AU Core Implementation Guide
0.3.0-ballot - R1 Australia flag

This page is part of the AU Core (v0.3.0-ballot: AU Core R1 Ballot 5) based on FHIR (HL7® FHIR® Standard) R4. . For a full list of available versions, see the Directory of published versions

Resource Profile: AUCorePatient - Detailed Descriptions

Page standards status: Draft Maturity Level: 0

Definitions for the au-core-patient resource profile.

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

0. Patient
ShortA patient in the context of electronic exchange of health information
Invariantsau-core-pat-01: At least one patient identifier shall be valid (identifier.where(system.count() + value.count() >1).exists())
au-core-pat-02: At least one patient name shall have a family name (name.family.exists())
LOINC Code
2. Patient.extension:birthPlace
Slice NamebirthPlace
Must Supporttrue
LOINC Code
4. Patient.extension:indigenousStatus
Slice NameindigenousStatus
Must Supporttrue
LOINC Code
6. Patient.extension:interpreterRequired
Slice NameinterpreterRequired
Must Supporttrue
LOINC Code
8. 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.

Must Supporttrue
LOINC Code
10. 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).

Must Supporttrue
LOINC Code
12. Patient.identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
Control1..?
This element is affected by the following invariants: au-core-pat-01
Must Supporttrue
LOINC Code
SlicingThis element introduces a set of slices on Patient.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • pattern @ type
14. Patient.identifier:ihi
Slice Nameihi
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..1
TypeIdentifier(AU IHI)
Must Supporttrue
16. Patient.identifier:medicare
Slice Namemedicare
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..1
TypeIdentifier(AU Medicare Card Number)
Must Supporttrue
18. Patient.identifier:dva
Slice Namedva
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..1
TypeIdentifier(AU DVA Number)
Must Supporttrue
20. Patient.name
Comments

A patient may have multiple names with different uses or applicable periods. At least one name SHOULD be the name the patient is considered to have for administrative and record keeping purposes - family name is used to enable matching against patient records.

Control1..?
This element is affected by the following invariants: inv-au-core-pat-02
Must Supporttrue
Invariantsau-core-pat-04: At least text, family name, or given name shall be present (text.exists() or family.exists() or given.exists())
LOINC Code
22. Patient.name.use
Must Supporttrue
24. Patient.telecom
Must Supporttrue
LOINC Code
26. Patient.gender
Control1..?
Must Supporttrue
LOINC Code
28. Patient.birthDate
Control1..?
Must Supporttrue
LOINC Code
30. Patient.birthDate.extension:accuracyIndicator
Slice NameaccuracyIndicator
Must Supporttrue
LOINC Code
32. Patient.birthDate.extension:birthTime
Slice NamebirthTime
Must Supporttrue
LOINC Code
34. Patient.address
Must Supporttrue
LOINC Code
36. Patient.communication
Must Supporttrue
LOINC Code
38. Patient.communication.language
Must Supporttrue
LOINC Code
40. Patient.communication.preferred
Must Supporttrue
LOINC Code

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 the context of electronic exchange of health informationInformation 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').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').value.memberOf('https://healthterminologies.gov.au/fhir/ValueSet/australian-pronouns-1'))
au-core-pat-01: At least one patient identifier shall be valid (identifier.where(system.count() + value.count() >1).exists())
au-core-pat-02: At least one patient name shall have a family name (name.family.exists())
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: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
This element is affected by the following invariants: ele-1
TypeExtension(Birth Place) (Extension Type: Address)
Is Modifierfalse
Must Supporttrue
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())
LOINC Code
6. 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
Must Supporttrue
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())
LOINC Code
8. 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())
LOINC Code
10. 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())
LOINC Code
12. Patient.extension:mothersMaidenName
Slice NamemothersMaidenName
Definition

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

ShortMother's Maiden name
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(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())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
LOINC Code
14. 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
This element is affected by the following invariants: ele-1
TypeExtension(interpreterRequired) (Extension Type: boolean)
Is Modifierfalse
Must Supporttrue
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())
LOINC Code
16. 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())
LOINC Code
18. 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
Must Supporttrue
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())
LOINC Code
20. 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
Must Supporttrue
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())
LOINC Code
22. Patient.extension:recordedSexOrGender
Slice NamerecordedSexOrGender
Definition

