AU Core Implementation Guide
0.4.0-preview - Preview Australia flag

This page is part of the AU Core (v0.4.0-preview: QA Preview) 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: 1

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:indigenousStatus
Slice NameindigenousStatus
Must Supporttrue
Obligations
    ObligationsActor
    SHALL:populate-if-knownAU Core Responder
    SHALL:no-errorAU Core Requester
    LOINC Code
    4. 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
    Obligations
      ObligationsActor
      SHALL:populate-if-knownAU Core Responder
      SHALL:no-errorAU Core Requester
      LOINC Code
      6. 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
      Obligations
        ObligationsActor
        SHALL:populate-if-knownAU Core Responder
        SHALL:no-errorAU Core Requester
        LOINC Code
        8. 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
        Obligations
          ObligationsActor
          SHALL:populate-if-knownAU Core Responder
          SHALL:no-errorAU Core Requester
          LOINC Code
          SlicingThis element introduces a set of slices on Patient.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • pattern @ type
          • 10. Patient.identifier:ihi
            Slice Nameihi
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..1
            TypeIdentifier(AU IHI)
            Must Supporttrue
            Obligations
              ObligationsActor
              SHALL:populate-if-knownAU Core Responder
              SHALL:no-errorAU Core Requester
              12. 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
              Obligations
                ObligationsActor
                SHALL:populate-if-knownAU Core Responder
                SHALL:no-errorAU Core Requester
                14. Patient.identifier:dva
                Slice Namedva
                NoteThis is a business identifier, not a resource identifier (see discussion)
                Control0..1
                TypeIdentifier(AU DVA Number)
                Must Supporttrue
                Obligations
                  ObligationsActor
                  SHALL:populate-if-knownAU Core Responder
                  SHALL:no-errorAU Core Requester
                  16. 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: au-core-pat-02
                  Must Supporttrue
                  Obligations
                    ObligationsActor
                    SHALL:populate-if-knownAU Core Responder
                    SHALL:no-errorAU Core Requester
                    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
                    18. Patient.name.use
                    Must Supporttrue
                    Obligations
                      ObligationsActor
                      SHALL:populate-if-knownAU Core Responder
                      SHALL:no-errorAU Core Requester
                      20. Patient.name.text
                      Must Supporttrue
                      Obligations
                        ObligationsActor
                        SHALL:populate-if-knownAU Core Responder
                        SHALL:no-errorAU Core Requester
                        22. Patient.name.family
                        Must Supporttrue
                        Obligations
                          ObligationsActor
                          SHALL:populate-if-knownAU Core Responder
                          SHALL:no-errorAU Core Requester
                          24. Patient.name.given
                          Must Supporttrue
                          Obligations
                            ObligationsActor
                            SHALL:populate-if-knownAU Core Responder
                            SHALL:no-errorAU Core Requester
                            26. Patient.telecom
                            Must Supporttrue
                            Obligations
                              ObligationsActor
                              SHALL:populate-if-knownAU Core Responder
                              SHALL:no-errorAU Core Requester
                              LOINC Code
                              28. Patient.gender
                              Control1..?
                              Must Supporttrue
                              Obligations
                                ObligationsActor
                                SHALL:populate-if-knownAU Core Responder
                                SHALL:no-errorAU Core Requester
                                LOINC Code
                                30. Patient.birthDate
                                Control1..?
                                Must Supporttrue
                                Obligations
                                  ObligationsActor
                                  SHALL:populate-if-knownAU Core Responder
                                  SHALL:no-errorAU Core Requester
                                  LOINC Code
                                  32. Patient.address
                                  Must Supporttrue
                                  Obligations
                                    ObligationsActor
                                    SHALL:populate-if-knownAU Core Responder
                                    SHALL:no-errorAU Core Requester
                                    LOINC Code
                                    34. Patient.communication
                                    Must Supporttrue
                                    Obligations
                                      ObligationsActor
                                      SHALL:populate-if-knownAU Core Responder
                                      SHALL:no-errorAU Core Requester
                                      LOINC Code
                                      36. Patient.communication.language
                                      Must Supporttrue
                                      Obligations
                                        ObligationsActor
                                        SHALL:populate-if-knownAU Core Responder
                                        SHALL:no-errorAU Core Requester
                                        LOINC Code
                                        38. Patient.communication.preferred
                                        Must Supporttrue
                                        Obligations
                                          ObligationsActor
                                          SHALL:populate-if-knownAU Core Responder
                                          SHALL:no-errorAU Core Requester
                                          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'))
                                          inv-pat-3: Recorded sex or gender type shall be a member of the Common AU Recorded Sex or Gender Type value set if any codes within that value set can apply (extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('type').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('type').value.memberOf('http://terminology.hl7.org.au/ValueSet/rsg-type'))
                                          inv-pat-4: Recorded sex or gender source document type shall be a member of the Common AU Recorded Sex or Gender (RSG) Source Document Type value set if any codes within that value set can apply (extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('sourceDocument').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('sourceDocument').value.memberOf('http://terminology.hl7.org.au/ValueSet/rsg-source-document-type'))
                                          inv-pat-5: Recorded sex or gender jurisdiction shall be a member of the Common AU Recorded Sex or Gender (RSG) Source Document Jurisdiction value set if any codes within that value set can apply (extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('jurisdiction').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('jurisdiction').value.memberOf('http://terminology.hl7.org.au/ValueSet/rsg-source-document-jurisdiction'))
                                          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
                                          TypeExtension(Patient Birth Place) (Extension Type: Address)
                                          Is Modifierfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          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
                                          Obligations
                                            ObligationsActor
                                            SHALL:populate-if-knownAU Core Responder
                                            SHALL:no-errorAU Core Requester
                                            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
                                            TypeExtension(Patient Mother's Maiden Name) (Extension Type: string)
                                            Is Modifierfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            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
                                            TypeExtension(Patient Interpreter Required) (Extension Type: boolean)
                                            Is Modifierfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            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
                                            Obligations
                                              ObligationsActor
                                              SHALL:populate-if-knownAU Core Responder
                                              SHALL:no-errorAU Core Requester
                                              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
                                              Obligations
                                                ObligationsActor
                                                SHALL:populate-if-knownAU Core Responder
                                                SHALL:no-errorAU Core Requester
                                                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

