We have introduced support for the following extensions: Individual Pronouns and Person Recorded Sex Or Gender. These extensions are published in this guide to pre-adopt the material published in the R5 FHIR Extensions Pack. These extensions are an R4 (4.0.1) conversion of the canonical extension and may contain forwards incompatible data types when converted to R4 (see the extension page in this guide for information on any material differences). Implementers are advised to take note that this content may be removed or changed and to take caution if using these extensions.

Usage Notes

Profile specific implementation guidance:

• This profile supports patient gender identity aligned to Australian Bureau of Statics Standard for Sex, Gender, Variations of Sex Characteristics and Sexual Orientation Variables, 2020 using the genderIdentity extension and Gender Identity Response value set.
  • Man or male may be represented by sending the SNOMED CT code 446151000124109|Identifies as male gender|
  • Woman or female may be represented by sending the SNOMED CT code 446141000124107|Identifies as female gender|
  • Non-binary may be represented by sending the SNOMED CT code 33791000087105|Identifies as nonbinary gender|, see example Patient/example4
  • [I/They] use a different term (please specify) may be represented by sending only text and no code, see example Patient/example7
  • Prefer not to answer may be represented by sending the code “asked-declined”, see example Patient/example0
  • Not stated or inadequately described may be represented by the code “unknown”
• When exchanging concepts of sex or gender, refer to the guidance in the Gender Harmony Implementation Guide.
• Need for an interpreter service can be represented with the interpreterRequired extension set to “true”
  • If the language for interpreter service is known, the language is included in Patient.communication.language and Patient.communication.preferred is set to “true”.
  • If Patient.communication.preferred has not been included, or is set to “false”, systems should understand this as the language for the interpreter service is not known.
• See each Identifier profile page for guidance related to that identifier type.

Extensions under consideration:

• Patient: Ethnicity

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

This structure is derived from Patient

Name	Flags	Card.	Type	Description & Constraints
Patient	C	0..*	Patient	A patient in an Australian healthcare context inv-pat-0: If present, birth time's date shall be the birth date
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
birthPlace		0..1	Address	Place of Birth for patient URL: http://hl7.org/fhir/StructureDefinition/patient-birthPlace
indigenousStatus		0..1	Coding	Indigenous status URL: http://hl7.org.au/fhir/StructureDefinition/indigenous-status Binding: https://healthterminologies.gov.au/fhir/ValueSet/australian-indigenous-status-1 (required)
closingTheGapRegistration		0..1	boolean	Closing the Gap co-payment eligibility indicator URL: http://hl7.org.au/fhir/StructureDefinition/closing-the-gap-registration
mothersMaidenName		0..1	string	Mother's Maiden name URL: http://hl7.org/fhir/StructureDefinition/patient-mothersMaidenName
interpreterRequired		0..1	boolean	Whether the patient needs an interpreter URL: http://hl7.org/fhir/StructureDefinition/patient-interpreterRequired
