Virtually Healthcare - IHE Patient Care Coordination (PCC)
0.1.1-current - ci-build United Kingdom flag

Virtually Healthcare - IHE Patient Care Coordination (PCC) - Local Development build (v0.1.1-current) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: Patient - Detailed Descriptions

Draft as of 2025-06-28

Definitions for the Patient 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
Summaryfalse
Alternate NamesSubjectOfCare Client Resident
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. Patient.implicitRules
Definition

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

ShortA set of rules under which this content was created
Comments

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

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

The registered place of birth of the patient.

ShortThe registered place of birth of the patient.
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..1
This element is affected by the following invariants: ele-1
TypeExtension(Patient Birth Place) (Extension Type: Address)
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. 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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortExtensionAdditional content defined by implementations
Comments

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

Control0..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
  • 8. 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
    10. 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).


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

    ShortThe registered place of birth of the patient.Value of extension
    Control10..1
    TypeAddress, date, Meta, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, 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()))
    12. Patient.extension:birthSex
    Slice NamebirthSex
    Definition

    The patient's phenotypic sex at birth.

    ShortThe patient's phenotypic sex at birth.
    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..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Extension UK Core Birth Sex) (Extension Type: CodeableConcept)
    Is Modifierfalse
    Standard StatusNormative (from Normative)
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    14. Patient.extension:cadavericDonor
    Slice NamecadavericDonor
    Definition

    Flag indicating whether the patient authorized the donation of body parts after death.

    ShortPost-mortem donor status.
    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..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Patient Is-Cadaveric Donor) (Extension Type: boolean)
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    16. Patient.extension:cadavericDonor.extension
    Definition

    An Extension


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

    ShortExtensionAdditional content defined by implementations
    Comments

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

    Control0..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
    • 18. Patient.extension:cadavericDonor.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-cadavericDonor
      20. Patient.extension:cadavericDonor.value[x]
      Definition

      Flag indicating whether the patient authorized the donation of body parts after death.


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

      ShortPost-mortem donor status.Value of extension
      Control10..1
      Typeboolean, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, Expression, Signature, unsignedInt, time
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. Patient.extension:contactPreference
      Slice NamecontactPreference
      Definition

      The preferred method of contact, contact times and written communication format given by a Patient or Related Person.

      ShortThe preferred method of contact, contact times and written communication format given by a Patient or Related Person.
      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..1
      This element is affected by the following invariants: ele-1
      TypeExtension(Extension UK Core Contact Preference) (Complex Extension)
      Is Modifierfalse
      Standard StatusNormative (from Normative)
      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())
      24. Patient.extension:deathNotificationStatus
      Slice NamedeathNotificationStatus
      Definition

      The patient's death notification status.

      ShortThe patient's death notification status.
      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..1
      This element is affected by the following invariants: ele-1
      TypeExtension(Extension UK Core Death Notification Status) (Complex Extension)
      Is Modifierfalse
      Standard StatusNormative (from Normative)
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      26. Patient.extension:ethnicCategory
      Slice NameethnicCategory
      Definition

      The ethnicity of the subject.

      ShortThe ethnicity of the subject.
      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..1
      This element is affected by the following invariants: ele-1
      TypeExtension(Extension UK Core Ethnic Category) (Extension Type: CodeableConcept)
      Is Modifierfalse
      Standard StatusNormative (from Normative)
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      28. Patient.extension:fetalStatus
      Slice NamefetalStatus
      Definition

      Typically used in maternity where the patient record may be created before the birth of the baby.

      ShortAn indicator on the fetal status of a baby.
      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..1
      This element is affected by the following invariants: ele-1
      TypeExtension(Extension UK Core Patient Fetal Status) (Extension Type: code)
      Is Modifierfalse
      Standard StatusNormative (from Normative)
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      30. Patient.extension:residentialStatus
      Slice NameresidentialStatus
      Definition

      The residential status of the patient. For example if this patient is a UK resident.

      ShortThe residential status of the patient.
      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..1
      This element is affected by the following invariants: ele-1
      TypeExtension(Extension UK Core Residential Status) (Extension Type: CodeableConcept)
      Is Modifierfalse
      Standard StatusNormative (from Normative)
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      32. Patient.extension:patientInterpreterRequired
      Slice NamepatientInterpreterRequired
      Definition

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

      ShortIndicator showing whether the patient needs an interpreter.
      Comments

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

      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(Interpreter Required) (Extension Type: boolean)
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      34. Patient.extension:patientInterpreterRequired.extension
      Definition

      An Extension


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

      ShortExtensionAdditional content defined by implementations
      Comments

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

      Control0..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
      • 36. Patient.extension:patientInterpreterRequired.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-interpreterRequired
        38. Patient.extension:patientInterpreterRequired.value[x]
        Definition

        Indicator showing if this Patient requires an interpreter to communicate healthcare information to the practitioner.


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

        ShortIndicator showing whether the patient needs an interpreterValue of extension
        Control10..1
        Typeboolean, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, Expression, Signature, unsignedInt, time
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        40. Patient.extension:nhsNumberUnavailableReason
        Slice NamenhsNumberUnavailableReason
        Definition

        The reason why a patient does not have an NHS Number. For example if this patient is an overseas patient.