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

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

                                                Control0..*
                                                This element is affected by the following invariants: inv-pat-3, inv-pat-4, inv-pat-5
                                                TypeExtension(Person Recorded Sex Or Gender) (Complex Extension)
                                                Is Modifierfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                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
                                                Obligations
                                                  ObligationsActor
                                                  SHALL:populate-if-knownAU Core Responder
                                                  SHALL:no-errorAU Core Requester
                                                  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 areUnordered 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
                                                    Obligations
                                                      ObligationsActor
                                                      SHALL:populate-if-knownAU Core Responder
                                                      SHALL:no-errorAU Core Requester
                                                      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
                                                      Obligations
                                                        ObligationsActor
                                                        SHALL:populate-if-knownAU Core Responder
                                                        SHALL:no-errorAU Core Requester
                                                        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
                                                        Obligations
                                                          ObligationsActor
                                                          SHALL:populate-if-knownAU Core Responder
                                                          SHALL:no-errorAU Core Requester
                                                          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: au-core-pat-02
                                                          TypeHumanName
                                                          Is Modifierfalse
                                                          Must Supporttrue
                                                          Obligations
                                                            ObligationsActor
                                                            SHALL:populate-if-knownAU Core Responder
                                                            SHALL:no-errorAU Core Requester
                                                            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)

                                                            The use of a human name.

                                                            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
                                                            Obligations
                                                              ObligationsActor
                                                              SHALL:populate-if-knownAU Core Responder
                                                              SHALL:no-errorAU Core Requester
                                                              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.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
                                                              Must Supporttrue
                                                              Obligations
                                                                ObligationsActor
                                                                SHALL:populate-if-knownAU Core Responder
                                                                SHALL:no-errorAU Core Requester
                                                                Summarytrue
                                                                Requirements

                                                                A renderable, unencoded form.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                42. 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
                                                                Must Supporttrue
                                                                Obligations
                                                                  ObligationsActor
                                                                  SHALL:populate-if-knownAU Core Responder
                                                                  SHALL:no-errorAU Core Requester
                                                                  Summarytrue
                                                                  Alternate Namessurname
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  44. 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
                                                                  Must Supporttrue
                                                                  Obligations
                                                                    ObligationsActor
                                                                    SHALL:populate-if-knownAU Core Responder
                                                                    SHALL:no-errorAU Core Requester
                                                                    Summarytrue
                                                                    Alternate Namesfirst name, middle name
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    46. 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
                                                                    Obligations
                                                                      ObligationsActor
                                                                      SHALL:populate-if-knownAU Core Responder
                                                                      SHALL:no-errorAU Core Requester
                                                                      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()))
                                                                      48. 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)

                                                                      The gender of a person used for administrative purposes.