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

ShortA recorded sex or gender property for the individual
Control0..*
This element is affected by the following invariants: ele-1
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())
LOINC Code
24. 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())
26. 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)
Control10..*
This element is affected by the following invariants: ele-1, au-core-pat-01
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
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
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()))
SlicingThis element introduces a set of slices on Patient.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • pattern @ type
28. Patient.identifier:ihi
Slice Nameihi
Definition

Individual Healthcare Identifier (IHI) assigned under the HI Service to a patient.


An identifier for this patient.

ShortIndividual Healthcare Identifier (IHI)An identifier for this patient
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..1*
This element is affected by the following invariants: ele-1
TypeIdentifier(AU IHI)
Is Modifierfalse
Must Supporttrue
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()))
inv-ihi-value-0: IHI shall be an exactly 16 digit number (value.matches('^([0-9]{16})$'))
inv-ihi-value-1: IHI prefix is 800360 (value.startsWith('800360'))
inv-ihi-value-2: IHI shall pass the Luhn algorithm check ((((select(value.substring(0,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(1,1).toInteger())+(select(value.substring(2,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(3,1).toInteger())+(select(value.substring(4,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(5,1).toInteger())+(select(value.substring(6,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(7,1).toInteger())+(select(value.substring(8,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(9,1).toInteger())+(select(value.substring(10,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(11,1).toInteger())+(select(value.substring(12,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(13,1).toInteger())+(select(value.substring(14,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(15,1).toInteger()))mod 10=0))
30. Patient.identifier:medicare
Slice Namemedicare
Definition

Medicare card number as either the the 10 digit Medicare card number or the 11 digit number (includes the individual reference number (IRN)). A Medicare card is provided to individuals who are enrolled in Medicare.


An identifier for this patient.

ShortMedicare Card NumberAn identifier for this patient
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..1*
This element is affected by the following invariants: ele-1
TypeIdentifier(AU Medicare Card Number)
Is Modifierfalse
Must Supporttrue
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()))
32. Patient.identifier:dva
Slice Namedva
Definition

Department of Veterans’ Affairs (DVA) file number displayed on a Veteran Card.


An identifier for this patient.

ShortDepartment of Veterans' Affairs (DVA) NumberAn identifier for this patient
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..1*
This element is affected by the following invariants: ele-1
TypeIdentifier(AU DVA Number)
Is Modifierfalse
Must Supporttrue
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()))
34. 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()))
36. 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. At least one name SHOULD be the name the patient is considered to have for administrative and record keeping purposes - family name is used to enable matching against patient records.


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.

Control10..*
This element is affected by the following invariants: inv-au-core-pat-02
TypeHumanName
Is Modifierfalse
Must Supporttrue
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()))
au-core-pat-04: At least text, family name, or given name shall be present (text.exists() or family.exists() or given.exists())
38. Patient.name.use
Definition

Identifies the purpose for this name.

Shortusual | official | temp | nickname | anonymous | old | maiden
Comments

Applications can assume that a name is current unless it explicitly says that it is temporary or old.

Control0..1
BindingThe codes SHALL be taken from NameUsehttp://hl7.org/fhir/ValueSet/name-use|4.0.1
(required to http://hl7.org/fhir/ValueSet/name-use|4.0.1
Typecode
Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Requirements

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

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. 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
Must Supporttrue
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()))
42. 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.

Control10..1
BindingThe codes SHALL be taken from AdministrativeGenderhttp://hl7.org/fhir/ValueSet/administrative-gender|4.0.1
(required to http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1
Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
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()))
44. 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).

Control10..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
Must Supporttrue
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
46. Patient.birthDate.extension:accuracyIndicator
Slice NameaccuracyIndicator
Definition

General date accuracy indicator coding.

