AU Base Implementation Guide
4.2.2-ballot - Ballot Australia flag

This page is part of the Australian Base IG (v4.2.2-ballot: AU Base R4.2 Ballot 5) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 4.1.0. For a full list of available versions, see the Directory of published versions

Resource Profile: AUBasePatient - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 3

Definitions for the au-patient resource profile.

Guidance on how to interpret the contents of this table can be found here

0. Patient
Definition

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

ShortA patient in an Australian healthcare context
Invariantsinv-pat-0: 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())
inv-pat-1: Individual gender identity shall be a member of the Gender Identity Response value set if any codes within that value set can apply (extension('http://hl7.org/fhir/StructureDefinition/individual-genderIdentity').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-genderIdentity').all(extension('value').value.memberOf('https://healthterminologies.gov.au/fhir/ValueSet/gender-identity-response-1')))
inv-pat-2: Individual pronouns shall be a member of the Australian Pronouns value set if any codes within that value set can apply (extension('http://hl7.org/fhir/StructureDefinition/individual-pronouns').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-pronouns').all(extension('value').value.memberOf('https://healthterminologies.gov.au/fhir/ValueSet/australian-pronouns-1')))
inv-pat-3: Recorded sex or gender type shall be a member of the AU Recorded Sex or Gender Type value set if any codes within that value set can apply (extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('type').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').all(extension('type').value.memberOf('http://terminology.hl7.org.au/ValueSet/rsg-type')))
inv-pat-4: Recorded sex or gender source document type shall be a member of the AU Recorded Sex or Gender (RSG) Source Document Type value set if any codes within that value set can apply (extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('sourceDocument').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').all(extension('sourceDocument').value.memberOf('http://terminology.hl7.org.au/ValueSet/rsg-source-document-type')))
inv-pat-5: Recorded sex or gender jurisdiction shall be a member of the Jurisdiction ValueSet - AU Extended value set if any codes within that value set can apply (extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('jurisdiction').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').all(extension('jurisdiction').value.memberOf('http://terminology.hl7.org.au/ValueSet/jurisdiction-extended')))
2. Patient.extension
SlicingThis element introduces a set of slices on Patient.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 4. Patient.extension:birthPlace
    Slice NamebirthPlace
    TypeExtension(Patient Birth Place) (Extension Type: Address)
    6. Patient.extension:indigenousStatus
    Slice NameindigenousStatus
    TypeExtension(Australian Indigenous Status) (Extension Type: Coding)
    8. Patient.extension:veteranStatus
    Slice NameveteranStatus
    TypeExtension(Australian Veteran Status) (Extension Type: Coding)
    10. Patient.extension:closingTheGapRegistration
    Slice NameclosingTheGapRegistration
    TypeExtension(Closing the Gap Registration) (Extension Type: boolean)
    12. Patient.extension:mothersMaidenName
    Slice NamemothersMaidenName
    TypeExtension(Patient Mother's Maiden Name) (Extension Type: string)
    14. Patient.extension:interpreterRequired
    Slice NameinterpreterRequired
    TypeExtension(Patient Interpreter Required) (Extension Type: boolean)
    16. Patient.extension:dateOfArrival
    Slice NamedateOfArrival
    TypeExtension(Date of Arrival in Australia) (Extension Type: date)
    18. Patient.extension:genderIdentity
    Slice NamegenderIdentity
    ShortGender identity shall be a member of the Gender Identity Response value set if any codes within that value set can apply
    Comments

    Individual Gender identity Gender Identity Response (Extensible). See Australian Bureau of Statics (ABS) Standard for Sex, Gender, Variations of Sex Characteristics and Sexual Orientation Variables, 2020 for further materials.

    TypeExtension(Individual Gender Identity) (Complex Extension)
    20. Patient.extension:individualPronouns
    Slice NameindividualPronouns
    ShortPronouns shall be a member of the Australian Pronouns value set if any codes within that value set can apply
    Comments

    Individual Pronouns Australian Pronouns (Extensible).

    TypeExtension(Individual Pronouns) (Complex Extension)
    22. Patient.extension:recordedSexOrGender
    Slice NamerecordedSexOrGender
    ShortRecorded sex or gender type shall be a member of the AU Recorded Sex or Gender Type value set if any codes within that value set can apply. Recorded sex or gender source document type shall be a member of the AU Recorded Sex or Gender (RSG) Source Document Type value set if any codes within that value set can apply. Recorded sex or gender jurisdiction shall be a member of the Jurisdiction - ValueSet AU Extended value set if any codes within that value set can apply
    Comments

    Person Recorded Sex Or Gender type AU Recorded Sex or Gender Type (extensible). Person Recorded Sex Or Gender source document AU Recorded Sex or Gender (RSG) Source Document Type (extensible). Person Recorded Sex Or Gender jurisdiction Jurisdiction ValueSet - AU Extended (extensible).

    TypeExtension(Person Recorded Sex Or Gender) (Complex Extension)
    24. Patient.identifier
    ShortIdentifies this patient across multiple systems
    NoteThis is a business identifier, not a resource identifier (see discussion)
    TypeIdentifier(Identifier, AU IHI, AU Medicare Card Number, AU DVA Number, AU Health Care Card Number, AU Pensioner Concession Card Number, AU Commonwealth Seniors Health Card Number, AU Medical Record Number, AU Insurance Member Number)
    26. Patient.birthDate
    ShortDate of birth extended for time and accuracy indicator
    Requirements

    Age of the individual drives many clinical processes. May include accuracy indicator and specific birth time.

