HL7 Europe Imaging Study Report
0.1.0-ballot - ci-build 150

HL7 Europe Imaging Study Report, published by HL7 Europe. This guide is not an authorized publication; it is the continuous build for version 0.1.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/oijauregui/ehdsimaging/tree/master and changes regularly. See the Directory of published versions

Resource Profile: Report_EuPatient - Detailed Descriptions

Draft as of 2025-07-02

Definitions for the Report-EuPatient resource profile.

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

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
Must Supportfalse
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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(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 its 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 its meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Patient.contained
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

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..*
This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
TypeResource
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
6. Patient.extension:birthPlace
Slice NamebirthPlace
Definition

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

ShortPlace of Birth for patient
Control0..1
TypeExtension(Patient Birth Place) (Extension Type: Address)
Is Modifierfalse
Must Supportfalse
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())
8. Patient.extension:birthPlace.extension
Definition

An Extension


May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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..0*
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.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 10. Patient.extension:birthPlace.url
    Definition

    Source of the definition for the extension code - a logical name or a URL.

    Shortidentifies the meaning of the extension
    Comments

    The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

    Control1..1
    Typeuri
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    Fixed Valuehttp://hl7.org/fhir/StructureDefinition/patient-birthPlace
    12. Patient.extension:birthPlace.value[x]
    Definition

    Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

    ShortValue of extension
    Control10..1
    This element is affected by the following invariants: ext-1
    TypeAddress(Address (EU)), date, Meta, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, RatioRange, Coding, SampledData, id, positiveInt, Distance, Availability, integer64, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ExtendedContactDetail, CodeableConcept, ParameterDefinition, dateTime, code, string, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, CodeableReference, Signature, unsignedInt, time
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    14. Patient.extension:sex-for-clinical-use
    Slice Namesex-for-clinical-use
    Definition

    A parameter that provides guidance on how a recipient should apply settings or reference ranges that are derived from observable information such as an organ inventory, recent hormone lab tests, genetic testing, menstrual status, obstetric history, etc..

    ShortSex for clinical use
    Control0..*
    TypeExtension(Patient Sex Parameter For Clinical Use) (Complex Extension)
    Is Modifierfalse
    Must Supportfalse
    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())
    16. Patient.extension:patient-citizenship
    Slice Namepatient-citizenship
    Definition

    The patient's legal status as citizen of a country.

    ShortNation(s) where the patient claims citizenship
    Control0..*
    TypeExtension(Patient Citizenship) (Complex Extension)
    Is Modifierfalse
    Must Supportfalse
    Obligations
      ObligationsActorDocumentation
      SHALL:populate-if-knownImaging study report provider

      EHDSPatient.citizenship

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      18. Patient.extension:patient-nationality
      Slice Namepatient-nationality
      Definition

      The nationality of the patient.

      ShortNationality
      Control0..*
      TypeExtension(Patient Nationality) (Complex Extension)
      Is Modifierfalse
      Must Supportfalse
      Obligations
        ObligationsActorDocumentation
        SHALL:populate-if-knownImaging study report provider

        EHDSPatient.citizenship

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

        An identifier for this patient.

        ShortPatient identifiersAn identifier for this patient
        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..*
        TypeIdentifier
        Is Modifierfalse
        Must Supportfalse
        Obligations
          ObligationsActorDocumentation
          SHALL:populate-if-knownImaging study report provider

          EHDSPatient.personalIdentifier

          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()))
          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
          Must Supportfalse
          Obligations
            ObligationsActorDocumentation
            SHALL:handleImaging study report provider
            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. Animal names may be communicated as given names, and optionally may include a family name.

            Control0..*
            TypeHumanName
            Is Modifierfalse
            Must Supportfalse
            Obligations
              ObligationsActorDocumentation
              SHALL:populate-if-knownImaging study report provider

              EHDSPatient.name

              Summarytrue
              Requirements

              Need to be able to track the patient by multiple names. Examples are your official name and a partner name. The Alphabetic representation of the name SHALL be always provided


              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.name.extension:name-absent-reason
              Slice Namename-absent-reason
              Definition

              Reason for not providing the name.