        ShortReason why this Patient does not include an NHS Number identifier.
        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..1
        This element is affected by the following invariants: ele-1
        TypeExtension(Extension UK Core NHS Number Unavailable Reason) (Extension Type: CodeableConcept)
        Is Modifierfalse
        Standard StatusNormative (from Normative)
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        42. Patient.modifierExtension
        Definition

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

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

        ShortExtensions that cannot be ignored
        Comments

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

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

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

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

        An identifier for this patient.

        ShortAn identifier for this patient.
        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control10..*
        TypeIdentifier
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Patients are almost always assigned specific numerical identifiers.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        SlicingThis element introduces a set of slices on Patient.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ system
        • 46. Patient.identifier.use
          Definition

          The purpose of this identifier.

          Shortusual | official | temp | secondary | old (If known)
          Comments

          Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

          Control0..1
          BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
          (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

          Identifies the purpose for this identifier, if known .

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

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

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

          A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

          ShortDescription of identifier
          Comments

          This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

          Control0..1
          BindingThe codes SHALL be taken from Unless not suitable, these codes SHALL be taken from Identifier Typehttp://hl7.org/fhir/ValueSet/identifier-type
          (required to https://fhir.virtually.healthcare/ValueSet/IdentifierTypeVH)
          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Requirements

          Allows users to make use of identifiers when the identifier system is not known.

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

          An identifier for this patient.

          ShortUK National Health IdentifiersAn identifier for this patient
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..1*
          TypeIdentifier(NHS, HCSN and CHI Numbers)
          Is Modifierfalse
          Must Supportfalse
          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()))
          52. Patient.identifier:nhsNumber.extension:nhsNumberVerificationStatus
          Slice NamenhsNumberVerificationStatus
          Definition

          The verification/tracing status of the NHS number.

          ShortNHS number verification status
          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..1
          This element is affected by the following invariants: ele-1
          TypeExtension(Extension UK Core NHS Number Verification Status) (Extension Type: CodeableConcept)
          Is Modifierfalse
          Must Supportfalse
          Standard StatusNormative (from Normative)
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          54. Patient.identifier:nhsNumber.use
          Definition

          The purpose of this identifier.

          Shortusual | official | temp | secondary | old (If known)
          Comments

          Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

          Control0..1
          BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
          (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

          Identifies the purpose for this identifier, if known .

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

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

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

          Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

          ShortThe namespace for the identifier value
          Comments

          Identifier.system is always case sensitive.

          Control10..1
          Typeuri
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

          Fixed Valuehttps://fhir.nhs.uk/Id/nhs-number
          Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          58. Patient.identifier:nhsNumber.value
          Definition

          The portion of the identifier typically relevant to the user and which is unique within the context of the system.

          ShortThe value that is unique
          Comments

          If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

          Control10..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Example<br/><b>General</b>:123456
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          60. Patient.identifier:MedicalRecordNumber
          Slice NameMedicalRecordNumber
          Definition

          An identifier for this patient.

          ShortMedical Record NumberAn identifier for this patient
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..*
          TypeIdentifier(Medical Record Number)
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Requirements

          Patients are almost always assigned specific numerical identifiers.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          62. 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 Supporttrue
          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()))
          64. 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.

          Control10..*
          TypeHumanName
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Requirements

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

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

          Identifies the purpose for this name.

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

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

          Control0..1
          BindingThe codes SHALL be taken from NameUsehttp://hl7.org/fhir/ValueSet/name-use|4.0.1
          (required to http://hl7.org/fhir/ValueSet/name-use|4.0.1)

          The use of a human name.

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

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

          ShortFamily name (often called 'Surname')
          Comments

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

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

          Given name.

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

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

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

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

          ShortA contact detail for the individual.
          Comments

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

          Control0..*
          TypeContactPoint
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Requirements

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

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

          Identifies the purpose for the contact point.

          Shorthome | work | temp | old | mobile - purpose of this contact point
          Comments

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

          Control0..1
          BindingThe codes SHALL be taken from ContactPointUsehttp://hl7.org/fhir/ValueSet/contact-point-use|4.0.1
          (required to http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1)

          Use of contact point.

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

          Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

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

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

          ShortThe gender that the patient is considered to have for administration and record keeping purposes.male | 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|4.0.1
          (required to http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1)

          The gender of a person used for administrative purposes.

          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          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()))
          78. Patient.birthDate
          Definition

          The date of birth for the individual.

          ShortThe date of birth for the individual.
          Comments

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

          Control0..1
          Typedate
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          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()))
          80. Patient.birthDate.extension:birthTime
          Slice NamebirthTime
          Definition

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

          ShortThe time of day that the patient was born. This SHOULD be included when the birth time is relevant.
          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..1
          This element is affected by the following invariants: ele-1
          TypeExtension(Patient/Person/RelatedPerson/Practitioner Birth Time) (Extension Type: dateTime)
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          82. Patient.birthDate.extension:birthTime.extension
          Definition

          An Extension


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

          ShortExtensionAdditional content defined by implementations
          Comments

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

          Control0..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.birthDate.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 84. Patient.birthDate.extension:birthTime.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-birthTime
            86. Patient.birthDate.extension:birthTime.value[x]
            Definition

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


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

            ShortTime of day of birth.Value of extension
            Control10..1
            TypedateTime, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            88. Patient.deceased[x]
            Definition

            Indicates if the individual is deceased or not.

