BC Client Registry FHIR Implementation Guide
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BC Client Registry FHIR Implementation Guide - Local Development build (v1.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: ClientRegistryPatient - Detailed Descriptions

Active as of 2024-05-03

Definitions for the bc-patient resource profile.

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

0. Patient
2. Patient.extension:effectiveDates
Slice NameeffectiveDates
Control0..1
TypeExtension(BC Business Dates) (Extension Type: Period)
Must Supporttrue
4. Patient.extension:genderIdentity
Slice NamegenderIdentity
Control0..1
TypeExtension(BC Gender Identity with business dates.) (Complex Extension)
Must Supporttrue
6. Patient.identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
Must Supporttrue
LOINC Code
8. Patient.identifier.extension:sourceID
Slice NamesourceID
Control0..1
TypeExtension(BC SourceID and UserID) (Complex Extension)
Must Supporttrue
10. Patient.identifier.extension:idStatus
Slice NameidStatus
Control0..1
TypeExtension(BC Identifier Status) (Extension Type: code)
Must Supporttrue
12. Patient.identifier:JHN
Slice NameJHN
NoteThis is a business identifier, not a resource identifier (see discussion)
TypeIdentifier(Identifier DataType Profile (CA Baseline))
LOINC Code
14. Patient.name
16. Patient.name.extension:sourceID
Slice NamesourceID
Control0..1
TypeExtension(BC SourceID and UserID) (Complex Extension)
Must Supporttrue
18. Patient.name.use
Shortusual | official | nickname
BindingThe codes SHALL be taken from BC Name Use value set.
(required to https://terminology.hlth.gov.bc.ca/ClientRegistry/ValueSet/bc-name-use-value-set)
LOINC Code
20. Patient.telecom
Must Supporttrue
LOINC Code
22. Patient.telecom.extension:sourceID
Slice NamesourceID
Control0..1
TypeExtension(BC SourceID and UserID) (Complex Extension)
Must Supporttrue
24. Patient.telecom.system
Shortphone | email
BindingThe codes SHALL be taken from BC Contact Point System Value Set
(required to https://terminology.hlth.gov.bc.ca/ClientRegistry/ValueSet/bc-contact-point-system-value-set)
LOINC Code
26. Patient.telecom.use
Shorthome | work | mobile
BindingThe codes SHALL be taken from BC Contact Point Use Value Set
(required to https://terminology.hlth.gov.bc.ca/ClientRegistry/ValueSet/bc-contact-point-use-value-set)
LOINC Code
28. Patient.gender
Must Supporttrue
LOINC Code
30. Patient.gender.extension
SlicingThis element introduces a set of slices on Patient.gender.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 32. Patient.gender.extension:genderEffectiveDates
    Slice NamegenderEffectiveDates
    Control0..1
    TypeExtension(BC Business Dates) (Extension Type: Period)
    Must Supporttrue
    34. Patient.gender.extension:sourceID
    Slice NamesourceID
    Control0..1
    TypeExtension(BC SourceID and UserID) (Complex Extension)
    Must Supporttrue
    36. Patient.gender.extension:history
    Slice Namehistory
    Control0..*
    TypeExtension(BC Gender History) (Complex Extension)
    Must Supporttrue
    38. Patient.birthDate
    40. Patient.birthDate.extension
    SlicingThis element introduces a set of slices on Patient.birthDate.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 42. Patient.birthDate.extension:birthDateEffectiveDates
      Slice NamebirthDateEffectiveDates
      Control0..1
      TypeExtension(BC Business Dates) (Extension Type: Period)
      44. Patient.birthDate.extension:sourceID
      Slice NamesourceID
      Control0..1
      TypeExtension(BC SourceID and UserID) (Complex Extension)
      Must Supporttrue
      46. Patient.birthDate.extension:history
      Slice Namehistory
      Control0..*
      TypeExtension(BC Birth Date History) (Complex Extension)
      Must Supporttrue
      48. Patient.deceased[x]
      TypedateTime, boolean
      [x] NoteSee Choice of Data Types for further information about how to use [x]
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      LOINC Code
      50. Patient.deceased[x].extension
      SlicingThis element introduces a set of slices on Patient.deceased[x].extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 52. Patient.deceased[x].extension:deathDateEffectiveDates
        Slice NamedeathDateEffectiveDates
        Control0..1
        TypeExtension(BC Business Dates) (Extension Type: Period)
        Must Supporttrue
        54. Patient.deceased[x].extension:sourceID
        Slice NamesourceID
        Control0..1
        TypeExtension(BC SourceID and UserID) (Complex Extension)
        Must Supporttrue
        56. Patient.deceased[x].extension:deathDateHistory
        Slice NamedeathDateHistory
        Control0..*
        TypeExtension(BC Death Date History) (Complex Extension)
        Must Supporttrue
        58. Patient.deceased[x].extension:verifiedDeathFlag
        Slice NameverifiedDeathFlag
        Control0..1
        TypeExtension(BC Death Verified Flag) (Complex Extension)
        Must Supporttrue
        60. Patient.address
        Must Supporttrue
        LOINC Code
        62. Patient.address.extension:sourceID
        Slice NamesourceID
        Control0..1
        TypeExtension(BC SourceID and UserID) (Complex Extension)
        Must Supporttrue
        64. Patient.address.extension:validationStatus
        Slice NamevalidationStatus
        Control0..1
        TypeExtension(BC Address Validation Status Code) (Extension Type: code)
        Must Supporttrue
        66. Patient.address.type
        Shortpostal | physical
        LOINC Code
        68. Patient.multipleBirth[x]
        [x] NoteSee Choice of Data Types for further information about how to use [x]
        70. Patient.multipleBirth[x].extension:multipleBirthEffectiveDates
        Slice NamemultipleBirthEffectiveDates
        Control0..1
        TypeExtension(BC Business Dates) (Extension Type: Period)
        Must Supporttrue
        72. Patient.multipleBirth[x].extension:sourceID
        Slice NamesourceID
        Control0..1
        TypeExtension(BC SourceID and UserID) (Complex Extension)
        Must Supporttrue
        74. Patient.multipleBirth[x].extension:history
        Slice Namehistory
        Control0..*
        TypeExtension(BC Multiple Birth History) (Complex Extension)
        Must Supporttrue
        76. Patient.link
        Must Supporttrue
        LOINC Code
        78. Patient.link.extension:mergeStatus
        Slice NamemergeStatus
        Control0..*
        TypeExtension(BC Merge Status Code) (Extension Type: code)
        Must Supporttrue