              ShortReason for not providing the name.
              Control0..*
              TypeExtension(Data Absent Reason) (Extension Type: code)
              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())
              30. Patient.name.use
              Definition

              Identifies the purpose for this name.

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

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

              Control0..1
              BindingThe codes SHALL be taken from NameUsehttp://hl7.org/fhir/ValueSet/name-use|5.0.0
              (required to http://hl7.org/fhir/ValueSet/name-use|5.0.0)

              The use of a human name.

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

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

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              32. 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 patientA contact detail for the individual
              Comments

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

              Control0..*
              TypeContactPoint
              Is Modifierfalse
              Must Supportfalse
              Obligations
                ObligationsActorDocumentation
                SHALL:populate-if-knownImaging study report provider

                EHDSPatient.telecom

                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()))
                34. Patient.gender
                Definition

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

                ShortAdministrative Gendermale | 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 AdministrativeGenderhttp://hl7.org/fhir/ValueSet/administrative-gender|5.0.0
                (required to http://hl7.org/fhir/ValueSet/administrative-gender|5.0.0)

                The gender of a person used for administrative purposes.

                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supportfalse
                Obligations
                  ObligationsActorDocumentation
                  SHALL:populate-if-knownImaging study report provider

                  EHDSPatient.administrativeGender

                  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()))
                  36. Patient.birthDate
                  Definition

                  The date of birth for the individual.

                  ShortThe date of birth for the patientThe date of birth for the individual
                  Comments

                  Partial dates are allowed if the specific date of birth 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
                  Must Supportfalse
                  Obligations
                    ObligationsActorDocumentation
                    SHALL:populate-if-knownImaging study report provider

                    EHDSPatient.dateOfBirth

                    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
                    38. 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
                    Must Supportfalse
                    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()))
                    40. 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..*
                    TypeAddress(Address (EU))
                    Is Modifierfalse
                    Must Supportfalse
                    Obligations
                      ObligationsActorDocumentation
                      SHALL:populate-if-knownImaging study report provider

                      EHDSPatient.address

                      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.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 MaritalStatusCodeshttp://hl7.org/fhir/ValueSet/marital-status
                      (extensible to http://hl7.org/fhir/ValueSet/marital-status)

                      The domestic partnership status of a person.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Must Supportfalse
                      Obligations
                        ObligationsActorDocumentation
                        SHALL:populate-if-knownImaging study report provider

                        EHDSPatient.maritalStatus

                        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()))
                        44. Patient.link
                        Definition

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

                        ShortLink to a Patient or RelatedPerson resource that concerns the same actual individual
                        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'
                        Must Supportfalse
                        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()))
                        46. 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 managable, 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())
                        48. Patient.link.other
                        Definition

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

                        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
                        Must Supportfalse
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        50. 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|5.0.0
                        (required to http://hl7.org/fhir/ValueSet/link-type|5.0.0)

                        The type of link between this patient resource and another Patient resource, or Patient/RelatedPerson when using the seealso code

                        Typecode
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supportfalse
                        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 foundhere

                        0. Patient
                        2. Patient.extension:patient-citizenship
                        Slice Namepatient-citizenship
                        Obligations
                          ObligationsActorDocumentation
                          SHALL:populate-if-knownImaging study report provider

                          EHDSPatient.citizenship

                          4. Patient.extension:patient-nationality
                          Slice Namepatient-nationality
                          Obligations
                            ObligationsActorDocumentation
                            SHALL:populate-if-knownImaging study report provider

                            EHDSPatient.citizenship

                            6. Patient.identifier
                            NoteThis is a business identifier, not a resource identifier (see discussion)
                            Obligations
                              ObligationsActorDocumentation
                              SHALL:populate-if-knownImaging study report provider

                              EHDSPatient.personalIdentifier

                              8. Patient.active
                              Obligations
                                ObligationsActorDocumentation
                                SHALL:handleImaging study report provider
                                10. Patient.name
                                Obligations
                                  ObligationsActorDocumentation
                                  SHALL:populate-if-knownImaging study report provider