            ShortIndicates if the individual is deceased or not
            Comments

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

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

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

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

              Indicates if the individual is deceased or not.

              ShortIndicates if the individual is deceased or not
              Comments

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

              Control0..1
              TypedateTime, boolean
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Is Modifiertrue because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              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()))
              92. 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
              Is Modifierfalse
              Must Supporttrue
              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()))
              94. Patient.address.extension:addressKey
              Slice NameaddressKey
              Definition

              A patient's address key and type.

              ShortA patient's address key and type
              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..*
              This element is affected by the following invariants: ele-1
              TypeExtension(Extension UK Core Address Key) (Complex Extension)
              Is Modifierfalse
              Must Supportfalse
              Standard StatusNormative (from Normative)
              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())
              96. Patient.address.use
              Definition

              The purpose of this address.

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

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

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

              The use of an address.

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

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

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

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

              ShortLink to another patient resource that concerns the same actual person
              Comments

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

              Control0..*
              TypeBackboneElement
              Is Modifiertrue because This element is labeled as a modifier because it might not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'
              Summarytrue
              Requirements

              There are multiple use cases:

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

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

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

              ShortExtensions that cannot be ignored even if unrecognized
              Comments

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

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

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

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

              The other patient resource that the link refers to.

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

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

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

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

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

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

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

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

              0. Patient
              2. Patient.identifier
              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control1..?
              4. Patient.identifier.type
              BindingThe codes SHALL be taken from Identifier Type
              (required to https://fhir.virtually.healthcare/ValueSet/IdentifierTypeVH)
              6. Patient.identifier:nhsNumber
              Slice NamenhsNumber
              ShortUK National Health Identifiers
              NoteThis is a business identifier, not a resource identifier (see discussion)
              TypeIdentifier(NHS, HCSN and CHI Numbers)
              8. Patient.identifier:MedicalRecordNumber
              Slice NameMedicalRecordNumber
              ShortMedical Record Number
              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control0..*
              TypeIdentifier(Medical Record Number)
              10. Patient.name
              Control1..?
              12. Patient.name.family
              Must Supporttrue
              14. Patient.name.given
              Must Supporttrue
              16. Patient.deceased[x]
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              SlicingThis element introduces a set of slices on Patient.deceased[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • type @ $this
              • 18. Patient.deceased[x]:deceasedDateTime
                Slice NamedeceasedDateTime
                Control0..1
                TypedateTime
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue

                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
                Summaryfalse
                Alternate NamesSubjectOfCare Client Resident
                Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
                dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                dom-6: A resource should have narrative for robust management (text.`div`.exists())
                2. Patient.id
                Definition

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

                ShortLogical id of this artifact
                Comments

                The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

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

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

                ShortMetadata about the resource
                Control0..1
                TypeMeta
                Is Modifierfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                6. Patient.implicitRules
                Definition

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

                ShortA set of rules under which this content was created
                Comments

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

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

                The base language in which the resource is written.

                ShortLanguage of the resource content
                Comments

                Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

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

                A human language.

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

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

                ShortText summary of the resource, for human interpretation
                Comments

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

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

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

                ShortContained, inline Resources
                Comments

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

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

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

                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.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.

                  ShortThe registered place of birth of the patient.
                  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..1
                  This element is affected by the following invariants: ele-1
                  TypeExtension(Patient Birth Place) (Extension Type: Address)
                  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())
                  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
                  Typestring
                  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).

                    ShortThe registered place of birth of the patient.
                    Control1..1
                    TypeAddress
                    [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:birthSex
                    Slice NamebirthSex
                    Definition

                    The patient's phenotypic sex at birth.

                    ShortThe patient's phenotypic sex at birth.
                    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..1
                    This element is affected by the following invariants: ele-1
                    TypeExtension(Extension UK Core Birth Sex) (Extension Type: CodeableConcept)
                    Is Modifierfalse
                    Standard StatusNormative (from Normative)
                    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())
                    28. Patient.extension:cadavericDonor
                    Slice NamecadavericDonor
                    Definition

                    Flag indicating whether the patient authorized the donation of body parts after death.

                    ShortPost-mortem donor status.
                    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..1
                    This element is affected by the following invariants: ele-1
                    TypeExtension(Patient Is-Cadaveric Donor) (Extension Type: boolean)
                    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())
                    30. Patient.extension:cadavericDonor.id
                    Definition

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

                    ShortUnique id for inter-element referencing
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    32. Patient.extension:cadavericDonor.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
                    • 34. Patient.extension:cadavericDonor.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-cadavericDonor
                      36. Patient.extension:cadavericDonor.value[x]
                      Definition

                      Flag indicating whether the patient authorized the donation of body parts after death.

                      ShortPost-mortem donor status.
                      Control1..1
                      Typeboolean
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      38. Patient.extension:contactPreference
                      Slice NamecontactPreference
                      Definition

                      The preferred method of contact, contact times and written communication format given by a Patient or Related Person.