dateOfArrival		0..1	date	The date a person first arrived in Australia, from another country, with the intention of living in Australia for one year or more URL: http://hl7.org.au/fhir/StructureDefinition/date-of-arrival
genderIdentity		0..1	CodeableConcept	The patient's gender identity shall be a member of the Gender Identity Response value set if any of the codes within that value set can apply URL: http://hl7.org/fhir/StructureDefinition/patient-genderIdentity Binding: GenderIdentity (example)
valueCodeableConcept		1..1	CodeableConcept	Value of extension Binding: https://healthterminologies.gov.au/fhir/ValueSet/gender-identity-response-1 (extensible)
individualPronouns		0..*	(Complex)	The pronouns to use when communicating about an individual. URL: http://hl7.org/fhir/StructureDefinition/individual-pronouns
recordedSexOrGender		0..*	(Complex)	A recorded sex or gender property for the individual URL: http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender
identifier		0..*	Identifier, AUIHI, AUMedicareCardNumber, AUDVANumber, AUHealthCareCardNumber, AUPensionerConcessionCardNumber, AUCwlthSeniorsHealthCardNumber, AUMedicalRecordNumber, AUInsuranceMemberNumber	Identifies this patient across multiple systems
birthDate	C	0..1	date	Date of birth extended for time and accuracy indicator
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
accuracyIndicator		0..1	Coding	Birth date accuracy indicator URL: http://hl7.org.au/fhir/StructureDefinition/date-accuracy-indicator Binding: https://healthterminologies.gov.au/fhir/ValueSet/date-accuracy-indicator-1 (required): Date accuracy coding
birthTime	C	0..1	dateTime	Birth time URL: http://hl7.org/fhir/StructureDefinition/patient-birthTime
Slices for deceased[x]		0..1	boolean, dateTime	Indicates if the individual is deceased or not Slice: Unordered, Closed by type:$this
deceased[x]:deceasedBoolean		0..1	boolean	Deceased indicator
deceased[x]:deceasedDateTime		0..1	dateTime	Deceased date time
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
accuracyIndicator		0..1	Coding	Deceased date accuracy indicator URL: http://hl7.org.au/fhir/StructureDefinition/date-accuracy-indicator Binding: https://healthterminologies.gov.au/fhir/ValueSet/date-accuracy-indicator-1 (required): Date accuracy coding
address		0..*	AustralianAddress, Address	An address for the individual
contact
relationship		0..*	CodeableConcept	The kind of relationship Binding: https://healthterminologies.gov.au/fhir/ValueSet/contact-relationship-type-3 (extensible)
address		0..1	Address, AustralianAddress	Address for the contact person
communication
language		1..1	CodeableConcept	The language which can be used to communicate with the patient about his or her health Binding: https://healthterminologies.gov.au/fhir/ValueSet/common-languages-australia-2 (extensible)
link		0..*	BackboneElement	Link to a Patient or RelatedPerson resource that concerns the same actual person
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Patient.extension:genderIdentity.valueCodeableConcept	extensible	https://healthterminologies.gov.au/fhir/ValueSet/gender-identity-response-1
Patient.contact.relationship	extensible	https://healthterminologies.gov.au/fhir/ValueSet/contact-relationship-type-3
Patient.communication.language	extensible	https://healthterminologies.gov.au/fhir/ValueSet/common-languages-australia-2