    LOINC Code
    28. Patient.birthDate.extension
    SlicingThis element introduces a set of slices on Patient.birthDate.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 30. Patient.birthDate.extension:accuracyIndicator
      Slice NameaccuracyIndicator
      ShortBirth date accuracy indicator
      Comments

      In some circumstances, systems may only have date or datetime data that has unknown or estimated parts. This coding establishes the accuracy of the day, month and year parts.

      TypeExtension(Date Accuracy Indicator) (Extension Type: Coding)
      32. Patient.birthDate.extension:birthTime
      Slice NamebirthTime
      Definition

      The time of day that the patient was born. This includes the date to ensure that the timezone information can be communicated effectively.

      ShortBirth time
      TypeExtension(Patient Birth Time) (Extension Type: dateTime)
      34. Patient.deceased[x]
      Definition

      Indicates if the individual is deceased or not. Deceased date accuracy indicator is optional.

      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      SlicingThis element introduces a set of slices on Patient.deceased[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
      • type @ $this
      • 36. Patient.deceased[x]:deceasedBoolean
        Slice NamedeceasedBoolean
        Definition

        Boolean indicator if the individual is deceased or not.

        ShortDeceased indicator
        Typeboolean
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        38. Patient.deceased[x]:deceasedDateTime
        Slice NamedeceasedDateTime
        Definition

        Individual deceased date-time with optional accuracy indicator.

        ShortDeceased date time
        TypedateTime
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        40. Patient.deceased[x]:deceasedDateTime.extension
        SlicingThis element introduces a set of slices on Patient.deceased[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 42. Patient.deceased[x]:deceasedDateTime.extension:accuracyIndicator
          Slice NameaccuracyIndicator
          ShortDeceased date accuracy indicator
          Comments

          In some circumstances, systems may only have date or datetime data that has unknown or estimated parts. This coding establishes the accuracy of the day, month and year parts.

          TypeExtension(Date Accuracy Indicator) (Extension Type: Coding)
          44. Patient.address
          ShortAn address for the individual
          Comments

          The address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource).

          TypeAddress(Australian Address, Address)
          46. Patient.contact
          48. Patient.contact.relationship
          BindingUnless not suitable, these codes SHALL be taken from Contact Relationship Type .
          (extensible to https://healthterminologies.gov.au/fhir/ValueSet/contact-relationship-type-3)
          50. Patient.contact.address
          ShortAddress for the contact person
          Comments

          The address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource).

          TypeAddress(Address, Australian Address)
          52. Patient.communication
          54. Patient.communication.language
          BindingUnless not suitable, these codes SHALL be taken from Common Languages in Australia .
          (extensible to https://healthterminologies.gov.au/fhir/ValueSet/common-languages-australia-2)
          56. Patient.link
          Definition

          Link to a Patient or RelatedPerson resource that concerns the same actual person.

          ShortLink to a Patient or RelatedPerson resource that concerns the same actual person

          Guidance on how to interpret the contents of this table can be found here

          0. Patient
          Definition

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


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

          ShortA patient in an Australian healthcare contextInformation about an individual or animal receiving health care services
          Control0..*
          Is Modifierfalse
          Summaryfalse
          Alternate NamesSubjectOfCare Client Resident
          Invariantsdom-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 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
          dom-6: A resource should have narrative for robust management (text.`div`.exists())
          inv-pat-0: 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())
          inv-pat-1: Individual gender identity shall be a member of the Gender Identity Response value set if any codes within that value set can apply (extension('http://hl7.org/fhir/StructureDefinition/individual-genderIdentity').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-genderIdentity').all(extension('value').value.memberOf('https://healthterminologies.gov.au/fhir/ValueSet/gender-identity-response-1')))
          inv-pat-2: Individual pronouns shall be a member of the Australian Pronouns value set if any codes within that value set can apply (extension('http://hl7.org/fhir/StructureDefinition/individual-pronouns').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-pronouns').all(extension('value').value.memberOf('https://healthterminologies.gov.au/fhir/ValueSet/australian-pronouns-1')))
          inv-pat-3: Recorded sex or gender type shall be a member of the AU Recorded Sex or Gender Type value set if any codes within that value set can apply (extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('type').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').all(extension('type').value.memberOf('http://terminology.hl7.org.au/ValueSet/rsg-type')))
          inv-pat-4: Recorded sex or gender source document type shall be a member of the AU Recorded Sex or Gender (RSG) Source Document Type value set if any codes within that value set can apply (extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('sourceDocument').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').all(extension('sourceDocument').value.memberOf('http://terminology.hl7.org.au/ValueSet/rsg-source-document-type')))
          inv-pat-5: Recorded sex or gender jurisdiction shall be a member of the Jurisdiction ValueSet - AU Extended value set if any codes within that value set can apply (extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('jurisdiction').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').all(extension('jurisdiction').value.memberOf('http://terminology.hl7.org.au/ValueSet/jurisdiction-extended')))
          2. 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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

          ShortA set of rules under which this content was created
          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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

          Control0..1
          Typeuri
          Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          4. Patient.extension
          Definition

          An Extension


          May be used to represent additional information that is not part of the basic definition of the resource. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortExtensionAdditional content defined by implementations
          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.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on Patient.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 6. Patient.extension:birthPlace
            Slice NamebirthPlace
            Definition

            The registered place of birth of the patient. A sytem may use the address.text if they don't store the birthPlace address in discrete elements.

            ShortPlace of Birth for patient
            Control0..1
            TypeExtension(Patient Birth Place) (Extension Type: Address)
            Is Modifierfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            8. Patient.extension:indigenousStatus
            Slice NameindigenousStatus
            Definition

            National Health Data Dictionary (NHDD) based indigenous status for a person.

            ShortIndigenous status
            Comments

            This concept is equivalent to Australian Institute of Health and Welfare data element 602543 Person—Indigenous status, code N.