                      ShortThe preferred method of contact, contact times and written communication format given by a Patient or Related Person.
                      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..1
                      This element is affected by the following invariants: ele-1
                      TypeExtension(Extension UK Core Contact Preference) (Complex Extension)
                      Is Modifierfalse
                      Standard StatusNormative (from Normative)
                      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())
                      40. Patient.extension:deathNotificationStatus
                      Slice NamedeathNotificationStatus
                      Definition

                      The patient's death notification status.

                      ShortThe patient's death notification status.
                      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..1
                      This element is affected by the following invariants: ele-1
                      TypeExtension(Extension UK Core Death Notification Status) (Complex Extension)
                      Is Modifierfalse
                      Standard StatusNormative (from Normative)
                      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())
                      42. Patient.extension:ethnicCategory
                      Slice NameethnicCategory
                      Definition

                      The ethnicity of the subject.

                      ShortThe ethnicity of the subject.
                      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..1
                      This element is affected by the following invariants: ele-1
                      TypeExtension(Extension UK Core Ethnic Category) (Extension Type: CodeableConcept)
                      Is Modifierfalse
                      Standard StatusNormative (from Normative)
                      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())
                      44. Patient.extension:fetalStatus
                      Slice NamefetalStatus
                      Definition

                      Typically used in maternity where the patient record may be created before the birth of the baby.

                      ShortAn indicator on the fetal status of a baby.
                      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..1
                      This element is affected by the following invariants: ele-1
                      TypeExtension(Extension UK Core Patient Fetal Status) (Extension Type: code)
                      Is Modifierfalse
                      Standard StatusNormative (from Normative)
                      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())
                      46. Patient.extension:residentialStatus
                      Slice NameresidentialStatus
                      Definition

                      The residential status of the patient. For example if this patient is a UK resident.

                      ShortThe residential status of the patient.
                      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..1
                      This element is affected by the following invariants: ele-1
                      TypeExtension(Extension UK Core Residential Status) (Extension Type: CodeableConcept)
                      Is Modifierfalse
                      Standard StatusNormative (from Normative)
                      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())
                      48. Patient.extension:patientInterpreterRequired
                      Slice NamepatientInterpreterRequired
                      Definition

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

                      ShortIndicator showing whether the patient needs an interpreter.
                      Comments

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

                      Control0..1
                      This element is affected by the following invariants: ele-1
                      TypeExtension(Interpreter Required) (Extension Type: boolean)
                      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())
                      50. Patient.extension:patientInterpreterRequired.id
                      Definition

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

                      ShortUnique id for inter-element referencing
                      Control0..1
                      Typestring
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      52. Patient.extension:patientInterpreterRequired.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
                      • 54. Patient.extension:patientInterpreterRequired.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-interpreterRequired
                        56. Patient.extension:patientInterpreterRequired.value[x]
                        Definition

                        Indicator showing if this Patient requires an interpreter to communicate healthcare information to the practitioner.

                        ShortIndicator showing whether the patient needs an interpreter
                        Control1..1
                        Typeboolean
                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        58. Patient.extension:nhsNumberUnavailableReason
                        Slice NamenhsNumberUnavailableReason
                        Definition

                        The reason why a patient does not have an NHS Number. For example if this patient is an overseas patient.

                        ShortReason why this Patient does not include an NHS Number identifier.
                        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..1
                        This element is affected by the following invariants: ele-1
                        TypeExtension(Extension UK Core NHS Number Unavailable Reason) (Extension Type: CodeableConcept)
                        Is Modifierfalse
                        Standard StatusNormative (from Normative)
                        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())
                        60. Patient.modifierExtension
                        Definition

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

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

                        ShortExtensions that cannot be ignored
                        Comments

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

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

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

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

                        An identifier for this patient.

                        ShortAn identifier for this patient.
                        NoteThis is a business identifier, not a resource identifier (see discussion)
                        Control1..*
                        TypeIdentifier
                        Is Modifierfalse
                        Must Supporttrue
                        Summarytrue
                        Requirements

                        Patients are almost always assigned specific numerical identifiers.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        SlicingThis element introduces a set of slices on Patient.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ system
                        • 64. Patient.identifier.id
                          Definition

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

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

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

                          ShortAdditional content defined by implementations
                          Comments

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

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

                            The purpose of this identifier.

                            Shortusual | official | temp | secondary | old (If known)
                            Comments

                            Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                            Control0..1
                            BindingThe codes SHALL be taken from IdentifierUse
                            (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                            Identifies the purpose for this identifier, if known .

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

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

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

                            A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                            ShortDescription of identifier
                            Comments

                            This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                            Control0..1
                            BindingThe codes SHALL be taken from Identifier Type
                            (required to https://fhir.virtually.healthcare/ValueSet/IdentifierTypeVH)
                            TypeCodeableConcept
                            Is Modifierfalse
                            Summarytrue
                            Requirements

                            Allows users to make use of identifiers when the identifier system is not known.

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

                            Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                            ShortThe namespace for the identifier value
                            Comments

                            Identifier.system is always case sensitive.