Constraints

Id	Grade	Path(s)	Details	Requirements
inv-pat-0	error	Patient	If present, birth time's date shall be the birth date : birthDate.extension('http://hl7.org/fhir/StructureDefinition/patient-birthTime').exists() implies birthDate.extension('http://hl7.org/fhir/StructureDefinition/patient-birthTime').value.toString().substring(0,10) = birthDate.toString()

Name	Flags	Card.	Type	Description & Constraints
Patient	C	0..*	Patient	A patient in an Australian healthcare context inv-pat-0: If present, birth time's date shall be the birth date
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
birthPlace		0..1	Address	Place of Birth for patient URL: http://hl7.org/fhir/StructureDefinition/patient-birthPlace
indigenousStatus		0..1	Coding	Indigenous status URL: http://hl7.org.au/fhir/StructureDefinition/indigenous-status Binding: https://healthterminologies.gov.au/fhir/ValueSet/australian-indigenous-status-1 (required)
closingTheGapRegistration		0..1	boolean	Closing the Gap co-payment eligibility indicator URL: http://hl7.org.au/fhir/StructureDefinition/closing-the-gap-registration
mothersMaidenName		0..1	string	Mother's Maiden name URL: http://hl7.org/fhir/StructureDefinition/patient-mothersMaidenName
interpreterRequired		0..1	boolean	Whether the patient needs an interpreter URL: http://hl7.org/fhir/StructureDefinition/patient-interpreterRequired
dateOfArrival		0..1	date	The date a person first arrived in Australia, from another country, with the intention of living in Australia for one year or more URL: http://hl7.org.au/fhir/StructureDefinition/date-of-arrival
genderIdentity		0..1	CodeableConcept	The patient's gender identity shall be a member of the Gender Identity Response value set if any of the codes within that value set can apply URL: http://hl7.org/fhir/StructureDefinition/patient-genderIdentity Binding: GenderIdentity (example)
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/patient-genderIdentity"
Slices for value[x]		1..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this Binding: GenderIdentity (example)
value[x]:valueCodeableConcept		1..1	CodeableConcept	Value of extension Binding: https://healthterminologies.gov.au/fhir/ValueSet/gender-identity-response-1 (extensible)
individualPronouns		0..*	(Complex)	The pronouns to use when communicating about an individual. URL: http://hl7.org/fhir/StructureDefinition/individual-pronouns
recordedSexOrGender		0..*	(Complex)	A recorded sex or gender property for the individual URL: http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		0..*	Identifier, AUIHI, AUMedicareCardNumber, AUDVANumber, AUHealthCareCardNumber, AUPensionerConcessionCardNumber, AUCwlthSeniorsHealthCardNumber, AUMedicalRecordNumber, AUInsuranceMemberNumber	Identifies this patient across multiple systems
active	?!Σ	0..1	boolean	Whether this patient's record is in active use
birthDate	ΣC	0..1	date	Date of birth extended for time and accuracy indicator
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
accuracyIndicator		0..1	Coding	Birth date accuracy indicator URL: http://hl7.org.au/fhir/StructureDefinition/date-accuracy-indicator Binding: https://healthterminologies.gov.au/fhir/ValueSet/date-accuracy-indicator-1 (required): Date accuracy coding
birthTime	C	0..1	dateTime	Birth time URL: http://hl7.org/fhir/StructureDefinition/patient-birthTime
Slices for deceased[x]	?!Σ	0..1		Indicates if the individual is deceased or not Slice: Unordered, Closed by type:$this
deceasedBoolean			boolean
deceasedDateTime			dateTime
deceased[x]:deceasedBoolean	?!Σ	0..1	boolean	Deceased indicator
deceased[x]:deceasedDateTime	?!Σ	0..1	dateTime	Deceased date time
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
accuracyIndicator		0..1	Coding	Deceased date accuracy indicator URL: http://hl7.org.au/fhir/StructureDefinition/date-accuracy-indicator Binding: https://healthterminologies.gov.au/fhir/ValueSet/date-accuracy-indicator-1 (required): Date accuracy coding
address	C	0..*	AustralianAddress, Address	An address for the individual
link	?!Σ	0..*	BackboneElement	Link to a Patient or RelatedPerson 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	Conformance	ValueSet
Patient.extension:genderIdentity.value[x]	example	GenderIdentity
Patient.extension:genderIdentity.value[x]:valueCodeableConcept	extensible	https://healthterminologies.gov.au/fhir/ValueSet/gender-identity-response-1
Patient.link.type	required	LinkType

Constraints

Id	Grade	Path(s)	Details	Requirements
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()
inv-add-0	error	Patient.address	The address shall at least have text or a line : text.exists() or line.exists()
inv-add-1	error	Patient.address	If asserting no fixed address, the type shall be 'physical' : extension('http://hl7.org.au/fhir/StructureDefinition/no-fixed-address').exists() implies type='physical'
inv-add-2	error	Patient.address	If asserting no fixed address, the address text shall begin with 'NO FIXED ADDRESS' : extension('http://hl7.org.au/fhir/StructureDefinition/no-fixed-address').exists() implies text.startsWith('NO FIXED ADDRESS')
inv-pat-0	error	Patient	If present, birth time's date shall be the birth date : birthDate.extension('http://hl7.org/fhir/StructureDefinition/patient-birthTime').exists() implies birthDate.extension('http://hl7.org/fhir/StructureDefinition/patient-birthTime').value.toString().substring(0,10) = birthDate.toString()