            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Australian Indigenous Status) (Extension Type: Coding)
            Is Modifierfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            10. Patient.extension:veteranStatus
            Slice NameveteranStatus
            Definition

            Veteran / Australian Defence Force (ADF) status for a person.

            ShortVeteran / Australian Defence Force (ADF) status
            Comments

            This concept is equivalent to Australian Institute of Health and Welfare data element 737931 Person—ADF veteran status, code N.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension(Australian Veteran Status) (Extension Type: Coding)
            Is Modifierfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            12. Patient.extension:closingTheGapRegistration
            Slice NameclosingTheGapRegistration
            Definition

            Indication of eligibility for the Closing the Gap co-payment.

            ShortClosing the Gap co-payment eligibility indicator
            Comments

            This concept is equivalent to Australian Institute of Health and Welfare data element 603671 Patient—Closing the Gap co-payment eligibility indicator.

            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Closing the Gap Registration) (Extension Type: boolean)
            Is Modifierfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            14. Patient.extension:mothersMaidenName
            Slice NamemothersMaidenName
            Definition

            Mother's maiden (unmarried) name, commonly collected to help verify patient identity.

            ShortMother's Maiden name
            Control0..1
            TypeExtension(Patient Mother's Maiden Name) (Extension Type: string)
            Is Modifierfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            16. Patient.extension:interpreterRequired
            Slice NameinterpreterRequired
            Definition

            This Patient requires an interpreter to communicate healthcare information to the practitioner.

            ShortWhether the patient needs an interpreter
            Comments

            The Patient does not speak the default language of the organization, and hence requires an interpreter. If the patient has other languages in the Communications list, then that would be the type of interpreter required.

            Control0..1
            TypeExtension(Patient Interpreter Required) (Extension Type: boolean)
            Is Modifierfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            18. Patient.extension:dateOfArrival
            Slice NamedateOfArrival
            Definition

            The date a person first arrived in Australia, from another country, with the intention of living in Australia for one year or more. This date is captured once for a person and is not subsequently updated with subsequent arrivals.

            ShortThe date a person first arrived in Australia, from another country, with the intention of living in Australia for one year or more
            Comments

            See Australian Bureau of Statics (ABS) 1200.0.55.007 - Year of Arrival Standard, 2014, Version 1.5 for further information. This concept is equivalent to Australian Institute of Health and Welfare data element 269447 Person—year of first arrival in Australia.

            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Date of Arrival in Australia) (Extension Type: date)
            Is Modifierfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            20. Patient.extension:genderIdentity
            Slice NamegenderIdentity
            Definition

            An individual's personal sense of being a man, woman, boy, girl, nonbinary, or something else.

            ShortGender identity shall be a member of the Gender Identity Response value set if any codes within that value set can apply
            Comments

            Individual Gender identity Gender Identity Response (Extensible). See Australian Bureau of Statics (ABS) Standard for Sex, Gender, Variations of Sex Characteristics and Sexual Orientation Variables, 2020 for further materials.

            Control0..*
            This element is affected by the following invariants: inv-pat-1
            TypeExtension(Individual Gender Identity) (Complex Extension)
            Is Modifierfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            22. Patient.extension:individualPronouns
            Slice NameindividualPronouns
            Definition

            The pronouns to use when referring to an individual in verbal or written communication.

            ShortPronouns shall be a member of the Australian Pronouns value set if any codes within that value set can apply
            Comments

            Individual Pronouns Australian Pronouns (Extensible).

            Control0..*
            This element is affected by the following invariants: inv-pat-2
            TypeExtension(Individual Pronouns) (Complex Extension)
            Is Modifierfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            24. Patient.extension:recordedSexOrGender
            Slice NamerecordedSexOrGender
            Definition

            A sex or gender property for the individual from a document or other record

            ShortRecorded sex or gender type shall be a member of the AU Recorded Sex or Gender Type value set if any codes within that value set can apply. Recorded sex or gender source document type shall be a member of the AU Recorded Sex or Gender (RSG) Source Document Type value set if any codes within that value set can apply. Recorded sex or gender jurisdiction shall be a member of the Jurisdiction - ValueSet AU Extended value set if any codes within that value set can apply
            Comments

            Person Recorded Sex Or Gender type AU Recorded Sex or Gender Type (extensible). Person Recorded Sex Or Gender source document AU Recorded Sex or Gender (RSG) Source Document Type (extensible). Person Recorded Sex Or Gender jurisdiction Jurisdiction ValueSet - AU Extended (extensible).

            Control0..*
            This element is affected by the following invariants: inv-pat-3, inv-pat-4, inv-pat-5
            TypeExtension(Person Recorded Sex Or Gender) (Complex Extension)
            Is Modifierfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            26. 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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored
            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.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
            Summaryfalse
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            28. Patient.identifier
            Definition

            An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.


            An identifier for this patient.

            ShortIdentifies this patient across multiple systemsAn identifier for this patient
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..*
            This element is affected by the following invariants: ele-1
            TypeIdentifier(Identifier, AU IHI, AU Medicare Card Number, AU DVA Number, AU Health Care Card Number, AU Pensioner Concession Card Number, AU Commonwealth Seniors Health Card Number, AU Medical Record Number, AU Insurance Member Number)
            Is Modifierfalse
            Requirements

            Patients are almost always assigned specific numerical identifiers.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            30. Patient.active
            Definition

            Whether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules.

            It is often used to filter patient lists to exclude inactive patients

            Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death.

            ShortWhether this patient's record is in active use
            Comments

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

            Control0..1
            Typeboolean
            Is Modifiertrue because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

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

            Meaning if MissingThis resource is generally assumed to be active if no value is provided for the active element
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            32. Patient.birthDate
            Definition

            The date of birth for the individual.