                                                                      Typecode
                                                                      Is Modifierfalse
                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                      Must Supporttrue
                                                                      Obligations
                                                                        ObligationsActor
                                                                        SHALL:populate-if-knownAU Core Responder
                                                                        SHALL:no-errorAU Core Requester
                                                                        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()))
                                                                        50. 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
                                                                        Obligations
                                                                          ObligationsActor
                                                                          SHALL:populate-if-knownAU Core Responder
                                                                          SHALL:no-errorAU Core Requester
                                                                          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
                                                                          52. Patient.birthDate.extension:accuracyIndicator
                                                                          Slice NameaccuracyIndicator
                                                                          Definition

                                                                          General date accuracy indicator coding.

                                                                          ShortBirth date accuracy indicator
                                                                          Comments

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

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

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

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

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


                                                                          Indicates if the individual is deceased or not.

                                                                          ShortIndicates if the individual is deceased or not
                                                                          Comments

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

                                                                          Control0..1
                                                                          TypeChoice of: boolean, dateTime
                                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                          Is Modifiertrue because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          Requirements

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

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

                                                                            Boolean indicator if the individual is deceased or not.


                                                                            Indicates if the individual is deceased or not.

                                                                            ShortDeceased indicatorIndicates if the individual is deceased or not
                                                                            Comments

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

                                                                            Control0..1
                                                                            Typeboolean, dateTime
                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                            Is Modifiertrue because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summarytrue
                                                                            Requirements

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

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

                                                                            Individual deceased date-time with optional accuracy indicator.


                                                                            Indicates if the individual is deceased or not.

                                                                            ShortDeceased date timeIndicates if the individual is deceased or not
                                                                            Comments

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

                                                                            Control0..1
                                                                            TypedateTime, boolean
                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                            Is Modifiertrue because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summarytrue
                                                                            Requirements

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

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            62. 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
                                                                            64. 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
                                                                            Obligations
                                                                              ObligationsActor
                                                                              SHALL:populate-if-knownAU Core Responder
                                                                              SHALL:no-errorAU Core Requester
                                                                              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'))
                                                                              66. 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
                                                                              Obligations
                                                                                ObligationsActor
                                                                                SHALL:populate-if-knownAU Core Responder
                                                                                SHALL:no-errorAU Core Requester
                                                                                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()))
                                                                                68. 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())
                                                                                70. 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
                                                                                Obligations
                                                                                  ObligationsActor
                                                                                  SHALL:populate-if-knownAU Core Responder
                                                                                  SHALL:no-errorAU Core Requester
                                                                                  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()))
                                                                                  72. 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
                                                                                  Obligations
                                                                                    ObligationsActor
                                                                                    SHALL:populate-if-knownAU Core Responder
                                                                                    SHALL:no-errorAU Core Requester
                                                                                    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()))
                                                                                    74. 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()))
                                                                                    76. 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())
                                                                                    78. 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()))
                                                                                    80. Patient.link.type
                                                                                    Definition

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

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

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

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

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

                                                                                    0. Patient
                                                                                    Definition

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

                                                                                    ShortA patient in 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'))
                                                                                    inv-pat-3: Recorded sex or gender type shall be a member of the Common AU Recorded Sex or Gender Type value set if any codes within that value set can apply (extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('type').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('type').value.memberOf('http://terminology.hl7.org.au/ValueSet/rsg-type'))
                                                                                    inv-pat-4: Recorded sex or gender source document type shall be a member of the Common AU Recorded Sex or Gender (RSG) Source Document Type value set if any codes within that value set can apply (extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('sourceDocument').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('sourceDocument').value.memberOf('http://terminology.hl7.org.au/ValueSet/rsg-source-document-type'))
                                                                                    inv-pat-5: Recorded sex or gender jurisdiction shall be a member of the Common AU Recorded Sex or Gender (RSG) Source Document Jurisdiction value set if any codes within that value set can apply (extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('jurisdiction').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('jurisdiction').value.memberOf('http://terminology.hl7.org.au/ValueSet/rsg-source-document-jurisdiction'))
                                                                                    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)

                                                                                    A human language.