                                  EHDSPatient.name

                                  12. Patient.telecom
                                  Obligations
                                    ObligationsActorDocumentation
                                    SHALL:populate-if-knownImaging study report provider

                                    EHDSPatient.telecom

                                    14. Patient.gender
                                    Obligations
                                      ObligationsActorDocumentation
                                      SHALL:populate-if-knownImaging study report provider

                                      EHDSPatient.administrativeGender

                                      16. Patient.birthDate
                                      Obligations
                                        ObligationsActorDocumentation
                                        SHALL:populate-if-knownImaging study report provider

                                        EHDSPatient.dateOfBirth

                                        LOINC Code
                                        18. Patient.address
                                        Obligations
                                          ObligationsActorDocumentation
                                          SHALL:populate-if-knownImaging study report provider

                                          EHDSPatient.address

                                          20. Patient.maritalStatus
                                          Obligations
                                            ObligationsActorDocumentation
                                            SHALL:populate-if-knownImaging study report provider

                                            EHDSPatient.maritalStatus

                                            22. Patient.communication
                                            24. Patient.communication.language
                                            Obligations
                                              ObligationsActorDocumentation
                                              SHALL:populate-if-knownImaging study report provider

                                              EHDSPatient.communicationLanguage

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

                                              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
                                              Must Supportfalse
                                              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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(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

                                              Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

                                              Control0..1
                                              Typeid
                                              Is Modifierfalse
                                              Must Supportfalse
                                              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
                                              Must Supportfalse
                                              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 its 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 its meaning or interpretation
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supportfalse
                                              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 SHALL be taken from AllLanguages
                                              (required to http://hl7.org/fhir/ValueSet/all-languages|5.0.0)

                                              IETF language tag for a human language

                                              Typecode
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supportfalse
                                              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 a 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
                                              This element is affected by the following invariants: dom-6
                                              TypeNarrative
                                              Is Modifierfalse
                                              Must Supportfalse
                                              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, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

                                              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..*
                                              This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
                                              TypeResource
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Alternate Namesinline resources, anonymous resources, contained resources
                                              14. Patient.extension
                                              Definition

                                              An Extension

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

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

                                                ShortPlace of Birth for patient
                                                Control0..1
                                                TypeExtension(Patient Birth Place) (Extension Type: Address)
                                                Is Modifierfalse
                                                Must Supportfalse
                                                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())
                                                18. Patient.extension:birthPlace.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
                                                This element is affected by the following invariants: ele-1
                                                Typeid
                                                Is Modifierfalse
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                Summaryfalse
                                                20. Patient.extension:birthPlace.extension
                                                Definition

                                                An Extension

                                                ShortExtension
                                                Control0..0
                                                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.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                • value @ url
                                                • 22. Patient.extension:birthPlace.url
                                                  Definition

                                                  Source of the definition for the extension code - a logical name or a URL.

                                                  Shortidentifies the meaning of the extension
                                                  Comments

                                                  The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                  Control1..1
                                                  Typeuri
                                                  Is Modifierfalse
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  Summaryfalse
                                                  Fixed Valuehttp://hl7.org/fhir/StructureDefinition/patient-birthPlace
                                                  24. Patient.extension:birthPlace.value[x]
                                                  Definition

                                                  Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                  ShortValue of extension
                                                  Control1..1
                                                  This element is affected by the following invariants: ext-1
                                                  TypeAddress(Address (EU))
                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  26. Patient.extension:sex-for-clinical-use
                                                  Slice Namesex-for-clinical-use
                                                  Definition

                                                  A parameter that provides guidance on how a recipient should apply settings or reference ranges that are derived from observable information such as an organ inventory, recent hormone lab tests, genetic testing, menstrual status, obstetric history, etc..

                                                  ShortSex for clinical use
                                                  Control0..*
                                                  TypeExtension(Patient Sex Parameter For Clinical Use) (Complex Extension)
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  28. Patient.extension:patient-citizenship
                                                  Slice Namepatient-citizenship
                                                  Definition

                                                  The patient's legal status as citizen of a country.