            ShortDate of birth extended for time and accuracy indicatorThe date of birth for the individual
            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 maternity/infant care systems).

            Control0..1
            This element is affected by the following invariants: inv-pat-0
            Typedate
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Age of the individual drives many clinical processes. May include accuracy indicator and specific birth time.


            Age of the individual drives many clinical processes.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            LOINC Code21112-8
            34. Patient.birthDate.extension
            Definition

            An Extension


            May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortExtensionAdditional content defined by implementations
            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.

            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on Patient.birthDate.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 36. Patient.birthDate.extension:accuracyIndicator
              Slice NameaccuracyIndicator
              Definition

              General date accuracy indicator coding.

              ShortBirth date accuracy indicator
              Comments

              In some circumstances, systems may only have date or datetime data that has unknown or estimated parts. This coding establishes the accuracy of the day, month and year parts.

              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(Date Accuracy Indicator) (Extension Type: Coding)
              Is Modifierfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              38. Patient.birthDate.extension:birthTime
              Slice NamebirthTime
              Definition

              The time of day that the patient was born. This includes the date to ensure that the timezone information can be communicated effectively.

              ShortBirth time
              Control0..1
              This element is affected by the following invariants: inv-pat-0
              TypeExtension(Patient Birth Time) (Extension Type: dateTime)
              Is Modifierfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              40. Patient.deceased[x]
              Definition

              Indicates if the individual is deceased or not. Deceased date accuracy indicator is optional.


              Indicates if the individual is deceased or not.

              ShortIndicates if the individual is deceased or not
              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.

              Control0..1
              TypeChoice of: boolean, dateTime
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Is Modifiertrue because 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.
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              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.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              SlicingThis element introduces a set of slices on Patient.deceased[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
              • type @ $this
              • 42. Patient.deceased[x]:deceasedBoolean
                Slice NamedeceasedBoolean
                Definition

                Boolean indicator if the individual is deceased or not.


                Indicates if the individual is deceased or not.

                ShortDeceased indicatorIndicates if the individual is deceased or not
                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.

                Control0..1
                Typeboolean, dateTime
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Is Modifiertrue because 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.
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                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.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                44. Patient.deceased[x]:deceasedDateTime
                Slice NamedeceasedDateTime
                Definition

                Individual deceased date-time with optional accuracy indicator.


                Indicates if the individual is deceased or not.

                ShortDeceased date timeIndicates if the individual is deceased or not
                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.

                Control0..1
                TypedateTime, boolean
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Is Modifiertrue because 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.
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                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.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                46. Patient.deceased[x]:deceasedDateTime.extension
                Definition

                An Extension


                May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                ShortExtensionAdditional content defined by implementations
                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.

                Control0..*
                TypeExtension
                Is Modifierfalse
                Summaryfalse
                Alternate Namesextensions, user content
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                SlicingThis element introduces a set of slices on Patient.deceased[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 48. Patient.deceased[x]:deceasedDateTime.extension:accuracyIndicator
                  Slice NameaccuracyIndicator
                  Definition

                  General date accuracy indicator coding.

                  ShortDeceased date accuracy indicator
                  Comments

                  In some circumstances, systems may only have date or datetime data that has unknown or estimated parts. This coding establishes the accuracy of the day, month and year parts.

                  Control0..1
                  This element is affected by the following invariants: ele-1
                  TypeExtension(Date Accuracy Indicator) (Extension Type: Coding)
                  Is Modifierfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  50. Patient.address
                  Definition

                  An Australian address expressed using postal conventions (as opposed to GPS or other location definition formats).


                  An address for the individual.

                  ShortAn address for the individual
                  Comments

                  The address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource).


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

                  Control0..*
                  This element is affected by the following invariants: ele-1
                  TypeAddress(Australian Address, Address)
                  Is Modifierfalse
                  Requirements

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

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  inv-add-0: The address shall at least have text or a line (text.exists() or line.exists())
                  inv-add-1: 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: 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'))
                  52. Patient.link
                  Definition

                  Link to a Patient or RelatedPerson resource that concerns the same actual person.


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

                  ShortLink to a Patient or RelatedPerson resource that concerns the same actual personLink to another patient resource that concerns the same actual person
                  Comments

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

                  Control0..*
                  TypeBackboneElement
                  Is Modifiertrue because This element is labeled as a modifier because it might 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'
                  Summarytrue
                  Requirements

                  There are multiple use cases:

                  • Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and
                  • Distribution of patient information across multiple servers.
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  54. 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                  ShortExtensions that cannot be ignored even if unrecognized
                  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.

                  Control0..*
                  TypeExtension
                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                  Summarytrue
                  Requirements

                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                  Alternate Namesextensions, user content, modifiers
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  56. Patient.link.other
                  Definition

                  The other patient resource that the link refers to.