ShortDate accuracy indicator
Comments

In some circumstances, systems may capture date or dateTime data that has unknown or estimated parts. This coding indicates the accuracy of the day, month and year parts. This concept is equivalent to Australian Institute of Health and Welfare data element 294418 Date—accuracy indicator.

Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(Date Accuracy Indicator) (Extension Type: Coding)
Is Modifierfalse
Must Supporttrue
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())
LOINC Code
48. 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.

ShortTime of day of birth
Control0..1
This element is affected by the following invariants: ele-1, inv-pat-0
TypeExtension(Birth Time) (Extension Type: dateTime)
Is Modifierfalse
Must Supporttrue
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())
LOINC Code
50. 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] NoteSee Choice of Data Types for 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 are unordered and Closed, and can be differentiated using the following discriminators:
  • type @ $this
52. 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] NoteSee Choice of Data Types for 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()))
54. 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] NoteSee Choice of Data Types for 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()))
56. 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())
LOINC Code
58. 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
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
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'))
60. 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
Must Supporttrue
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()))
62. 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())
64. 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 The codes SHOULD be taken from Common Languages in Australia .http://hl7.org/fhir/ValueSet/languages
(extensible to https://healthterminologies.gov.au/fhir/ValueSet/common-languages-australia-2
TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
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()))
66. 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
Must Supporttrue
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()))
68. 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()))
70. 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())
72. 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()))
74. 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
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 the context of electronic exchange of health information
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').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').value.memberOf('https://healthterminologies.gov.au/fhir/ValueSet/australian-pronouns-1'))
au-core-pat-01: At least one patient identifier shall be valid (identifier.where(system.count() + value.count() >1).exists())
au-core-pat-02: At least one patient name shall have a family name (name.family.exists())
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
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 are unordered 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
This element is affected by the following invariants: ele-1
TypeExtension(Birth Place) (Extension Type: Address)
Is Modifierfalse
Must Supporttrue
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
Must Supporttrue
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
This element is affected by the following invariants: ele-1
TypeExtension(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
This element is affected by the following invariants: ele-1
TypeExtension(interpreterRequired) (Extension Type: boolean)
Is Modifierfalse
Must Supporttrue
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
Must Supporttrue
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
Must Supporttrue
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

ShortA recorded sex or gender property for the individual
Control0..*
This element is affected by the following invariants: ele-1
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)
Control1..*
This element is affected by the following invariants: ele-1, au-core-pat-01
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
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
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()))
SlicingThis element introduces a set of slices on Patient.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • pattern @ type
40. Patient.identifier:ihi
Slice Nameihi
Definition

Individual Healthcare Identifier (IHI) assigned under the HI Service to a patient.

ShortIndividual Healthcare Identifier (IHI)
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..1
This element is affected by the following invariants: ele-1
TypeIdentifier(AU IHI)
Is Modifierfalse
Must Supporttrue
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()))
inv-ihi-value-0: IHI shall be an exactly 16 digit number (value.matches('^([0-9]{16})$'))
inv-ihi-value-1: IHI prefix is 800360 (value.startsWith('800360'))
inv-ihi-value-2: IHI shall pass the Luhn algorithm check ((((select(value.substring(0,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(1,1).toInteger())+(select(value.substring(2,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(3,1).toInteger())+(select(value.substring(4,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(5,1).toInteger())+(select(value.substring(6,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(7,1).toInteger())+(select(value.substring(8,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(9,1).toInteger())+(select(value.substring(10,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(11,1).toInteger())+(select(value.substring(12,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(13,1).toInteger())+(select(value.substring(14,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(15,1).toInteger()))mod 10=0))
42. Patient.identifier:medicare
Slice Namemedicare
Definition

Medicare card number as either the the 10 digit Medicare card number or the 11 digit number (includes the individual reference number (IRN)). A Medicare card is provided to individuals who are enrolled in Medicare.

ShortMedicare Card Number
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..1
This element is affected by the following invariants: ele-1
TypeIdentifier(AU Medicare Card Number)
Is Modifierfalse
Must Supporttrue
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()))
44. Patient.identifier:dva
Slice Namedva
Definition

Department of Veterans’ Affairs (DVA) file number displayed on a Veteran Card.