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

                            There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                            Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            74. Patient.identifier.value
                            Definition

                            The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                            ShortThe value that is unique
                            Comments

                            If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                            Control0..1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Example<br/><b>General</b>:123456
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            76. Patient.identifier.period
                            Definition

                            Time period during which identifier is/was valid for use.

                            ShortTime period when id is/was valid for use
                            Control0..1
                            TypePeriod
                            Is Modifierfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            78. Patient.identifier.assigner
                            Definition

                            Organization that issued/manages the identifier.

                            ShortOrganization that issued id (may be just text)
                            Comments

                            The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                            Control0..1
                            TypeReference(Organization)
                            Is Modifierfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            80. Patient.identifier:nhsNumber
                            Slice NamenhsNumber
                            Definition

                            An identifier for this patient.

                            ShortUK National Health Identifiers
                            NoteThis is a business identifier, not a resource identifier (see discussion)
                            Control0..1
                            TypeIdentifier(NHS, HCSN and CHI Numbers)
                            Is Modifierfalse
                            Must Supportfalse
                            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()))
                            82. Patient.identifier:nhsNumber.id
                            Definition

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

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

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

                            ShortAdditional content defined by implementations
                            Comments

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

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

                              The verification/tracing status of the NHS number.

                              ShortNHS number verification status
                              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..1
                              This element is affected by the following invariants: ele-1
                              TypeExtension(Extension UK Core NHS Number Verification Status) (Extension Type: CodeableConcept)
                              Is Modifierfalse
                              Must Supportfalse
                              Standard StatusNormative (from Normative)
                              Summaryfalse
                              Alternate Namesextensions, user content
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              88. Patient.identifier:nhsNumber.use
                              Definition

                              The purpose of this identifier.

                              Shortusual | official | temp | secondary | old (If known)
                              Comments

                              Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                              Control0..1
                              BindingThe codes SHALL be taken from IdentifierUse
                              (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                              Identifies the purpose for this identifier, if known .

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

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

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              90. Patient.identifier:nhsNumber.type
                              Definition

                              A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                              ShortDescription of identifier
                              Comments

                              This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                              (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

                              A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Summarytrue
                              Requirements

                              Allows users to make use of identifiers when the identifier system is not known.

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

                              Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                              ShortThe namespace for the identifier value
                              Comments

                              Identifier.system is always case sensitive.

                              Control1..1
                              Typeuri
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Requirements

                              There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                              Fixed Valuehttps://fhir.nhs.uk/Id/nhs-number
                              Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              94. Patient.identifier:nhsNumber.value
                              Definition

                              The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                              ShortThe value that is unique
                              Comments

                              If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                              Control1..1
                              Typestring
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Example<br/><b>General</b>:123456
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              96. Patient.identifier:nhsNumber.period
                              Definition

                              Time period during which identifier is/was valid for use.

                              ShortTime period when id is/was valid for use
                              Control0..1
                              TypePeriod
                              Is Modifierfalse
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              98. Patient.identifier:nhsNumber.assigner
                              Definition

                              Organization that issued/manages the identifier.

                              ShortOrganization that issued id (may be just text)
                              Comments

                              The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                              Control0..1
                              TypeReference(Organization)
                              Is Modifierfalse
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              100. Patient.identifier:MedicalRecordNumber
                              Slice NameMedicalRecordNumber
                              Definition

                              An identifier for this patient.

                              ShortMedical Record Number
                              NoteThis is a business identifier, not a resource identifier (see discussion)
                              Control0..*
                              TypeIdentifier(Medical Record Number)
                              Is Modifierfalse
                              Must Supporttrue
                              Summarytrue
                              Requirements

                              Patients are almost always assigned specific numerical identifiers.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              102. 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 Supporttrue
                              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()))
                              104. 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.

                              Control1..*
                              TypeHumanName
                              Is Modifierfalse
                              Must Supporttrue
                              Summarytrue
                              Requirements

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

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

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

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

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

                              ShortAdditional content defined by implementations
                              Comments

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

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

                                Identifies the purpose for this name.

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

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

                                Control0..1
                                BindingThe codes SHALL be taken from NameUse
                                (required to http://hl7.org/fhir/ValueSet/name-use|4.0.1)

                                The use of a human name.

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

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

                                ShortText representation of the full name
                                Comments

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

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

                                A renderable, unencoded form.

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

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

                                ShortFamily name (often called 'Surname')
                                Comments

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

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

                                Given name.

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

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

                                Control0..*
                                Typestring
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supporttrue
                                Summarytrue
                                Alternate Namesfirst name, middle name
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                118. 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()))
                                120. 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()))
                                122. 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()))
                                124. Patient.telecom
                                Definition

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

                                ShortA contact detail for the individual.
                                Comments

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

                                Control0..*
                                TypeContactPoint
                                Is Modifierfalse
                                Must Supporttrue
                                Summarytrue
                                Requirements

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

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

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

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

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

                                ShortAdditional content defined by implementations
                                Comments

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

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

                                  Telecommunications form for contact point - what communications system is required to make use of the contact.