                  ShortThe other patient or related person resource that the link refers to
                  Comments

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

                  Control1..1
                  TypeReference(Patient, RelatedPerson)
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  58. Patient.link.type
                  Definition

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

                  Shortreplaced-by | replaces | refer | seealso
                  Control1..1
                  BindingThe codes SHALL be taken from LinkTypehttp://hl7.org/fhir/ValueSet/link-type|4.0.1
                  (required to http://hl7.org/fhir/ValueSet/link-type|4.0.1)

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

                  Typecode
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

                  Guidance on how to interpret the contents of this table can be found here

                  0. Patient
                  Definition

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

                  ShortA patient in an Australian healthcare context
                  Control0..*
                  Is Modifierfalse
                  Summaryfalse
                  Alternate NamesSubjectOfCare Client Resident
                  Invariantsdom-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 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                  dom-6: A resource should have narrative for robust management (text.`div`.exists())
                  inv-pat-0: 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())
                  inv-pat-1: Individual gender identity shall be a member of the Gender Identity Response value set if any codes within that value set can apply (extension('http://hl7.org/fhir/StructureDefinition/individual-genderIdentity').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-genderIdentity').all(extension('value').value.memberOf('https://healthterminologies.gov.au/fhir/ValueSet/gender-identity-response-1')))
                  inv-pat-2: Individual pronouns shall be a member of the Australian Pronouns value set if any codes within that value set can apply (extension('http://hl7.org/fhir/StructureDefinition/individual-pronouns').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-pronouns').all(extension('value').value.memberOf('https://healthterminologies.gov.au/fhir/ValueSet/australian-pronouns-1')))
                  inv-pat-3: Recorded sex or gender type shall be a member of the AU Recorded Sex or Gender Type value set if any codes within that value set can apply (extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('type').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').all(extension('type').value.memberOf('http://terminology.hl7.org.au/ValueSet/rsg-type')))
                  inv-pat-4: Recorded sex or gender source document type shall be a member of the AU Recorded Sex or Gender (RSG) Source Document Type value set if any codes within that value set can apply (extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('sourceDocument').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').all(extension('sourceDocument').value.memberOf('http://terminology.hl7.org.au/ValueSet/rsg-source-document-type')))
                  inv-pat-5: Recorded sex or gender jurisdiction shall be a member of the Jurisdiction ValueSet - AU Extended value set if any codes within that value set can apply (extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('jurisdiction').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').all(extension('jurisdiction').value.memberOf('http://terminology.hl7.org.au/ValueSet/jurisdiction-extended')))
                  2. Patient.id
                  Definition

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

                  ShortLogical id of this artifact
                  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.

                  Control0..1
                  Typeid
                  Is Modifierfalse
                  Summarytrue
                  4. Patient.meta
                  Definition

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

                  ShortMetadata about the resource
                  Control0..1
                  TypeMeta
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  6. 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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                  ShortA set of rules under which this content was created
                  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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

                  Control0..1
                  Typeuri
                  Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  8. Patient.language
                  Definition

                  The base language in which the resource is written.

                  ShortLanguage of the resource content
                  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).

                  Control0..1
                  BindingThe codes SHOULD be taken from CommonLanguages
                  (preferred to http://hl7.org/fhir/ValueSet/languages)

                  A human language.

                  Additional BindingsPurpose
                  AllLanguagesMax Binding
                  Typecode
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  10. Patient.text
                  Definition

                  A human-readable narrative that contains a summary of the resource and can 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.

                  ShortText summary of the resource, for human interpretation
                  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 information is added later.

                  Control0..1
                  TypeNarrative
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesnarrative, html, xhtml, display
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  12. 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.

                  ShortContained, inline 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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

                  Control0..*
                  TypeResource
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesinline resources, anonymous resources, contained resources
                  14. Patient.extension
                  Definition

                  An Extension

                  ShortExtension
                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  SlicingThis element introduces a set of slices on Patient.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 16. Patient.extension:birthPlace
                    Slice NamebirthPlace
                    Definition

                    The registered place of birth of the patient. A sytem may use the address.text if they don't store the birthPlace address in discrete elements.

                    ShortPlace of Birth for patient
                    Control0..1
                    TypeExtension(Patient Birth Place) (Extension Type: Address)
                    Is Modifierfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    18. Patient.extension:indigenousStatus
                    Slice NameindigenousStatus
                    Definition

                    National Health Data Dictionary (NHDD) based indigenous status for a person.

                    ShortIndigenous status
                    Comments

                    This concept is equivalent to Australian Institute of Health and Welfare data element 602543 Person—Indigenous status, code N.

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeExtension(Australian Indigenous Status) (Extension Type: Coding)
                    Is Modifierfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    20. Patient.extension:veteranStatus
                    Slice NameveteranStatus
                    Definition

                    Veteran / Australian Defence Force (ADF) status for a person.

                    ShortVeteran / Australian Defence Force (ADF) status
                    Comments

                    This concept is equivalent to Australian Institute of Health and Welfare data element 737931 Person—ADF veteran status, code N.

                    Control0..*
                    This element is affected by the following invariants: ele-1
                    TypeExtension(Australian Veteran Status) (Extension Type: Coding)
                    Is Modifierfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    22. Patient.extension:closingTheGapRegistration
                    Slice NameclosingTheGapRegistration
                    Definition

                    Indication of eligibility for the Closing the Gap co-payment.

                    ShortClosing the Gap co-payment eligibility indicator
                    Comments

                    This concept is equivalent to Australian Institute of Health and Welfare data element 603671 Patient—Closing the Gap co-payment eligibility indicator.

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeExtension(Closing the Gap Registration) (Extension Type: boolean)
                    Is Modifierfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    24. Patient.extension:mothersMaidenName
                    Slice NamemothersMaidenName
                    Definition

                    Mother's maiden (unmarried) name, commonly collected to help verify patient identity.

                    ShortMother's Maiden name
                    Control0..1
                    TypeExtension(Patient Mother's Maiden Name) (Extension Type: string)
                    Is Modifierfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    26. Patient.extension:interpreterRequired
                    Slice NameinterpreterRequired
                    Definition

                    This Patient requires an interpreter to communicate healthcare information to the practitioner.

                    ShortWhether the patient needs an interpreter
                    Comments

                    The Patient does not speak the default language of the organization, and hence requires an interpreter. If the patient has other languages in the Communications list, then that would be the type of interpreter required.