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

        0. Patient
        Definition

        The Patient Profile is based upon the core FHIR Patient Resource


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

        ShortPatient ProfileInformation about an individual or animal receiving health care services
        Control0..*
        Is Modifierfalse
        Alternate NamesSubjectOfCare Client Resident
        Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.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-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-6: A resource should have narrative for robust management (text.`div`.exists())
        dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
        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
        This element is affected by the following invariants: ele-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:aboriginalidentitygroup
        Slice Nameaboriginalidentitygroup
        Definition

        A code classifying the person's aboriginal identity

        ShortExtension: Aboriginal Identity Group
        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: Aboriginal Identity Group) (Extension Type: Coding)
        Is Modifierfalse
        Must Supportfalse
        Standards 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())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        LOINC Code
        6. Patient.extension:aboriginalidentityindicator
        Slice Nameaboriginalidentityindicator
        Definition

        A code classifying the person's self identity as an aboriginal person

        ShortExtension: Aboriginal Identity Indicator
        Comments

        This attribute is based on the belief of the person or the person reporting the attribute, not on any formal analysis of genetic, geneological or historical relationships as these would need to be captured as observations.

        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(Extension: Aboriginal Identity Indicator) (Extension Type: Coding)
        Is Modifierfalse
        Must Supportfalse
        Standards 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())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        LOINC Code
        8. Patient.extension:birthsex
        Slice Namebirthsex
        Definition

        A code classifying the person's sex assigned at birth as specified by the [TODO: assigning authority]. This extension aligns with the C-CDA Birth Sex Observation (LOINC 76689-9)

        ShortExtension: Sex at Birth
        Comments

        The codes required are intended to present birth sex (i.e., the sex recorded on the patient’s birth certificate) and not gender identity or reassigned sex.