ShortDepartment of Veterans' Affairs (DVA) Number
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..1
This element is affected by the following invariants: ele-1
TypeIdentifier(AU DVA Number)
Is Modifierfalse
Must Supporttrue
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()))
46. 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()))
48. 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. At least one name SHOULD be the name the patient is considered to have for administrative and record keeping purposes - family name is used to enable matching against patient records.

Control1..*
This element is affected by the following invariants: inv-au-core-pat-02
TypeHumanName
Is Modifierfalse
Must Supporttrue
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()))
au-core-pat-04: At least text, family name, or given name shall be present (text.exists() or family.exists() or given.exists())
50. Patient.name.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
52. Patient.name.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())
SlicingThis element introduces a set of slices on Patient.name.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
54. Patient.name.use
Definition

Identifies the purpose for this name.

Shortusual | official | temp | nickname | anonymous | old | maiden
Comments

Applications can assume that a name is current unless it explicitly says that it is temporary or old.

Control0..1
BindingThe codes SHALL be taken from NameUse
(required to http://hl7.org/fhir/ValueSet/name-use|4.0.1
Typecode
Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Requirements

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

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

Specifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts.

ShortText representation of the full name
Comments

Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

A renderable, unencoded form.

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

The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.

ShortFamily name (often called 'Surname')
Comments

Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).

Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Alternate Namessurname
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
60. Patient.name.given
Definition

Given name.

ShortGiven names (not always 'first'). Includes middle names
Comments

If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first.

Control0..*
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Alternate Namesfirst name, middle name
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
62. Patient.name.prefix
Definition

Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name.

ShortParts that come before the name
Control0..*
Typestring
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()))
64. Patient.name.suffix
Definition

Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name.

ShortParts that come after the name
Control0..*
Typestring
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()))
66. Patient.name.period
Definition

Indicates the period of time when this name was valid for the named person.

ShortTime period when name was/is in use
Control0..1
TypePeriod
Is Modifierfalse
Summarytrue
Requirements

Allows names to be placed in historical context.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
68. 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
Must Supporttrue
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()))
70. 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.

Control1..1
BindingThe codes SHALL be taken from AdministrativeGender
(required to http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1
Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
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()))
72. 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).

Control1..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
Must Supporttrue
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
74. 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
76. 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 are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
78. Patient.birthDate.extension:accuracyIndicator
Slice NameaccuracyIndicator
Definition

General date accuracy indicator coding.

ShortDate accuracy indicator
Comments

In some circumstances, systems may capture date or dateTime data that has unknown or estimated parts. This coding indicates the accuracy of the day, month and year parts. This concept is equivalent to Australian Institute of Health and Welfare data element 294418 Date—accuracy indicator.

Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(Date Accuracy Indicator) (Extension Type: Coding)
Is Modifierfalse
Must Supporttrue
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())
80. 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.

ShortTime of day of birth
Control0..1
This element is affected by the following invariants: ele-1, inv-pat-0
TypeExtension(Birth Time) (Extension Type: dateTime)
Is Modifierfalse
Must Supporttrue
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())
82. 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
84. 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] NoteSee Choice of Data Types for 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 are unordered and Closed, and can be differentiated using the following discriminators:
  • type @ $this
86. 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] NoteSee Choice of Data Types for 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()))
88. 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] NoteSee Choice of Data Types for 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()))
90. 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
92. 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 are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
94. 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())
96. 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
98. 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
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
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'))
100. 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
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()))
102. 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] NoteSee Choice of Data Types for 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()))
104. 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()))
106. 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())
108. 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
110. 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())
112. 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())
114. 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()))
116. 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()))
118. 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()))
120. 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()))
122. 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
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()))
124. 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()))
126. 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()))
128. 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
Must Supporttrue
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()))
130. 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
132. 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())
134. 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())
136. 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
Must Supporttrue
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()))
138. 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
Must Supporttrue
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()))
140. 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()))
142. 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()))
144. 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()))
146. 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
148. 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())
150. 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())
152. 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()))
154. 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
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()))