Name	Flags	Card.	Type	Description & Constraints
Patient	C	0..*	Patient	A patient in an Australian healthcare context inv-pat-0: If present, birth time's date shall be the birth date
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
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
birthPlace		0..1	Address	Place of Birth for patient URL: http://hl7.org/fhir/StructureDefinition/patient-birthPlace
indigenousStatus		0..1	Coding	Indigenous status URL: http://hl7.org.au/fhir/StructureDefinition/indigenous-status Binding: https://healthterminologies.gov.au/fhir/ValueSet/australian-indigenous-status-1 (required)
closingTheGapRegistration		0..1	boolean	Closing the Gap co-payment eligibility indicator URL: http://hl7.org.au/fhir/StructureDefinition/closing-the-gap-registration
mothersMaidenName		0..1	string	Mother's Maiden name URL: http://hl7.org/fhir/StructureDefinition/patient-mothersMaidenName
interpreterRequired		0..1	boolean	Whether the patient needs an interpreter URL: http://hl7.org/fhir/StructureDefinition/patient-interpreterRequired
dateOfArrival		0..1	date	The date a person first arrived in Australia, from another country, with the intention of living in Australia for one year or more URL: http://hl7.org.au/fhir/StructureDefinition/date-of-arrival
genderIdentity		0..1	CodeableConcept	The patient's gender identity shall be a member of the Gender Identity Response value set if any of the codes within that value set can apply URL: http://hl7.org/fhir/StructureDefinition/patient-genderIdentity Binding: GenderIdentity (example)
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/patient-genderIdentity"
Slices for value[x]		1..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this Binding: GenderIdentity (example)
value[x]:valueCodeableConcept		1..1	CodeableConcept	Value of extension Binding: https://healthterminologies.gov.au/fhir/ValueSet/gender-identity-response-1 (extensible)
individualPronouns		0..*	(Complex)	The pronouns to use when communicating about an individual. URL: http://hl7.org/fhir/StructureDefinition/individual-pronouns
recordedSexOrGender		0..*	(Complex)	A recorded sex or gender property for the individual URL: http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		0..*	Identifier, AUIHI, AUMedicareCardNumber, AUDVANumber, AUHealthCareCardNumber, AUPensionerConcessionCardNumber, AUCwlthSeniorsHealthCardNumber, AUMedicalRecordNumber, AUInsuranceMemberNumber	Identifies this patient across multiple systems
active	?!Σ	0..1	boolean	Whether this patient's record is in active use
name	Σ	0..*	HumanName	A name associated with the patient
telecom	Σ	0..*	ContactPoint	A contact detail for the individual
gender	Σ	0..1	code	male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
birthDate	ΣC	0..1	date	Date of birth extended for time and accuracy indicator
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
accuracyIndicator		0..1	Coding	Birth date accuracy indicator URL: http://hl7.org.au/fhir/StructureDefinition/date-accuracy-indicator Binding: https://healthterminologies.gov.au/fhir/ValueSet/date-accuracy-indicator-1 (required): Date accuracy coding
birthTime	C	0..1	dateTime	Birth time URL: http://hl7.org/fhir/StructureDefinition/patient-birthTime
value		0..1	date	Primitive value for date
Slices for deceased[x]	?!Σ	0..1		Indicates if the individual is deceased or not Slice: Unordered, Closed by type:$this
deceasedBoolean			boolean
deceasedDateTime			dateTime
deceased[x]:deceasedBoolean	?!Σ	0..1	boolean	Deceased indicator
deceased[x]:deceasedDateTime	?!Σ	0..1	dateTime	Deceased date time
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
accuracyIndicator		0..1	Coding	Deceased date accuracy indicator URL: http://hl7.org.au/fhir/StructureDefinition/date-accuracy-indicator Binding: https://healthterminologies.gov.au/fhir/ValueSet/date-accuracy-indicator-1 (required): Date accuracy coding
value		0..1	dateTime	Primitive value for dateTime
address	C	0..*	AustralianAddress, 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
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: https://healthterminologies.gov.au/fhir/ValueSet/contact-relationship-type-3 (extensible)
name		0..1	HumanName	A name associated with the contact person
telecom		0..*	ContactPoint	A contact detail for the person
address		0..1	Address, AustralianAddress	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: https://healthterminologies.gov.au/fhir/ValueSet/common-languages-australia-2 (extensible)
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 a Patient or RelatedPerson 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	Conformance	ValueSet
Patient.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Patient.extension:genderIdentity.value[x]	example	GenderIdentity
Patient.extension:genderIdentity.value[x]:valueCodeableConcept	extensible	https://healthterminologies.gov.au/fhir/ValueSet/gender-identity-response-1
Patient.gender	required	AdministrativeGender
Patient.maritalStatus	extensible	Marital Status Codes
Patient.contact.relationship	extensible	https://healthterminologies.gov.au/fhir/ValueSet/contact-relationship-type-3
Patient.contact.gender	required	AdministrativeGender
Patient.communication.language	extensible	https://healthterminologies.gov.au/fhir/ValueSet/common-languages-australia-2
Patient.link.type	required	LinkType