                                                  ShortNation(s) where the patient claims citizenship
                                                  Control0..*
                                                  TypeExtension(Patient Citizenship) (Complex Extension)
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Obligations
                                                    ObligationsActorDocumentation
                                                    SHALL:populate-if-knownImaging study report provider

                                                    EHDSPatient.citizenship

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    30. Patient.extension:patient-nationality
                                                    Slice Namepatient-nationality
                                                    Definition

                                                    The nationality of the patient.

                                                    ShortNationality
                                                    Control0..*
                                                    TypeExtension(Patient Nationality) (Complex Extension)
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Obligations
                                                      ObligationsActorDocumentation
                                                      SHALL:populate-if-knownImaging study report provider

                                                      EHDSPatient.citizenship

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

                                                      An identifier for this patient.

                                                      ShortPatient identifiers
                                                      NoteThis is a business identifier, not a resource identifier (see discussion)
                                                      Control0..*
                                                      TypeIdentifier
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Obligations
                                                        ObligationsActorDocumentation
                                                        SHALL:populate-if-knownImaging study report provider

                                                        EHDSPatient.personalIdentifier

                                                        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()))
                                                        36. 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
                                                        Must Supportfalse
                                                        Obligations
                                                          ObligationsActorDocumentation
                                                          SHALL:handleImaging study report provider
                                                          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()))
                                                          38. 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. Animal names may be communicated as given names, and optionally may include a family name.

                                                          Control0..*
                                                          TypeHumanName
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Obligations
                                                            ObligationsActorDocumentation
                                                            SHALL:populate-if-knownImaging study report provider

                                                            EHDSPatient.name

                                                            Summarytrue
                                                            Requirements

                                                            Need to be able to track the patient by multiple names. Examples are your official name and a partner name. The Alphabetic representation of the name SHALL be always provided

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

                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                            ShortUnique id for inter-element referencing
                                                            Control0..1
                                                            This element is affected by the following invariants: ele-1
                                                            Typeid
                                                            Is Modifierfalse
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            Summaryfalse
                                                            42. Patient.name.extension
                                                            Definition

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

                                                            ShortAdditional content defined by implementations
                                                            Comments

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

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

                                                              Reason for not providing the name.

                                                              ShortReason for not providing the name.
                                                              Control0..*
                                                              TypeExtension(Data Absent Reason) (Extension Type: code)
                                                              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())
                                                              46. Patient.name.use
                                                              Definition

                                                              Identifies the purpose for this name.

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

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

                                                              Control0..1
                                                              BindingThe codes SHALL be taken from NameUse
                                                              (required to http://hl7.org/fhir/ValueSet/name-use|5.0.0)

                                                              The use of a human name.

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

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

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

                                                              Text representation of the full name. Due to the cultural variance around the world a consuming system may not know how to present the name correctly; moreover not all the parts of the name go in given or family. Creators are therefore strongly encouraged to provide through this element a presented version of the name. Future versions of this guide may require this element.

                                                              ShortText representation of the full name.
                                                              Comments

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

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

                                                              A renderable, unencoded form.

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

                                                              Family name. When more the family is composed by more than one names, this element documents the full composed family name with the proper * name.familyrder. The parts are recorded in the fhater and mother family names extensions.

                                                              ShortFamily name.
                                                              Comments

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

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

                                                              Given name.

                                                              ShortGiven names. Includes middle names
                                                              Comments

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

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

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

                                                              ShortParts that come before the name
                                                              Control0..*
                                                              Typestring
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Summarytrue
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              56. Patient.name.suffix
                                                              Definition

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

                                                              ShortParts that come after the name
                                                              Control0..*
                                                              Typestring
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Summarytrue
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              58. Patient.name.period
                                                              Definition

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

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

                                                              Allows names to be placed in historical context.

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

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

                                                              Control0..*
                                                              TypeContactPoint
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Obligations
                                                                ObligationsActorDocumentation
                                                                SHALL:populate-if-knownImaging study report provider

                                                                EHDSPatient.telecom

                                                                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()))
                                                                62. Patient.gender
                                                                Definition

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

                                                                ShortAdministrative Gender
                                                                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|5.0.0)

                                                                The gender of a person used for administrative purposes.