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

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

                                                                                    ShortText summary of the resource, for human interpretation
                                                                                    Comments

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

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

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

                                                                                    ShortContained, inline Resources
                                                                                    Comments

                                                                                    This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

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

                                                                                    An Extension

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

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

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

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

                                                                                      ShortIndigenous status
                                                                                      Comments

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

                                                                                      Control0..1
                                                                                      This element is affected by the following invariants: ele-1
                                                                                      TypeExtension(Australian Indigenous Status) (Extension Type: Coding)
                                                                                      Is Modifierfalse
                                                                                      Must Supporttrue
                                                                                      Obligations
                                                                                        ObligationsActor
                                                                                        SHALL:populate-if-knownAU Core Responder
                                                                                        SHALL:no-errorAU Core Requester
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                        20. Patient.extension:veteranStatus
                                                                                        Slice NameveteranStatus
                                                                                        Definition

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

                                                                                        ShortVeteran / Australian Defence Force (ADF) status
                                                                                        Comments

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

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

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

                                                                                        ShortClosing the Gap co-payment eligibility indicator
                                                                                        Comments

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

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

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

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

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

                                                                                        ShortWhether the patient needs an interpreter
                                                                                        Comments

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

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

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

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

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

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

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

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

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

                                                                                        Control0..*
                                                                                        This element is affected by the following invariants: inv-pat-1
                                                                                        TypeExtension(Individual Gender Identity) (Complex Extension)
                                                                                        Is Modifierfalse
                                                                                        Must Supporttrue
                                                                                        Obligations
                                                                                          ObligationsActor
                                                                                          SHALL:populate-if-knownAU Core Responder
                                                                                          SHALL:no-errorAU Core Requester
                                                                                          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
                                                                                          Obligations
                                                                                            ObligationsActor
                                                                                            SHALL:populate-if-knownAU Core Responder
                                                                                            SHALL:no-errorAU Core Requester
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                            34. Patient.extension:recordedSexOrGender
                                                                                            Slice NamerecordedSexOrGender
                                                                                            Definition

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

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

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

                                                                                            Control0..*
                                                                                            This element is affected by the following invariants: inv-pat-3, inv-pat-4, inv-pat-5
                                                                                            TypeExtension(Person Recorded Sex Or Gender) (Complex Extension)
                                                                                            Is Modifierfalse
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                            36. Patient.modifierExtension
                                                                                            Definition

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

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

                                                                                            ShortExtensions that cannot be ignored
                                                                                            Comments

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

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

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

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

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

                                                                                            ShortIdentifies this patient across multiple systems
                                                                                            NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                                            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
                                                                                            Obligations
                                                                                              ObligationsActor
                                                                                              SHALL:populate-if-knownAU Core Responder
                                                                                              SHALL:no-errorAU Core Requester
                                                                                              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 areUnordered 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
                                                                                                Obligations
                                                                                                  ObligationsActor
                                                                                                  SHALL:populate-if-knownAU Core Responder
                                                                                                  SHALL:no-errorAU Core Requester
                                                                                                  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
                                                                                                  Obligations
                                                                                                    ObligationsActor
                                                                                                    SHALL:populate-if-knownAU Core Responder
                                                                                                    SHALL:no-errorAU Core Requester
                                                                                                    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
                                                                                                    Obligations
                                                                                                      ObligationsActor
                                                                                                      SHALL:populate-if-knownAU Core Responder
                                                                                                      SHALL:no-errorAU Core Requester
                                                                                                      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: au-core-pat-02
                                                                                                      TypeHumanName
                                                                                                      Is Modifierfalse
                                                                                                      Must Supporttrue
                                                                                                      Obligations
                                                                                                        ObligationsActor
                                                                                                        SHALL:populate-if-knownAU Core Responder
                                                                                                        SHALL:no-errorAU Core Requester
                                                                                                        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 areUnordered 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)

                                                                                                          The use of a human name.