                    Control0..1
                    TypeExtension(Patient Interpreter Required) (Extension Type: boolean)
                    Is Modifierfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    28. Patient.extension:dateOfArrival
                    Slice NamedateOfArrival
                    Definition

                    The date a person first arrived in Australia, from another country, with the intention of living in Australia for one year or more. This date is captured once for a person and is not subsequently updated with subsequent arrivals.

                    ShortThe date a person first arrived in Australia, from another country, with the intention of living in Australia for one year or more
                    Comments

                    See Australian Bureau of Statics (ABS) 1200.0.55.007 - Year of Arrival Standard, 2014, Version 1.5 for further information. This concept is equivalent to Australian Institute of Health and Welfare data element 269447 Person—year of first arrival in Australia.

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeExtension(Date of Arrival in Australia) (Extension Type: date)
                    Is Modifierfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    30. Patient.extension:genderIdentity
                    Slice NamegenderIdentity
                    Definition

                    An individual's personal sense of being a man, woman, boy, girl, nonbinary, or something else.

                    ShortGender identity shall be a member of the Gender Identity Response value set if any codes within that value set can apply
                    Comments

                    Individual Gender identity Gender Identity Response (Extensible). See Australian Bureau of Statics (ABS) Standard for Sex, Gender, Variations of Sex Characteristics and Sexual Orientation Variables, 2020 for further materials.

                    Control0..*
                    This element is affected by the following invariants: inv-pat-1
                    TypeExtension(Individual Gender Identity) (Complex Extension)
                    Is Modifierfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    32. Patient.extension:individualPronouns
                    Slice NameindividualPronouns
                    Definition

                    The pronouns to use when referring to an individual in verbal or written communication.

                    ShortPronouns shall be a member of the Australian Pronouns value set if any codes within that value set can apply
                    Comments

                    Individual Pronouns Australian Pronouns (Extensible).

                    Control0..*
                    This element is affected by the following invariants: inv-pat-2
                    TypeExtension(Individual Pronouns) (Complex Extension)
                    Is Modifierfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    34. Patient.extension:recordedSexOrGender
                    Slice NamerecordedSexOrGender
                    Definition

                    A sex or gender property for the individual from a document or other record

                    ShortRecorded sex or gender type shall be a member of the AU Recorded Sex or Gender Type value set if any codes within that value set can apply. Recorded sex or gender source document type shall be a member of the AU Recorded Sex or Gender (RSG) Source Document Type value set if any codes within that value set can apply. Recorded sex or gender jurisdiction shall be a member of the Jurisdiction - ValueSet AU Extended value set if any codes within that value set can apply
                    Comments

                    Person Recorded Sex Or Gender type AU Recorded Sex or Gender Type (extensible). Person Recorded Sex Or Gender source document AU Recorded Sex or Gender (RSG) Source Document Type (extensible). Person Recorded Sex Or Gender jurisdiction Jurisdiction ValueSet - AU Extended (extensible).

                    Control0..*
                    This element is affected by the following invariants: inv-pat-3, inv-pat-4, inv-pat-5
                    TypeExtension(Person Recorded Sex Or Gender) (Complex Extension)
                    Is Modifierfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    36. 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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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.

                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                    ShortExtensions that cannot be ignored
                    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.

                    Control0..*
                    TypeExtension
                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                    Summaryfalse
                    Requirements

                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                    Alternate Namesextensions, user content
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    38. Patient.identifier
                    Definition

                    An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.

                    ShortIdentifies this patient across multiple systems
                    NoteThis is a business identifier, not a resource identifier (see discussion)
                    Control0..*
                    This element is affected by the following invariants: ele-1
                    TypeIdentifier(Identifier, AU IHI, AU Medicare Card Number, AU DVA Number, AU Health Care Card Number, AU Pensioner Concession Card Number, AU Commonwealth Seniors Health Card Number, AU Medical Record Number, AU Insurance Member Number)
                    Is Modifierfalse
                    Requirements

                    Patients are almost always assigned specific numerical identifiers.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    40. Patient.active
                    Definition

                    Whether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules.

                    It is often used to filter patient lists to exclude inactive patients

                    Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death.

                    ShortWhether this patient's record is in active use
                    Comments

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

                    Control0..1
                    Typeboolean
                    Is Modifiertrue because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

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

                    Meaning if MissingThis resource is generally assumed to be active if no value is provided for the active element
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    42. Patient.name
                    Definition

                    A name associated with the individual.

                    ShortA name associated with the patient
                    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.

                    Control0..*
                    TypeHumanName
                    Is Modifierfalse
                    Summarytrue
                    Requirements

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

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    44. Patient.telecom
                    Definition

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

                    ShortA contact detail for the individual
                    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 might 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).

                    Control0..*
                    TypeContactPoint
                    Is Modifierfalse
                    Summarytrue
                    Requirements

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

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    46. Patient.gender
                    Definition

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

                    Shortmale | female | other | unknown
                    Comments

                    The gender might 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 male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, 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, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex.

                    Control0..1
                    BindingThe codes SHALL be taken from AdministrativeGender
                    (required to http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1)

                    The gender of a person used for administrative purposes.

                    Typecode
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    Needed for identification of the individual, in combination with (at least) name and birth date.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    48. Patient.birthDate
                    Definition

                    The date of birth for the individual.

                    ShortDate of birth extended for time and accuracy indicator
                    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 maternity/infant care systems).

                    Control0..1
                    This element is affected by the following invariants: inv-pat-0
                    Typedate
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    Age of the individual drives many clinical processes. May include accuracy indicator and specific birth time.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    LOINC Code21112-8
                    50. Patient.birthDate.id
                    Definition

                    unique id for the element within a resource (for internal references)

                    Shortxml:id (or equivalent in JSON)
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    52. Patient.birthDate.extension
                    Definition

                    An Extension

                    ShortExtension
                    Control0..*
                    TypeExtension
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    SlicingThis element introduces a set of slices on Patient.birthDate.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 54. Patient.birthDate.extension:accuracyIndicator
                      Slice NameaccuracyIndicator
                      Definition

                      General date accuracy indicator coding.

