT code for "Hereford Cattle Breed" does.).

Patient.animal.breed
Definition

Identifies the detailed categorization of the kind of animal.

Control0..1
BindingThe breed of an animal.
For example codes, see AnimalBreeds
TypeCodeableConcept
Requirements

May need to know the specific kind within the species.

Comments

Breed MAY be used to provide further taxonomic or non-taxonomic classification. It may involve local or proprietary designation--such as commercial strain--and/or additional information such as production type.

Patient.animal.genderStatus
Definition

Indicates the current state of the animal's reproductive organs.

Control0..1
BindingThe state of the animal's reproductive organs.
For example codes, see GenderStatus
TypeCodeableConcept
Requirements

Gender status can affect housing and animal behavior.

Patient.communication
Definition

Languages which may be used to communicate with the patient about his or her health.

Control0..*
TypeBackboneElement
Requirements

If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency is an important things to keep track of both for patient and other persons of interest.

Comments

If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
Patient.communication.id
Definition

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

Control0..1
Typestring
Patient.communication.extension
Definition

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

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

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

Patient.communication.modifierExtension
Definition

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

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
Comments

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

Patient.communication.language
Definition

The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English.

Control1..1
BindingA human language.
The codes SHALL be taken from Common Languages; other codes may be used where these codes are not suitable
TypeCodeableConcept
Requirements

Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.

Comments

The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.

Patient.communication.preferred
Definition

Indicates whether or not the patient prefers this language (over other languages he masters up a certain level).

Control0..1
Typeboolean
Requirements

People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method.

Comments

This language is specifically identified for communicating healthcare information.

Patient.generalPractitioner
Definition

Patient's nominated care provider.

Control0..*
TypeChoice of: Reference(Organization), Reference(Practitioner)
Alternate NamescareProvider
Comments

This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disablity setting, or even organization that will provide people to perform the care provider roles.

It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources.

Patient.managingOrganization
Definition

Organization that is the custodian of the patient record.

Control0..1
TypeReference(Organization)
Requirements

Need to know who recognizes this patient record, manages and updates it.

Comments

There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association).

Patient.link
Definition

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

Control0..*
TypeBackboneElement
Is Modifiertrue
Requirements

There are multiple usecases:

  • Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and * Distribution of patient information across multiple servers.
Comments

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

This element is labelled as a modifier because it may not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
Patient.link.id
Definition

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

Control0..1
Typestring
Patient.link.extension
Definition

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

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

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

Patient.link.modifierExtension
Definition

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

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
Comments

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

Patient.link.other
Definition

The other patient resource that the link refers to.

Control1..1
TypeChoice of: Reference(Patient), Reference(RelatedPerson)
Comments

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

Patient.link.type
Definition

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

Control1..1
BindingThe type of link between this patient resource and another patient resource.
The codes SHALL be taken from LinkType
Typecode