Constraints

Id	Grade	Path(s)	Details	Requirements
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()
inv-add-0	error	Patient.address	The address shall at least have text or a line : text.exists() or line.exists()
inv-add-1	error	Patient.address	If asserting no fixed address, the type shall be 'physical' : extension('http://hl7.org.au/fhir/StructureDefinition/no-fixed-address').exists() implies type='physical'
inv-add-2	error	Patient.address	If asserting no fixed address, the address text shall begin with 'NO FIXED ADDRESS' : extension('http://hl7.org.au/fhir/StructureDefinition/no-fixed-address').exists() implies text.startsWith('NO FIXED ADDRESS')
pat-1	error	Patient.contact	SHALL at least contain a contact's details or a reference to an organization : name.exists() or telecom.exists() or address.exists() or organization.exists()

Differential View

This structure is derived from Patient

Name	Flags	Card.	Type	Description & Constraints
Patient	C	0..*	Patient	A patient in an Australian healthcare context inv-pat-0: If present, birth time's date shall be the birth date
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
birthPlace		0..1	Address	Place of Birth for patient URL: http://hl7.org/fhir/StructureDefinition/patient-birthPlace
indigenousStatus		0..1	Coding	Indigenous status URL: http://hl7.org.au/fhir/StructureDefinition/indigenous-status Binding: https://healthterminologies.gov.au/fhir/ValueSet/australian-indigenous-status-1 (required)
closingTheGapRegistration		0..1	boolean	Closing the Gap co-payment eligibility indicator URL: http://hl7.org.au/fhir/StructureDefinition/closing-the-gap-registration
mothersMaidenName		0..1	string	Mother's Maiden name URL: http://hl7.org/fhir/StructureDefinition/patient-mothersMaidenName
interpreterRequired		0..1	boolean	Whether the patient needs an interpreter URL: http://hl7.org/fhir/StructureDefinition/patient-interpreterRequired
dateOfArrival		0..1	date	The date a person first arrived in Australia, from another country, with the intention of living in Australia for one year or more URL: http://hl7.org.au/fhir/StructureDefinition/date-of-arrival
genderIdentity		0..1	CodeableConcept	The patient's gender identity shall be a member of the Gender Identity Response value set if any of the codes within that value set can apply URL: http://hl7.org/fhir/StructureDefinition/patient-genderIdentity Binding: GenderIdentity (example)
valueCodeableConcept		1..1	CodeableConcept	Value of extension Binding: https://healthterminologies.gov.au/fhir/ValueSet/gender-identity-response-1 (extensible)
individualPronouns		0..*	(Complex)	The pronouns to use when communicating about an individual. URL: http://hl7.org/fhir/StructureDefinition/individual-pronouns
recordedSexOrGender		0..*	(Complex)	A recorded sex or gender property for the individual URL: http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender
identifier		0..*	Identifier, AUIHI, AUMedicareCardNumber, AUDVANumber, AUHealthCareCardNumber, AUPensionerConcessionCardNumber, AUCwlthSeniorsHealthCardNumber, AUMedicalRecordNumber, AUInsuranceMemberNumber	Identifies this patient across multiple systems
birthDate	C	0..1	date	Date of birth extended for time and accuracy indicator
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
accuracyIndicator		0..1	Coding	Birth date accuracy indicator URL: http://hl7.org.au/fhir/StructureDefinition/date-accuracy-indicator Binding: https://healthterminologies.gov.au/fhir/ValueSet/date-accuracy-indicator-1 (required): Date accuracy coding
birthTime	C	0..1	dateTime	Birth time URL: http://hl7.org/fhir/StructureDefinition/patient-birthTime
Slices for deceased[x]		0..1	boolean, dateTime	Indicates if the individual is deceased or not Slice: Unordered, Closed by type:$this
deceased[x]:deceasedBoolean		0..1	boolean	Deceased indicator
deceased[x]:deceasedDateTime		0..1	dateTime	Deceased date time
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
accuracyIndicator		0..1	Coding	Deceased date accuracy indicator URL: http://hl7.org.au/fhir/StructureDefinition/date-accuracy-indicator Binding: https://healthterminologies.gov.au/fhir/ValueSet/date-accuracy-indicator-1 (required): Date accuracy coding
address		0..*	AustralianAddress, Address	An address for the individual
contact
relationship		0..*	CodeableConcept	The kind of relationship Binding: https://healthterminologies.gov.au/fhir/ValueSet/contact-relationship-type-3 (extensible)
address		0..1	Address, AustralianAddress	Address for the contact person
communication
language		1..1	CodeableConcept	The language which can be used to communicate with the patient about his or her health Binding: https://healthterminologies.gov.au/fhir/ValueSet/common-languages-australia-2 (extensible)
link		0..*	BackboneElement	Link to a Patient or RelatedPerson resource that concerns the same actual person
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Patient.extension:genderIdentity.valueCodeableConcept	extensible	https://healthterminologies.gov.au/fhir/ValueSet/gender-identity-response-1
Patient.contact.relationship	extensible	https://healthterminologies.gov.au/fhir/ValueSet/contact-relationship-type-3
Patient.communication.language	extensible	https://healthterminologies.gov.au/fhir/ValueSet/common-languages-australia-2