                                  Shortphone | fax | email | pager | url | sms | other
                                  Control0..1
                                  This element is affected by the following invariants: cpt-2
                                  BindingThe codes SHALL be taken from ContactPointSystem
                                  (required to http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1)

                                  Telecommunications form for contact point.

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

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

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

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

                                  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.telecom.system.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 136. Patient.telecom.system.extension:otherContactSystem
                                    Slice NameotherContactSystem
                                    Definition

                                    Other contact system value which extends the system element in the ContactPoint datatype.

                                    ShortInformation about other contact methods which could be used in addition to those listed in `ContactPoint.system`.
                                    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..1
                                    This element is affected by the following invariants: ele-1
                                    TypeExtension(Extension UK Core Other Contact System) (Extension Type: CodeableConcept)
                                    Is Modifierfalse
                                    Standard StatusNormative (from Normative)
                                    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())
                                    138. Patient.telecom.system.value
                                    Definition

                                    Primitive value for code

                                    ShortPrimitive value for code
                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    Summaryfalse
                                    140. Patient.telecom.value
                                    Definition

                                    The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

                                    ShortThe actual contact point details
                                    Comments

                                    Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

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

                                    Need to support legacy numbers that are not in a tightly controlled format.

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

                                    Identifies the purpose for the contact point.

                                    Shorthome | work | temp | old | mobile - purpose of this contact point
                                    Comments

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

                                    Control0..1
                                    BindingThe codes SHALL be taken from ContactPointUse
                                    (required to http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1)

                                    Use of contact point.

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

                                    Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

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

                                    Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.

                                    ShortSpecify preferred order of use (1 = highest)
                                    Comments

                                    Note that rank does not necessarily follow the order in which the contacts are represented in the instance.

                                    Control0..1
                                    TypepositiveInt
                                    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()))
                                    146. Patient.telecom.period
                                    Definition

                                    Time period when the contact point was/is in use.

                                    ShortTime period when the contact point was/is in use
                                    Control0..1
                                    TypePeriod
                                    Is Modifierfalse
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    148. Patient.gender
                                    Definition

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

                                    ShortThe gender that the patient is considered to have for administration and record keeping purposes.
                                    Comments

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

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

                                    The gender of a person used for administrative purposes.

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

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

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

                                    The date of birth for the individual.

                                    ShortThe date of birth for the individual.
                                    Comments

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

                                    Control0..1
                                    Typedate
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Must Supporttrue
                                    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()))
                                    152. Patient.birthDate.id
                                    Definition

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

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

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

                                    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.birthDate.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 156. Patient.birthDate.extension:birthTime
                                      Slice NamebirthTime
                                      Definition

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

                                      ShortThe time of day that the patient was born. This SHOULD be included when the birth time is relevant.
                                      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..1
                                      This element is affected by the following invariants: ele-1
                                      TypeExtension(Patient/Person/RelatedPerson/Practitioner Birth Time) (Extension Type: dateTime)
                                      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())
                                      158. Patient.birthDate.extension:birthTime.id
                                      Definition

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

                                      ShortUnique id for inter-element referencing
                                      Control0..1
                                      Typestring
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      160. Patient.birthDate.extension:birthTime.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.birthDate.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 162. Patient.birthDate.extension:birthTime.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-birthTime
                                        164. Patient.birthDate.extension:birthTime.value[x]
                                        Definition

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

                                        ShortTime of day of birth.
                                        Control1..1
                                        TypedateTime
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        166. Patient.birthDate.value
                                        Definition

                                        The actual value

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

                                        Indicates if the individual is deceased or not.

                                        ShortIndicates if the individual is deceased or not
                                        Comments

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

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

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

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

                                          Indicates if the individual is deceased or not.

                                          ShortIndicates if the individual is deceased or not
                                          Comments

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

                                          Control0..1
                                          TypedateTime
                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                          Is Modifiertrue because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supporttrue
                                          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()))
                                          172. 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
                                          Is Modifierfalse
                                          Must Supporttrue
                                          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()))
                                          174. Patient.address.id
                                          Definition

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

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

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

                                          ShortAdditional content defined by implementations
                                          Comments

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

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

                                            A patient's address key and type.

                                            ShortA patient's address key and type
                                            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..*
                                            This element is affected by the following invariants: ele-1
                                            TypeExtension(Extension UK Core Address Key) (Complex Extension)
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Standard StatusNormative (from Normative)
                                            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())
                                            180. Patient.address.use
                                            Definition

                                            The purpose of this address.

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

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

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

                                            The use of an address.

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

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

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

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

                                            Shortpostal | physical | both
                                            Comments

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

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

                                            The type of an address (physical / postal).

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

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

                                            ShortText representation of the address
                                            Comments

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

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

                                            A renderable, unencoded form.

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

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

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

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

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

                                            The name of the administrative area (county).

                                            ShortDistrict name (aka county)
                                            Comments

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

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

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

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

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

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

                                            Country - a nation as commonly understood or generally accepted.

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

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

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

                                            Time period when address was/is in use.

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

                                            Allows addresses to be placed in historical context.

