eHealth Infrastructure
3.2.0 - release

This page is part of the FUT Infrastructure (v3.2.0: Release) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Resource Profile: ehealth-skrs-patient - Detailed Descriptions

Active as of 2024-09-02

Definitions for the ehealth-skrs-patient resource profile.

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

0. Patient
2. Patient.extension
SlicingThis element introduces a set of slices on Patient.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 4. Patient.extension:nameAndAddressProtection
    Slice NamenameAndAddressProtection
    Control0..1
    TypeExtension(Name and address protection) (Extension Type: Period)
    6. Patient.identifier
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control1..1
    Must Supporttrue
    SlicingThis element introduces a set of slices on Patient.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ system
    • 8. Patient.identifier:ehealth-dk-crn-identifier
      Slice Nameehealth-dk-crn-identifier
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control1..1
      TypeIdentifier(Danish Central Person Register (CPR) Identifier)
      10. Patient.deceased[x]
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      SlicingThis element introduces a set of slices on Patient.deceased[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
      • type @ $this
      • 12. Patient.deceased[x]:deceasedDateTime
        Slice NamedeceasedDateTime
        Control0..1
        TypedateTime
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        14. Patient.address
        Control0..1
        SlicingThis element introduces a set of slices on Patient.address. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
        • value @ use
        • 16. Patient.address:officialHomeAddress
          Slice NameofficialHomeAddress
          Control0..1
          18. Patient.address:officialHomeAddress.extension:municipalityCodes
          Slice NamemunicipalityCodes
          Control0..*
          TypeExtension(Danish Core Municipality codes) (Extension Type: CodeableConcept)
          20. Patient.address:officialHomeAddress.extension:regionalSubDivisionCodes
          Slice NameregionalSubDivisionCodes
          Control0..*
          TypeExtension(Danish Core Regional Sub Division Codes Extension) (Extension Type: CodeableConcept)
          22. Patient.address:officialHomeAddress.use
          Control1..?
          Fixed Valuehome

          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 or animal receiving care or other health-related services.

          ShortInformation 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())
          2. Patient.implicitRules
          Definition

          A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

          ShortA set of rules under which this content was created
          Comments

          Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

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

          An Extension


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

          ShortExtensionAdditional content defined by implementations
          Comments

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

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

            Period of name and address protection. Patients with name and address protection are marked with security label ‘restricted’ (R in http://hl7.org/fhir/v3/Confidentiality).

            ShortPeriod of name and address protection
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Name and address protection) (Extension Type: Period)
            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())
            8. 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())
            10. Patient.identifier
            Definition

            An identifier for this patient.

            ShortAn identifier for this patient
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control10..1*
            TypeIdentifier
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            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:
            • value @ system
            • 12. Patient.identifier:ehealth-dk-crn-identifier
              Slice Nameehealth-dk-crn-identifier
              Definition

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


              An identifier for this patient.

              ShortAn identifier intended for computationAn identifier for this patient
              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control10..1*
              This element is affected by the following invariants: ele-1
              TypeIdentifier(Danish Central Person Register (CPR) Identifier)
              Is Modifierfalse
              Requirements

              Patients are almost always assigned specific numerical identifiers.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              14. 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()))
              16. Patient.deceased[x]
              Definition

              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 Open, and can be differentiated using the following discriminators:
              • type @ $this
              • 18. Patient.deceased[x]:deceasedDateTime
                Slice NamedeceasedDateTime
                Definition

                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
                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()))
                20. Patient.address
                Definition

                An address for the individual.

                ShortAn address for the individual
                Comments

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

                Control0..1*
                TypeAddress
                Is Modifierfalse
                Summarytrue
                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()))
                SlicingThis element introduces a set of slices on Patient.address. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                • value @ use
                • 22. Patient.address:officialHomeAddress
                  Slice NameofficialHomeAddress
                  Definition

                  An address for the individual.

                  ShortAn address for the individual
                  Comments

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

                  Control0..1*
                  TypeAddress
                  Is Modifierfalse
                  Summarytrue
                  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()))
                  24. Patient.address:officialHomeAddress.extension:municipalityCodes
                  Slice NamemunicipalityCodes
                  Definition

                  Identifier holding the official identifier for a danish municipality

                  ShortDanish Core Municipality codes
                  Control0..*
                  TypeExtension(Danish Core Municipality codes) (Extension Type: CodeableConcept)
                  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())
                  26. Patient.address:officialHomeAddress.extension:regionalSubDivisionCodes
                  Slice NameregionalSubDivisionCodes
                  Definition

                  Identifier holding the official organization identifier for a danish region

                  ShortDanish Core Regional Sub Division Codes Extension
                  Control0..*
                  TypeExtension(Danish Core Regional Sub Division Codes Extension) (Extension Type: CodeableConcept)
                  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())
                  28. Patient.address:officialHomeAddress.use
                  Definition

                  The purpose of this address.