Constraints

Id	Grade	Path(s)	Details	Requirements
inv-pat-0	error	Patient	If present, birth time's date shall be the birth date : birthDate.extension('http://hl7.org/fhir/StructureDefinition/patient-birthTime').exists() implies birthDate.extension('http://hl7.org/fhir/StructureDefinition/patient-birthTime').value.toString().substring(0,10) = birthDate.toString()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Patient	C	0..*	Patient	A patient in an Australian healthcare context inv-pat-0: If present, birth time's date shall be the birth date
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
birthPlace		0..1	Address	Place of Birth for patient URL: http://hl7.org/fhir/StructureDefinition/patient-birthPlace
indigenousStatus		0..1	Coding	Indigenous status URL: http://hl7.org.au/fhir/StructureDefinition/indigenous-status Binding: https://healthterminologies.gov.au/fhir/ValueSet/australian-indigenous-status-1 (required)
closingTheGapRegistration		0..1	boolean	Closing the Gap co-payment eligibility indicator URL: http://hl7.org.au/fhir/StructureDefinition/closing-the-gap-registration
mothersMaidenName		0..1	string	Mother's Maiden name URL: http://hl7.org/fhir/StructureDefinition/patient-mothersMaidenName
interpreterRequired		0..1	boolean	Whether the patient needs an interpreter URL: http://hl7.org/fhir/StructureDefinition/patient-interpreterRequired
dateOfArrival		0..1	date	The date a person first arrived in Australia, from another country, with the intention of living in Australia for one year or more URL: http://hl7.org.au/fhir/StructureDefinition/date-of-arrival
genderIdentity		0..1	CodeableConcept	The patient's gender identity shall be a member of the Gender Identity Response value set if any of the codes within that value set can apply URL: http://hl7.org/fhir/StructureDefinition/patient-genderIdentity Binding: GenderIdentity (example)
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/patient-genderIdentity"
Slices for value[x]		1..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this Binding: GenderIdentity (example)
value[x]:valueCodeableConcept		1..1	CodeableConcept	Value of extension Binding: https://healthterminologies.gov.au/fhir/ValueSet/gender-identity-response-1 (extensible)
individualPronouns		0..*	(Complex)	The pronouns to use when communicating about an individual. URL: http://hl7.org/fhir/StructureDefinition/individual-pronouns
recordedSexOrGender		0..*	(Complex)	A recorded sex or gender property for the individual URL: http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		0..*	Identifier, AUIHI, AUMedicareCardNumber, AUDVANumber, AUHealthCareCardNumber, AUPensionerConcessionCardNumber, AUCwlthSeniorsHealthCardNumber, AUMedicalRecordNumber, AUInsuranceMemberNumber	Identifies this patient across multiple systems
active	?!Σ	0..1	boolean	Whether this patient's record is in active use
birthDate	ΣC	0..1	date	Date of birth extended for time and accuracy indicator
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
accuracyIndicator		0..1	Coding	Birth date accuracy indicator URL: http://hl7.org.au/fhir/StructureDefinition/date-accuracy-indicator Binding: https://healthterminologies.gov.au/fhir/ValueSet/date-accuracy-indicator-1 (required): Date accuracy coding
birthTime	C	0..1	dateTime	Birth time URL: http://hl7.org/fhir/StructureDefinition/patient-birthTime
Slices for deceased[x]	?!Σ	0..1		Indicates if the individual is deceased or not Slice: Unordered, Closed by type:$this
deceasedBoolean			boolean
deceasedDateTime			dateTime
deceased[x]:deceasedBoolean	?!Σ	0..1	boolean	Deceased indicator
deceased[x]:deceasedDateTime	?!Σ	0..1	dateTime	Deceased date time
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
accuracyIndicator		0..1	Coding	Deceased date accuracy indicator URL: http://hl7.org.au/fhir/StructureDefinition/date-accuracy-indicator Binding: https://healthterminologies.gov.au/fhir/ValueSet/date-accuracy-indicator-1 (required): Date accuracy coding
address	C	0..*	AustralianAddress, Address	An address for the individual
link	?!Σ	0..*	BackboneElement	Link to a Patient or RelatedPerson 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	Conformance	ValueSet
Patient.extension:genderIdentity.value[x]	example	GenderIdentity
Patient.extension:genderIdentity.value[x]:valueCodeableConcept	extensible	https://healthterminologies.gov.au/fhir/ValueSet/gender-identity-response-1
Patient.link.type	required	LinkType