                                                                Typecode
                                                                Is Modifierfalse
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Must Supportfalse
                                                                Obligations
                                                                  ObligationsActorDocumentation
                                                                  SHALL:populate-if-knownImaging study report provider

                                                                  EHDSPatient.administrativeGender

                                                                  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()))
                                                                  64. Patient.birthDate
                                                                  Definition

                                                                  The date of birth for the individual.

                                                                  ShortThe date of birth for the patient
                                                                  Comments

                                                                  Partial dates are allowed if the specific date of birth 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
                                                                  Must Supportfalse
                                                                  Obligations
                                                                    ObligationsActorDocumentation
                                                                    SHALL:populate-if-knownImaging study report provider

                                                                    EHDSPatient.dateOfBirth

                                                                    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
                                                                    66. 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
                                                                    Must Supportfalse
                                                                    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()))
                                                                    68. 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..*
                                                                    TypeAddress(Address (EU))
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Obligations
                                                                      ObligationsActorDocumentation
                                                                      SHALL:populate-if-knownImaging study report provider

                                                                      EHDSPatient.address

                                                                      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()))
                                                                      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 MaritalStatusCodes
                                                                      (extensible to http://hl7.org/fhir/ValueSet/marital-status)

                                                                      The domestic partnership status of a person.

                                                                      TypeCodeableConcept
                                                                      Is Modifierfalse
                                                                      Must Supportfalse
                                                                      Obligations
                                                                        ObligationsActorDocumentation
                                                                        SHALL:populate-if-knownImaging study report provider

                                                                        EHDSPatient.maritalStatus

                                                                        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
                                                                        Must Supportfalse
                                                                        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
                                                                        Must Supportfalse
                                                                        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
                                                                        Must Supportfalse
                                                                        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
                                                                        This element is affected by the following invariants: ele-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 managable, 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 managable, 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.

                                                                        ShortContact 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
                                                                        Must Supportfalse
                                                                        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.

                                                                        ShortContact name
                                                                        Control0..1
                                                                        This element is affected by the following invariants: pat-1
                                                                        TypeHumanName
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        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.

                                                                        ShortContact details 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..*
                                                                        This element is affected by the following invariants: pat-1
                                                                        TypeContactPoint
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        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.

                                                                        ShortContact person address
                                                                        Control0..1
                                                                        This element is affected by the following invariants: pat-1
                                                                        TypeAddress(Address (EU))
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        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|5.0.0)

                                                                        The gender of a person used for administrative purposes.

                                                                        Typecode
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Must Supportfalse
                                                                        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
                                                                        Must Supportfalse
                                                                        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
                                                                        Must Supportfalse
                                                                        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
                                                                        Must Supportfalse
                                                                        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
                                                                        This element is affected by the following invariants: ele-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 managable, 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 managable, 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-AU" for Australian English.

                                                                        ShortCommunication language
                                                                        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 SHALL be taken from AllLanguages
                                                                        (required to http://hl7.org/fhir/ValueSet/all-languages|5.0.0)

                                                                        IETF language tag for a human language

                                                                        TypeCodeableConcept
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Obligations
                                                                          ObligationsActorDocumentation
                                                                          SHALL:populate-if-knownImaging study report provider

                                                                          EHDSPatient.communicationLanguage

                                                                          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
                                                                          Must Supportfalse
                                                                          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 (EU base), PractitionerRole (EU base), Practitioner (EU base))
                                                                          Is Modifierfalse
                                                                          Must Supportfalse
                                                                          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
                                                                          Must Supportfalse
                                                                          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 a Patient or RelatedPerson resource that concerns the same actual individual.

                                                                          ShortLink to a Patient or RelatedPerson resource that concerns the same actual individual
                                                                          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'
                                                                          Must Supportfalse
                                                                          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
                                                                          This element is affected by the following invariants: ele-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 managable, 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 managable, 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

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

                                                                          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
                                                                          Must Supportfalse
                                                                          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|5.0.0)

                                                                          The type of link between this patient resource and another Patient resource, or Patient/RelatedPerson when using the seealso code

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