        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(Extension: Birth Sex) (Extension Type: Coding)
        Is Modifierfalse
        Must Supportfalse
        Standards 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())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        LOINC Code
        10. Patient.extension:ethnicity
        Slice Nameethnicity
        Definition

        A code classifying the person's ethnic group or ethnicity as the category of people who identify with each other, usually on the basis of a presumed common genealogy or ancestry or on other similarities.

        ShortExtension: ethnicity extension
        Comments

        This attribute is based on the belief of the person or the person reporting the attribute, not on any formal analysis of genetic, geneological or historical relationships as these would need to be captured as observations.

        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(Extension: Ethnicity) (Extension Type: Coding)
        Is Modifierfalse
        Must Supportfalse
        Standards 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())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        LOINC Code
        12. Patient.extension:effectiveDates
        Slice NameeffectiveDates
        Definition

        The effective dates for the parent element.

        ShortBC Business Dates
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(BC Business Dates) (Extension Type: Period)
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        LOINC Code
        14. Patient.extension:genderIdentity
        Slice NamegenderIdentity
        Definition

        Gender Identity with business dates.

        ShortBC Gender Identity with business dates.
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(BC Gender Identity with business dates.) (Complex Extension)
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        LOINC Code
        16. 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..*
        This element is affected by the following invariants: ele-1
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
        Standards StatusNormative (from Normative)
        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())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on Patient.modifierExtension. The slices are unordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 18. Patient.identifier
          Definition

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


          An identifier for this patient.

          ShortAn identifier intended for computationAn identifier for this patient
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..*
          This element is affected by the following invariants: ele-1
          TypeIdentifier(Identifier DataType Profile (CA Baseline))
          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 are unordered and Open, and can be differentiated using the following discriminators:
          • pattern @ type
          • 20. Patient.identifier.extension:sourceID
            Slice NamesourceID
            Definition

            Identifiers for the source and user that modified the specific element that this extension is on.

            ShortBC SourceID and UserID
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(BC SourceID and UserID) (Complex Extension)
            Must Supporttrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            LOINC Code
            22. Patient.identifier.extension:idStatus
            Slice NameidStatus
            Definition

            Identifier status.

            ShortBC Identifier Status
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(BC Identifier Status) (Extension Type: code)
            Must Supporttrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            LOINC Code
            24. 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
            This element is affected by the following invariants: ele-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()))
            26. 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.

            Control10..1
            This element is affected by the following invariants: ele-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()))
            28. 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 within the system.
            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
            This element is affected by the following invariants: ele-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()))
            30. Patient.identifier:JHN
            Slice NameJHN
            Definition

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


            An identifier for this patient.

            ShortAn identifier intended for computationAn identifier for this patient
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..*
            This element is affected by the following invariants: ele-1
            TypeIdentifier(Identifier DataType Profile (CA Baseline))
            Is Modifierfalse
            Requirements

            Patients are almost always assigned specific numerical identifiers.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            32. Patient.identifier:JHN.extension:versionCode
            Slice NameversionCode
            Definition

            A code indicating a specific version of an identifier credential

            ShortHealth Number Version Code
            Comments

            For example, a health card version number, credit card version number, etc. Used to help verify the authenticity of a credential

            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Extension: Identifier Version) (Extension Type: string)
            Must Supportfalse
            Standards 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())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            LOINC Code
            34. Patient.identifier:JHN.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
            This element is affected by the following invariants: ele-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()))
            36. Patient.identifier:JHN.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.

            Control10..1
            This element is affected by the following invariants: ele-1
            BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type
            (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.

            Fixed Value{
              "coding" : [{
                "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                "code" : "JHN"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            38. Patient.identifier:JHN.system
            Definition

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

            ShortA Health Number Naming System from the Canadian URI RegistryThe namespace for the identifier value
            Comments

            Identifier.system is always case sensitive.