Constraints

Id	Grade	Path(s)	Details	Requirements
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()
inv-add-0	error	Patient.address	The address shall at least have text or a line : text.exists() or line.exists()
inv-add-1	error	Patient.address	If asserting no fixed address, the type shall be 'physical' : extension('http://hl7.org.au/fhir/StructureDefinition/no-fixed-address').exists() implies type='physical'
inv-add-2	error	Patient.address	If asserting no fixed address, the address text shall begin with 'NO FIXED ADDRESS' : extension('http://hl7.org.au/fhir/StructureDefinition/no-fixed-address').exists() implies text.startsWith('NO FIXED ADDRESS')
inv-pat-0	error	Patient	If present, birth time's date shall be the birth date : birthDate.extension('http://hl7.org/fhir/StructureDefinition/patient-birthTime').exists() implies birthDate.extension('http://hl7.org/fhir/StructureDefinition/patient-birthTime').value.toString().substring(0,10) = birthDate.toString()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Patient	C	0..*	Patient	A patient in an Australian healthcare context inv-pat-0: If present, birth time's date shall be the birth date
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
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
birthPlace		0..1	Address	Place of Birth for patient URL: http://hl7.org/fhir/StructureDefinition/patient-birthPlace
indigenousStatus		0..1	Coding	Indigenous status URL: http://hl7.org.au/fhir/StructureDefinition/indigenous-status Binding: https://healthterminologies.gov.au/fhir/ValueSet/australian-indigenous-status-1 (required)
closingTheGapRegistration		0..1	boolean	Closing the Gap co-payment eligibility indicator URL: http://hl7.org.au/fhir/StructureDefinition/closing-the-gap-registration
mothersMaidenName		0..1	string	Mother's Maiden name URL: http://hl7.org/fhir/StructureDefinition/patient-mothersMaidenName
interpreterRequired		0..1	boolean	Whether the patient needs an interpreter URL: http://hl7.org/fhir/StructureDefinition/patient-interpreterRequired
dateOfArrival		0..1	date	The date a person first arrived in Australia, from another country, with the intention of living in Australia for one year or more URL: http://hl7.org.au/fhir/StructureDefinition/date-of-arrival
genderIdentity		0..1	CodeableConcept	The patient's gender identity shall be a member of the Gender Identity Response value set if any of the codes within that value set can apply URL: http://hl7.org/fhir/StructureDefinition/patient-genderIdentity Binding: GenderIdentity (example)
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/patient-genderIdentity"
Slices for value[x]		1..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this Binding: GenderIdentity (example)
value[x]:valueCodeableConcept		1..1	CodeableConcept	Value of extension Binding: https://healthterminologies.gov.au/fhir/ValueSet/gender-identity-response-1 (extensible)
individualPronouns		0..*	(Complex)	The pronouns to use when communicating about an individual. URL: http://hl7.org/fhir/StructureDefinition/individual-pronouns
recordedSexOrGender		0..*	(Complex)	A recorded sex or gender property for the individual URL: http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		0..*	Identifier, AUIHI, AUMedicareCardNumber, AUDVANumber, AUHealthCareCardNumber, AUPensionerConcessionCardNumber, AUCwlthSeniorsHealthCardNumber, AUMedicalRecordNumber, AUInsuranceMemberNumber	Identifies this patient across multiple systems
active	?!Σ	0..1	boolean	Whether this patient's record is in active use
name	Σ	0..*	HumanName	A name associated with the patient
telecom	Σ	0..*	ContactPoint	A contact detail for the individual
gender	Σ	0..1	code	male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
birthDate	ΣC	0..1	date	Date of birth extended for time and accuracy indicator
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
accuracyIndicator		0..1	Coding	Birth date accuracy indicator URL: http://hl7.org.au/fhir/StructureDefinition/date-accuracy-indicator Binding: https://healthterminologies.gov.au/fhir/ValueSet/date-accuracy-indicator-1 (required): Date accuracy coding
birthTime	C	0..1	dateTime	Birth time URL: http://hl7.org/fhir/StructureDefinition/patient-birthTime
value		0..1	date	Primitive value for date
Slices for deceased[x]	?!Σ	0..1		Indicates if the individual is deceased or not Slice: Unordered, Closed by type:$this
deceasedBoolean			boolean
deceasedDateTime			dateTime
deceased[x]:deceasedBoolean	?!Σ	0..1	boolean	Deceased indicator
deceased[x]:deceasedDateTime	?!Σ	0..1	dateTime	Deceased date time
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
accuracyIndicator		0..1	Coding	Deceased date accuracy indicator URL: http://hl7.org.au/fhir/StructureDefinition/date-accuracy-indicator Binding: https://healthterminologies.gov.au/fhir/ValueSet/date-accuracy-indicator-1 (required): Date accuracy coding
value		0..1	dateTime	Primitive value for dateTime
address	C	0..*	AustralianAddress, 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
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: https://healthterminologies.gov.au/fhir/ValueSet/contact-relationship-type-3 (extensible)
name		0..1	HumanName	A name associated with the contact person
telecom		0..*	ContactPoint	A contact detail for the person
address		0..1	Address, AustralianAddress	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: https://healthterminologies.gov.au/fhir/ValueSet/common-languages-australia-2 (extensible)
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 a Patient or RelatedPerson 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	Conformance	ValueSet
Patient.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Patient.extension:genderIdentity.value[x]	example	GenderIdentity
Patient.extension:genderIdentity.value[x]:valueCodeableConcept	extensible	https://healthterminologies.gov.au/fhir/ValueSet/gender-identity-response-1
Patient.gender	required	AdministrativeGender
Patient.maritalStatus	extensible	Marital Status Codes
Patient.contact.relationship	extensible	https://healthterminologies.gov.au/fhir/ValueSet/contact-relationship-type-3
Patient.contact.gender	required	AdministrativeGender
Patient.communication.language	extensible	https://healthterminologies.gov.au/fhir/ValueSet/common-languages-australia-2
Patient.link.type	required	LinkType