                                            Example<br/><b>General</b>:{ "start" : "2010-03-23", "end" : "2010-07-01" }
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            200. 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 UK Core Person Marital Status Code
                                            (extensible to https://fhir.hl7.org.uk/ValueSet/UKCore-PersonMaritalStatusCode)

                                            An indicator to identify the legal marital status of a person

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Summaryfalse
                                            Requirements

                                            Most, if not all systems capture it.

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

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

                                            ShortWhether patient is part of a multiple birth
                                            Comments

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

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

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

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

                                            Image of the patient.

                                            ShortImage of the patient
                                            Comments

                                            Guidelines:

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

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

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

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

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

                                            Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.

                                            Control0..*
                                            TypeBackboneElement
                                            Is Modifierfalse
                                            Summaryfalse
                                            Requirements

                                            Need to track people you can contact about the patient.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            pat-1: SHALL at least contain a contact's details or a reference to an organization (name.exists() or telecom.exists() or address.exists() or organization.exists())
                                            208. Patient.contact.id
                                            Definition

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

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

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

                                            ShortAdditional content defined by implementations
                                            Comments

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

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

                                              The preferred ranking or order of contact applied to a contact on a patient's contact list.

                                              ShortThe preferred ranking or order of contact applied to a contact on a Patient's contact list.
                                              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..1
                                              This element is affected by the following invariants: ele-1
                                              TypeExtension(Extension UK Core Contact Rank) (Extension Type: positiveInt)
                                              Is Modifierfalse
                                              Standard StatusNormative (from Normative)
                                              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())
                                              214. Patient.contact.extension:copyCorrespondenceIndicator
                                              Slice NamecopyCorrespondenceIndicator
                                              Definition

                                              Extension carrying a boolean indicator showing that a patient's contact or related person SHALL be copied in to patient correspondence.

                                              ShortIndicates that a must be copied in to all related correspondence.
                                              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..1
                                              This element is affected by the following invariants: ele-1
                                              TypeExtension(Extension UK Core Copy Correspondence Indicator) (Extension Type: boolean)
                                              Is Modifierfalse
                                              Standard StatusNormative (from Normative)
                                              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())
                                              216. Patient.contact.modifierExtension
                                              Definition

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

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

                                              ShortExtensions that cannot be ignored even if unrecognized
                                              Comments

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

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

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

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

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

                                              ShortThe kind of relationship
                                              Control0..*
                                              BindingUnless not suitable, these codes SHALL be taken from UK Core Person Relationship Type
                                              (extensible to https://fhir.hl7.org.uk/ValueSet/UKCore-PersonRelationshipType)

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

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Summaryfalse
                                              Requirements

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

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

                                              A name associated with the contact person.

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

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

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

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

                                              ShortA contact detail for the person
                                              Comments

                                              Contact may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification.

                                              Control0..*
                                              TypeContactPoint
                                              Is Modifierfalse
                                              Summaryfalse
                                              Requirements

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

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

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

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

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

                                              ShortAdditional content defined by implementations
                                              Comments

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

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

                                                Telecommunications form for contact point - what communications system is required to make use of the contact.

                                                Shortphone | fax | email | pager | url | sms | other
                                                Control0..1
                                                This element is affected by the following invariants: cpt-2
                                                BindingThe codes SHALL be taken from ContactPointSystem
                                                (required to http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1)

                                                Telecommunications form for contact point.

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

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

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

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

                                                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.contact.telecom.system.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                • value @ url
                                                • 234. Patient.contact.telecom.system.extension:otherContactSystem
                                                  Slice NameotherContactSystem
                                                  Definition

                                                  Other contact system value which extends the system element in the ContactPoint datatype.

                                                  ShortInformation about other contact methods which could be used in addition to those listed in `ContactPoint.system`.
                                                  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..1
                                                  This element is affected by the following invariants: ele-1
                                                  TypeExtension(Extension UK Core Other Contact System) (Extension Type: CodeableConcept)
                                                  Is Modifierfalse
                                                  Standard StatusNormative (from Normative)
                                                  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())
                                                  236. Patient.contact.telecom.system.value
                                                  Definition

                                                  Primitive value for code

                                                  ShortPrimitive value for code
                                                  Control0..1
                                                  Typestring
                                                  Is Modifierfalse
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  Summaryfalse
                                                  238. Patient.contact.telecom.value
                                                  Definition

                                                  The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

                                                  ShortThe actual contact point details
                                                  Comments

                                                  Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

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

                                                  Need to support legacy numbers that are not in a tightly controlled format.

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

                                                  Identifies the purpose for the contact point.

                                                  Shorthome | work | temp | old | mobile - purpose of this contact point
                                                  Comments

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

                                                  Control0..1
                                                  BindingThe codes SHALL be taken from ContactPointUse
                                                  (required to http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1)

                                                  Use of contact point.

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

                                                  Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

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

                                                  Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.

                                                  ShortSpecify preferred order of use (1 = highest)
                                                  Comments

                                                  Note that rank does not necessarily follow the order in which the contacts are represented in the instance.

                                                  Control0..1
                                                  TypepositiveInt
                                                  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()))
                                                  244. Patient.contact.telecom.period
                                                  Definition

                                                  Time period when the contact point was/is in use.

                                                  ShortTime period when the contact point was/is in use
                                                  Control0..1
                                                  TypePeriod
                                                  Is Modifierfalse
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  246. Patient.contact.address
                                                  Definition

                                                  Address for the contact person.