                                                                                                          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
                                                                                                          Obligations
                                                                                                            ObligationsActor
                                                                                                            SHALL:populate-if-knownAU Core Responder
                                                                                                            SHALL:no-errorAU Core Requester
                                                                                                            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
                                                                                                            Must Supporttrue
                                                                                                            Obligations
                                                                                                              ObligationsActor
                                                                                                              SHALL:populate-if-knownAU Core Responder
                                                                                                              SHALL:no-errorAU Core Requester
                                                                                                              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
                                                                                                              Must Supporttrue
                                                                                                              Obligations
                                                                                                                ObligationsActor
                                                                                                                SHALL:populate-if-knownAU Core Responder
                                                                                                                SHALL:no-errorAU Core Requester
                                                                                                                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
                                                                                                                Must Supporttrue
                                                                                                                Obligations
                                                                                                                  ObligationsActor
                                                                                                                  SHALL:populate-if-knownAU Core Responder
                                                                                                                  SHALL:no-errorAU Core Requester
                                                                                                                  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
                                                                                                                  Obligations
                                                                                                                    ObligationsActor
                                                                                                                    SHALL:populate-if-knownAU Core Responder
                                                                                                                    SHALL:no-errorAU Core Requester
                                                                                                                    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)

                                                                                                                    The gender of a person used for administrative purposes.

                                                                                                                    Typecode
                                                                                                                    Is Modifierfalse
                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                    Must Supporttrue
                                                                                                                    Obligations
                                                                                                                      ObligationsActor
                                                                                                                      SHALL:populate-if-knownAU Core Responder
                                                                                                                      SHALL:no-errorAU Core Requester
                                                                                                                      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
                                                                                                                      Obligations
                                                                                                                        ObligationsActor
                                                                                                                        SHALL:populate-if-knownAU Core Responder
                                                                                                                        SHALL:no-errorAU Core Requester
                                                                                                                        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 areUnordered 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.

                                                                                                                          ShortBirth date accuracy indicator
                                                                                                                          Comments

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

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

                                                                                                                          ShortBirth time
                                                                                                                          Control0..1
                                                                                                                          This element is affected by the following invariants: inv-pat-0
                                                                                                                          TypeExtension(Patient Birth Time) (Extension Type: dateTime)
                                                                                                                          Is Modifierfalse
                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                          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] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                          Is Modifiertrue because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
                                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                          Summarytrue
                                                                                                                          Requirements

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

                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          SlicingThis element introduces a set of slices on Patient.deceased[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                                                                                          • type @ $this
                                                                                                                          • 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] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                            Is Modifiertrue because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
                                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                            Summarytrue
                                                                                                                            Requirements

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

                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            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] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                            Is Modifiertrue because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
                                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                            Summarytrue
                                                                                                                            Requirements

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

                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            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 areUnordered 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
                                                                                                                              Obligations
                                                                                                                                ObligationsActor
                                                                                                                                SHALL:populate-if-knownAU Core Responder
                                                                                                                                SHALL:no-errorAU Core Requester
                                                                                                                                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)

                                                                                                                                The domestic partnership status of a person.

                                                                                                                                TypeCodeableConcept
                                                                                                                                Is Modifierfalse
                                                                                                                                Summaryfalse
                                                                                                                                Requirements

                                                                                                                                Most, if not all systems capture it.

                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                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] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                Is Modifierfalse
                                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                Summaryfalse
                                                                                                                                Requirements

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

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

                                                                                                                                The gender of a person used for administrative purposes.

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

                                                                                                                                Needed to address the person correctly.

                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                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
                                                                                                                                Obligations
                                                                                                                                  ObligationsActor
                                                                                                                                  SHALL:populate-if-knownAU Core Responder
                                                                                                                                  SHALL:no-errorAU Core Requester
                                                                                                                                  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
                                                                                                                                  Obligations
                                                                                                                                    ObligationsActor
                                                                                                                                    SHALL:populate-if-knownAU Core Responder
                                                                                                                                    SHALL:no-errorAU Core Requester
                                                                                                                                    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
                                                                                                                                    Obligations
                                                                                                                                      ObligationsActor
                                                                                                                                      SHALL:populate-if-knownAU Core Responder
                                                                                                                                      SHALL:no-errorAU Core Requester
                                                                                                                                      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)

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

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