Constraints

Id	Grade	Path(s)	Details	Requirements
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()
inv-add-0	error	Patient.address	The address shall at least have text or a line : text.exists() or line.exists()
inv-add-1	error	Patient.address	If asserting no fixed address, the type shall be 'physical' : extension('http://hl7.org.au/fhir/StructureDefinition/no-fixed-address').exists() implies type='physical'
inv-add-2	error	Patient.address	If asserting no fixed address, the address text shall begin with 'NO FIXED ADDRESS' : extension('http://hl7.org.au/fhir/StructureDefinition/no-fixed-address').exists() implies text.startsWith('NO FIXED ADDRESS')
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

Structures

This structure refers to these other structures:

• Australian Address (http://hl7.org.au/fhir/StructureDefinition/au-address)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/StructureDefinition/patient-birthPlace
• http://hl7.org.au/fhir/StructureDefinition/indigenous-status
• http://hl7.org.au/fhir/StructureDefinition/closing-the-gap-registration
• http://hl7.org/fhir/StructureDefinition/patient-mothersMaidenName
• http://hl7.org/fhir/StructureDefinition/patient-interpreterRequired
• http://hl7.org.au/fhir/StructureDefinition/date-of-arrival
• http://hl7.org/fhir/StructureDefinition/patient-genderIdentity
• http://hl7.org/fhir/StructureDefinition/individual-pronouns
• http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender
• http://hl7.org.au/fhir/StructureDefinition/date-accuracy-indicator
• http://hl7.org/fhir/StructureDefinition/patient-birthTime

Slices

This structure defines the following Slices:

• The element Patient.deceased[x] is sliced based on the value of type:$this (Closed)

Maturity: 3