                                                  ShortAddress for the contact person
                                                  Control0..1
                                                  TypeAddress
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Requirements

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

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

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

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

                                                  The gender of a person used for administrative purposes.

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

                                                  Needed to address the person correctly.

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

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

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

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

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

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

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

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

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

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

                                                  Control0..*
                                                  TypeBackboneElement
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Requirements

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

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

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

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

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

                                                  ShortAdditional content defined by implementations
                                                  Comments

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

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

                                                    Proficiency level of the communication.

                                                    ShortThe patient's proficiency level of the communication method.
                                                    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..1
                                                    This element is affected by the following invariants: ele-1
                                                    TypeExtension(Patient Proficiency) (Complex Extension)
                                                    Is Modifierfalse
                                                    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())
                                                    262. Patient.communication.extension:proficiency.id
                                                    Definition

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

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

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

                                                    ShortAdditional content defined by implementations
                                                    Comments

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

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

                                                      How well the patient can communicate this communication (good, poor, etc.).

                                                      ShortThe proficiency level of the communication
                                                      Control0..1
                                                      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())
                                                      268. Patient.communication.extension:proficiency.extension:level.id
                                                      Definition

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

                                                      ShortUnique id for inter-element referencing
                                                      Control0..1
                                                      Typestring
                                                      Is Modifierfalse
                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                      Summaryfalse
                                                      270. Patient.communication.extension:proficiency.extension:level.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.communication.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                      • value @ url
                                                      • 272. Patient.communication.extension:proficiency.extension:level.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
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        Summaryfalse
                                                        Fixed Valuelevel
                                                        274. Patient.communication.extension:proficiency.extension:level.value[x]
                                                        Definition

                                                        The proficiency level for the communication.

                                                        ShortThe proficiency level for the communication
                                                        Control1..1
                                                        BindingThe codes SHOULD be taken from LanguageAbilityProficiency
                                                        (preferred to http://terminology.hl7.org/ValueSet/v3-LanguageAbilityProficiency)

                                                        The proficiency level for the communication.

                                                        TypeCoding
                                                        [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()))
                                                        276. Patient.communication.extension:proficiency.extension:type
                                                        Slice Nametype
                                                        Definition

                                                        What type of communication for the proficiency (spoken, written, etc.).

                                                        ShortThe proficiency type of the communication
                                                        Control0..*
                                                        TypeExtension
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        278. Patient.communication.extension:proficiency.extension:type.id
                                                        Definition

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

                                                        ShortUnique id for inter-element referencing
                                                        Control0..1
                                                        Typestring
                                                        Is Modifierfalse
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        Summaryfalse
                                                        280. Patient.communication.extension:proficiency.extension:type.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.communication.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                        • value @ url
                                                        • 282. Patient.communication.extension:proficiency.extension:type.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
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                          Summaryfalse
                                                          Fixed Valuetype
                                                          284. Patient.communication.extension:proficiency.extension:type.value[x]
                                                          Definition

                                                          The proficiency type for the communication.

                                                          ShortThe proficiency type for the communication
                                                          Control1..1
                                                          BindingThe codes SHOULD be taken from LanguageAbilityMode
                                                          (preferred to http://terminology.hl7.org/ValueSet/v3-LanguageAbilityMode)

                                                          The proficiency type for the communication.

                                                          TypeCoding
                                                          [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()))
                                                          286. Patient.communication.extension:proficiency.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-proficiency
                                                          288. Patient.communication.extension:proficiency.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
                                                          Control0..0
                                                          TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          290. Patient.communication.modifierExtension
                                                          Definition

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

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

                                                          ShortExtensions that cannot be ignored even if unrecognized
                                                          Comments

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

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

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

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

                                                          A ValueSet that identifies the language used by a person.

                                                          ShortA ValueSet that identifies the language used by a person.
                                                          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)

                                                          A ValueSet that identifies the language used by a person.

                                                          Additional BindingsPurpose
                                                          AllLanguagesMax Binding
                                                          TypeCodeableConcept
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Requirements

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

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

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

                                                          ShortLanguage preference indicator
                                                          Comments

                                                          This language is specifically identified for communicating healthcare information.

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

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

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

                                                          Patient's nominated care provider.

                                                          ShortPatient's nominated primary care provider
                                                          Comments

                                                          This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues.

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

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

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

                                                          ShortLink to another patient resource that concerns the same actual person
                                                          Comments

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

                                                          Control0..*
                                                          TypeBackboneElement
                                                          Is Modifiertrue because This element is labeled as a modifier because it might not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'
                                                          Summarytrue
                                                          Requirements

                                                          There are multiple use cases:

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

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

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

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

                                                          ShortAdditional content defined by implementations
                                                          Comments

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

                                                          Control0..*
                                                          TypeExtension
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Alternate Namesextensions, user content
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          306. Patient.link.modifierExtension
                                                          Definition

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

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

                                                          ShortExtensions that cannot be ignored even if unrecognized
                                                          Comments

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

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

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

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

                                                          The other patient resource that the link refers to.

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

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

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

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

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

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

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