                      ShortBirth date accuracy indicator
                      Comments

                      In some circumstances, systems may only have date or datetime data that has unknown or estimated parts. This coding establishes the accuracy of the day, month and year parts.

                      Control0..1
                      This element is affected by the following invariants: ele-1
                      TypeExtension(Date Accuracy Indicator) (Extension Type: Coding)
                      Is Modifierfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      56. Patient.birthDate.extension:birthTime
                      Slice NamebirthTime
                      Definition

                      The time of day that the patient was born. This includes the date to ensure that the timezone information can be communicated effectively.

                      ShortBirth time
                      Control0..1
                      This element is affected by the following invariants: inv-pat-0
                      TypeExtension(Patient Birth Time) (Extension Type: dateTime)
                      Is Modifierfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      58. Patient.birthDate.value
                      Definition

                      The actual value

                      ShortPrimitive value for date
                      Control0..1
                      Typedate
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      60. Patient.deceased[x]
                      Definition

                      Indicates if the individual is deceased or not. Deceased date accuracy indicator is optional.

                      ShortIndicates if the individual is deceased or not
                      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.

                      Control0..1
                      TypeChoice of: boolean, dateTime
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Is Modifiertrue because 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.
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      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.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      SlicingThis element introduces a set of slices on Patient.deceased[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                      • type @ $this
                      • 62. Patient.deceased[x]:deceasedBoolean
                        Slice NamedeceasedBoolean
                        Definition

                        Boolean indicator if the individual is deceased or not.

                        ShortDeceased indicator
                        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.

                        Control0..1
                        Typeboolean
                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                        Is Modifiertrue because 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.
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        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.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        64. Patient.deceased[x]:deceasedDateTime
                        Slice NamedeceasedDateTime
                        Definition

                        Individual deceased date-time with optional accuracy indicator.

                        ShortDeceased date time
                        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.

                        Control0..1
                        TypedateTime
                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                        Is Modifiertrue because 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.
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        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.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        66. Patient.deceased[x]:deceasedDateTime.id
                        Definition

                        unique id for the element within a resource (for internal references)

                        Shortxml:id (or equivalent in JSON)
                        Control0..1
                        Typestring
                        Is Modifierfalse
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Summaryfalse
                        68. Patient.deceased[x]:deceasedDateTime.extension
                        Definition

                        An Extension

                        ShortExtension
                        Control0..*
                        TypeExtension
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        SlicingThis element introduces a set of slices on Patient.deceased[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 70. Patient.deceased[x]:deceasedDateTime.extension:accuracyIndicator
                          Slice NameaccuracyIndicator
                          Definition

                          General date accuracy indicator coding.

                          ShortDeceased date accuracy indicator
                          Comments

                          In some circumstances, systems may only have date or datetime data that has unknown or estimated parts. This coding establishes the accuracy of the day, month and year parts.

                          Control0..1
                          This element is affected by the following invariants: ele-1
                          TypeExtension(Date Accuracy Indicator) (Extension Type: Coding)
                          Is Modifierfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          72. Patient.deceased[x]:deceasedDateTime.value
                          Definition

                          The actual value

                          ShortPrimitive value for dateTime
                          Control0..1
                          TypedateTime
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          74. Patient.address
                          Definition

                          An Australian address expressed using postal conventions (as opposed to GPS or other location definition formats).

                          ShortAn address for the individual
                          Comments

                          The address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource).

                          Control0..*
                          This element is affected by the following invariants: ele-1
                          TypeAddress(Australian Address, Address)
                          Is Modifierfalse
                          Requirements

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

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          inv-add-0: The address shall at least have text or a line (text.exists() or line.exists())
                          inv-add-1: 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: 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'))
                          76. Patient.maritalStatus
                          Definition

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

                          ShortMarital (civil) status of a patient
                          Control0..1
                          BindingUnless not suitable, these codes SHALL be taken from Marital Status Codes
                          (extensible to http://hl7.org/fhir/ValueSet/marital-status)

                          The domestic partnership status of a person.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Summaryfalse
                          Requirements

                          Most, if not all systems capture it.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          78. Patient.multipleBirth[x]
                          Definition

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

                          ShortWhether patient is part of a multiple birth
                          Comments

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

                          Control0..1
                          TypeChoice of: boolean, integer
                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summaryfalse
                          Requirements

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

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          80. Patient.photo
                          Definition

                          Image of the patient.

                          ShortImage of the patient
                          Comments

                          Guidelines:

                          • Use id photos, not clinical photos.
                          • Limit dimensions to thumbnail.
                          • Keep byte count low to ease resource updates.
                          Control0..*
                          TypeAttachment
                          Is Modifierfalse
                          Summaryfalse
                          Requirements

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

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          82. Patient.contact
                          Definition

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

                          ShortA contact party (e.g. guardian, partner, friend) for 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.

                          Control0..*
                          TypeBackboneElement
                          Is Modifierfalse
                          Summaryfalse
                          Requirements

                          Need to track people you can contact about the patient.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (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())
                          84. 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.

                          ShortUnique id for inter-element referencing
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          86. Patient.contact.extension
                          Definition

                          May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                          ShortAdditional content defined by implementations
                          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.

                          Control0..*
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesextensions, user content
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          88. 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                          ShortExtensions that cannot be ignored even if unrecognized
                          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.