                  Shorthome | work | temp | old | billing - purpose of this address
                  Comments

                  Applications can assume that an address is current unless it explicitly says that it is temporary or old.

                  Control10..1
                  BindingThe codes SHALL be taken from AddressUsehttp://hl7.org/fhir/ValueSet/address-use|4.0.1
                  (required to http://hl7.org/fhir/ValueSet/address-use|4.0.1)

                  The use of an address.

                  Typecode
                  Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Requirements

                  Allows an appropriate address to be chosen from a list of many.

                  Fixed Valuehome
                  Example<br/><b>General</b>:home
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  30. Patient.link
                  Definition

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

                  ShortLink 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()))
                  32. 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())
                  34. 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()))
                  36. 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 or animal receiving care or other health-related services.

                  ShortInformation 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())
                  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:nameAndAddressProtection
                    Slice NamenameAndAddressProtection
                    Definition

                    Period of name and address protection. Patients with name and address protection are marked with security label ‘restricted’ (R in http://hl7.org/fhir/v3/Confidentiality).

                    ShortPeriod of name and address protection
                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeExtension(Name and address protection) (Extension Type: Period)
                    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.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())
                    20. Patient.identifier
                    Definition

                    An identifier for this patient.

                    ShortAn identifier for this patient
                    NoteThis is a business identifier, not a resource identifier (see discussion)
                    Control1..1
                    TypeIdentifier
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    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:
                    • value @ system
                    • 22. Patient.identifier:ehealth-dk-crn-identifier
                      Slice Nameehealth-dk-crn-identifier
                      Definition

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

                      ShortAn identifier intended for computation
                      NoteThis is a business identifier, not a resource identifier (see discussion)
                      Control1..1
                      This element is affected by the following invariants: ele-1
                      TypeIdentifier(Danish Central Person Register (CPR) Identifier)
                      Is Modifierfalse
                      Requirements

                      Patients are almost always assigned specific numerical identifiers.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      24. 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()))
                      26. Patient.name
                      Definition

                      A name associated with the individual.

                      ShortA name associated with the patient
                      Comments

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

                      Control0..*
                      TypeHumanName
                      Is Modifierfalse
                      Summarytrue
                      Requirements

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

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

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

                      ShortA contact detail for the individual
                      Comments

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

                      Control0..*
                      TypeContactPoint
                      Is Modifierfalse
                      Summarytrue
                      Requirements

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

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

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

                      Shortmale | female | other | unknown
                      Comments

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

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

                      The gender of a person used for administrative purposes.

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

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

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

                      The date of birth for the individual.

                      ShortThe date of birth for the individual
                      Comments

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

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

                      Age of the individual drives many clinical processes.

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

                      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 Open, and can be differentiated using the following discriminators:
                      • type @ $this
                      • 36. Patient.deceased[x]:deceasedDateTime
                        Slice NamedeceasedDateTime
                        Definition

                        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
                        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()))
                        38. Patient.address
                        Definition

                        An address for the individual.

                        ShortAn address for the individual
                        Comments

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

                        Control0..1
                        TypeAddress
                        Is Modifierfalse
                        Summarytrue
                        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()))
                        SlicingThis element introduces a set of slices on Patient.address. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                        • value @ use
                        • 40. Patient.address:officialHomeAddress
                          Slice NameofficialHomeAddress
                          Definition

                          An address for the individual.

                          ShortAn address for the individual
                          Comments

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

                          Control0..1
                          TypeAddress
                          Is Modifierfalse
                          Summarytrue
                          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()))
                          42. Patient.address:officialHomeAddress.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
                          44. Patient.address:officialHomeAddress.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.address.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 46. Patient.address:officialHomeAddress.extension:municipalityCodes
                            Slice NamemunicipalityCodes
                            Definition

                            Identifier holding the official identifier for a danish municipality

                            ShortDanish Core Municipality codes
                            Control0..*
                            TypeExtension(Danish Core Municipality codes) (Extension Type: CodeableConcept)
                            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())
                            48. Patient.address:officialHomeAddress.extension:regionalSubDivisionCodes
                            Slice NameregionalSubDivisionCodes
                            Definition

                            Identifier holding the official organization identifier for a danish region

                            ShortDanish Core Regional Sub Division Codes Extension
                            Control0..*
                            TypeExtension(Danish Core Regional Sub Division Codes Extension) (Extension Type: CodeableConcept)
                            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())
                            50. Patient.address:officialHomeAddress.use
                            Definition

                            The purpose of this address.