                          Control0..*
                          TypeExtension
                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                          Summarytrue
                          Requirements

                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                          Alternate Namesextensions, user content, modifiers
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          90. Patient.contact.relationship
                          Definition

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

                          ShortThe kind of relationship
                          Control0..*
                          BindingUnless not suitable, these codes SHALL be taken from Contact Relationship Type .
                          (extensible to https://healthterminologies.gov.au/fhir/ValueSet/contact-relationship-type-3)
                          TypeCodeableConcept
                          Is Modifierfalse
                          Summaryfalse
                          Requirements

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

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          92. Patient.contact.name
                          Definition

                          A name associated with the contact person.

                          ShortA name associated with the contact person
                          Control0..1
                          TypeHumanName
                          Is Modifierfalse
                          Summaryfalse
                          Requirements

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

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          94. Patient.contact.telecom
                          Definition

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

                          ShortA contact detail for the person
                          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.

                          Control0..*
                          TypeContactPoint
                          Is Modifierfalse
                          Summaryfalse
                          Requirements

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

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          96. Patient.contact.address
                          Definition

                          An address expressed using postal conventions (as opposed to GPS or other location definition formats). This data type may be used to convey addresses for use in delivering mail as well as for visiting locations which might not be valid for mail delivery. There are a variety of postal address formats defined around the world.

                          ShortAddress for the contact person
                          Comments

                          The address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource).

                          Control0..1
                          This element is affected by the following invariants: ele-1
                          TypeAddress(Address, Australian Address)
                          Is Modifierfalse
                          Requirements

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

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          98. Patient.contact.gender
                          Definition

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

                          Shortmale | female | other | unknown
                          Control0..1
                          BindingThe codes SHALL be taken from AdministrativeGender
                          (required to http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1)

                          The gender of a person used for administrative purposes.

                          Typecode
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summaryfalse
                          Requirements

                          Needed to address the person correctly.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          100. Patient.contact.organization
                          Definition

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

                          ShortOrganization that is associated with the contact
                          Control0..1
                          This element is affected by the following invariants: pat-1
                          TypeReference(Organization)
                          Is Modifierfalse
                          Summaryfalse
                          Requirements

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

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          102. Patient.contact.period
                          Definition

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

                          ShortThe period during which this contact person or organization is valid to be contacted relating to this patient
                          Control0..1
                          TypePeriod
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          104. Patient.communication
                          Definition

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

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

                          Control0..*
                          TypeBackboneElement
                          Is Modifierfalse
                          Summaryfalse
                          Requirements

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

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          106. 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.

                          ShortUnique id for inter-element referencing
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          108. Patient.communication.extension
                          Definition

                          May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                          ShortAdditional content defined by implementations
                          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.

                          Control0..*
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesextensions, user content
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          110. 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                          ShortExtensions that cannot be ignored even if unrecognized
                          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.

                          Control0..*
                          TypeExtension
                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                          Summarytrue
                          Requirements

                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                          Alternate Namesextensions, user content, modifiers
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          112. 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.

                          ShortThe language which can be used to communicate with the patient about his or her health
                          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.

                          Control1..1
                          BindingUnless not suitable, these codes SHALL be taken from Common Languages in Australia .
                          (extensible to https://healthterminologies.gov.au/fhir/ValueSet/common-languages-australia-2)
                          TypeCodeableConcept
                          Is Modifierfalse
                          Summaryfalse
                          Requirements

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

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          114. Patient.communication.preferred
                          Definition

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

                          ShortLanguage preference indicator
                          Comments

                          This language is specifically identified for communicating healthcare information.

                          Control0..1
                          Typeboolean
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summaryfalse
                          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.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          116. Patient.generalPractitioner
                          Definition

                          Patient's nominated care provider.

                          ShortPatient's nominated primary care provider
                          Comments

                          This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability 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. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues.

                          Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type.

                          Control0..*
                          TypeReference(Organization, Practitioner, PractitionerRole)
                          Is Modifierfalse
                          Summaryfalse
                          Alternate NamescareProvider
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          118. Patient.managingOrganization
                          Definition

                          Organization that is the custodian of the patient record.

                          ShortOrganization that is the custodian of the patient record
                          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).

                          Control0..1
                          TypeReference(Organization)
                          Is Modifierfalse
                          Summarytrue
                          Requirements

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

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          120. Patient.link
                          Definition

                          Link to a Patient or RelatedPerson resource that concerns the same actual person.

                          ShortLink to a Patient or RelatedPerson resource that concerns the same actual person
                          Comments

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

                          Control0..*
                          TypeBackboneElement
                          Is Modifiertrue because This element is labeled as a modifier because it might 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'
                          Summarytrue
                          Requirements

                          There are multiple use cases:

                          • Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and
                          • Distribution of patient information across multiple servers.
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          122. 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.

                          ShortUnique id for inter-element referencing
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          124. Patient.link.extension
                          Definition

                          May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                          ShortAdditional content defined by implementations
                          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.

                          Control0..*
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesextensions, user content
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          126. 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                          ShortExtensions that cannot be ignored even if unrecognized
                          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.

                          Control0..*
                          TypeExtension
                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                          Summarytrue
                          Requirements

                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                          Alternate Namesextensions, user content, modifiers
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          128. Patient.link.other
                          Definition

                          The other patient resource that the link refers to.

                          ShortThe other patient or related person resource that the link refers to
                          Comments

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

                          Control1..1
                          TypeReference(Patient, RelatedPerson)
                          Is Modifierfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          130. Patient.link.type
                          Definition

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

                          Shortreplaced-by | replaces | refer | seealso
                          Control1..1
                          BindingThe codes SHALL be taken from LinkType
                          (required to http://hl7.org/fhir/ValueSet/link-type|4.0.1)

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

                          Typecode
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))