                            Shorthome | work | temp | old | billing - purpose of this address
                            Comments

                            Applications can assume that an address is current unless it explicitly says that it is temporary or old.

                            Control1..1
                            BindingThe codes SHALL be taken from AddressUse
                            (required to http://hl7.org/fhir/ValueSet/address-use|4.0.1)

                            The use of an address.

                            Typecode
                            Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            Allows an appropriate address to be chosen from a list of many.

                            Fixed Valuehome
                            Example<br/><b>General</b>:home
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            52. Patient.address:officialHomeAddress.type
                            Definition

                            Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both.

                            Shortpostal | physical | both
                            Comments

                            The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource).

                            Control0..1
                            BindingThe codes SHALL be taken from AddressType
                            (required to http://hl7.org/fhir/ValueSet/address-type|4.0.1)

                            The type of an address (physical / postal).

                            Typecode
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Example<br/><b>General</b>:both
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            54. Patient.address:officialHomeAddress.text
                            Definition

                            Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts.

                            ShortText representation of the address
                            Comments

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

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

                            A renderable, unencoded form.

                            Example<br/><b>General</b>:137 Nowhere Street, Erewhon 9132
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            56. Patient.address:officialHomeAddress.line
                            Definition

                            This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.

                            ShortStreet name, number, direction & P.O. Box etc.
                            Control0..*
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Example<br/><b>General</b>:137 Nowhere Street
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            58. Patient.address:officialHomeAddress.city
                            Definition

                            The name of the city, town, suburb, village or other community or delivery center.

                            ShortName of city, town etc.
                            Control0..1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Alternate NamesMunicpality
                            Example<br/><b>General</b>:Erewhon
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            60. Patient.address:officialHomeAddress.district
                            Definition

                            The name of the administrative area (county).

                            ShortDistrict name (aka county)
                            Comments

                            District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.

                            Control0..1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Alternate NamesCounty
                            Example<br/><b>General</b>:Madison
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            62. Patient.address:officialHomeAddress.state
                            Definition

                            Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes).

                            ShortSub-unit of country (abbreviations ok)
                            Control0..1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Alternate NamesProvince, Territory
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            64. Patient.address:officialHomeAddress.postalCode
                            Definition

                            A postal code designating a region defined by the postal service.

                            ShortPostal code for area
                            Control0..1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Alternate NamesZip
                            Example<br/><b>General</b>:9132
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            66. Patient.address:officialHomeAddress.country
                            Definition

                            Country - a nation as commonly understood or generally accepted.

                            ShortCountry (e.g. can be ISO 3166 2 or 3 letter code)
                            Comments

                            ISO 3166 3 letter codes can be used in place of a human readable country name.

                            Control0..1
                            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()))
                            68. Patient.address:officialHomeAddress.period
                            Definition

                            Time period when address was/is in use.

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

                            Allows addresses to be placed in historical context.

                            Example<br/><b>General</b>:{ "start" : "2010-03-23", "end" : "2010-07-01" }
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            70. 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()))
                            72. 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()))
                            74. 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()))
                            76. 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())
                            78. 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
                            80. 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())
                            82. 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())
                            84. 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 PatientContactRelationship
                            (extensible to http://hl7.org/fhir/ValueSet/patient-contactrelationship)

                            The nature of the relationship between a patient and a contact person for that patient.

                            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()))
                            86. 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()))
                            88. 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()))
                            90. Patient.contact.address
                            Definition

                            Address for the contact person.

                            ShortAddress for the contact person
                            Control0..1
                            TypeAddress
                            Is Modifierfalse
                            Summaryfalse
                            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()))
                            92. 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()))
                            94. 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()))
                            96. 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()))
                            98. Patient.communication
                            Definition

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

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

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

                            Control0..*
                            TypeBackboneElement
                            Is Modifierfalse
                            Summaryfalse
                            Requirements

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

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            100. 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
                            102. 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())
                            104. 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())
                            106. 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
                            BindingThe codes SHOULD be taken from CommonLanguages
                            (preferred to http://hl7.org/fhir/ValueSet/languages)

                            A human language.

                            Additional BindingsPurpose
                            AllLanguagesMax Binding
                            TypeCodeableConcept
                            Is Modifierfalse
                            Summaryfalse
                            Requirements

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

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

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

                            ShortLanguage preference indicator
                            Comments

                            This language is specifically identified for communicating healthcare information.

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

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

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            110. 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()))
                            112. 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()))
                            114. Patient.link
                            Definition

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

                            ShortLink 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()))
                            116. 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
                            118. 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())
                            120. 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())
                            122. 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()))
                            124. 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()))