            Control10..1
            This element is affected by the following invariants: ele-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()))
            40. Patient.identifier:JHN.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
            This element is affected by the following invariants: ele-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()))
            42. 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
            This element is affected by the following invariants: ele-1
            Typeboolean
            Is Modifiertrue because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Need to be able to mark a patient record as not to be used because it was created in error.

            Meaning if MissingThis resource is generally assumed to be active if no value is provided for the active element
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            44. Patient.name
            Definition

            A name associated with the individual.

            ShortA name associated with the patient
            Comments

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

            Control0..*
            This element is affected by the following invariants: ele-1
            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()))
            ca-baseline-name: Patient.name.given or Patient.name.family or both SHALL be present (family.exists() or given.exists())
            46. Patient.name.extension:sourceID
            Slice NamesourceID
            Definition

            Identifiers for the source and user that modified the specific element that this extension is on.

            ShortBC SourceID and UserID
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(BC SourceID and UserID) (Complex Extension)
            Must Supporttrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            LOINC Code
            48. Patient.name.use
            Definition

            Identifies the purpose for this name.

            Shortusual | official | nicknameusual | 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
            This element is affected by the following invariants: ele-1
            BindingThe codes SHALL be taken from BC Name Use value set.http://hl7.org/fhir/ValueSet/name-use|4.0.1
            (required to https://terminology.hlth.gov.bc.ca/ClientRegistry/ValueSet/bc-name-use-value-set)
            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()))
            50. 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..*
            This element is affected by the following invariants: ele-1
            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()))
            cpt-2: A system is required if a value is provided. (value.empty() or system.exists())
            52. Patient.telecom.extension:sourceID
            Slice NamesourceID
            Definition

            Identifiers for the source and user that modified the specific element that this extension is on.

            ShortBC SourceID and UserID
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(BC SourceID and UserID) (Complex Extension)
            Must Supporttrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            LOINC Code
            54. Patient.telecom.system
            Definition

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

            Shortphone | emailphone | fax | email | pager | url | sms | other
            Comments

            Note that FHIR strings SHALL NOT exceed 1MB in size

            Control10..1
            This element is affected by the following invariants: ele-1, cpt-2
            BindingThe codes SHALL be taken from BC Contact Point System Value Sethttp://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
            (required to https://terminology.hlth.gov.bc.ca/ClientRegistry/ValueSet/bc-contact-point-system-value-set)
            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()))
            56. 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.

            Control10..1
            This element is affected by the following invariants: ele-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()))
            58. Patient.telecom.use
            Definition

            Identifies the purpose for the contact point.

            Shorthome | work | mobilehome | 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
            This element is affected by the following invariants: ele-1
            BindingThe codes SHALL be taken from BC Contact Point Use Value Sethttp://hl7.org/fhir/ValueSet/contact-point-use|4.0.1
            (required to https://terminology.hlth.gov.bc.ca/ClientRegistry/ValueSet/bc-contact-point-use-value-set)
            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()))
            60. Patient.gender
            Definition

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

            Shortmale | female | other | unknown
            Comments

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

            Control0..1
            This element is affected by the following invariants: ele-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()))
            62. Patient.gender.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..*
            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())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on Patient.gender.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 64. Patient.gender.extension:genderEffectiveDates
              Slice NamegenderEffectiveDates
              Definition

              The effective dates for the parent element.

              ShortBC Business Dates
              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(BC Business Dates) (Extension Type: Period)
              Is Modifierfalse
              Must Supporttrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              LOINC Code
              66. Patient.gender.extension:sourceID
              Slice NamesourceID
              Definition

              Identifiers for the source and user that modified the specific element that this extension is on.

              ShortBC SourceID and UserID
              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(BC SourceID and UserID) (Complex Extension)
              Is Modifierfalse
              Must Supporttrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              LOINC Code
              68. Patient.gender.extension:history
              Slice Namehistory
              Definition

              This extension allows the Client Registry to include historical gender codes in a single Patient resource.

              ShortBC Gender History
              Control0..*
              This element is affected by the following invariants: ele-1
              TypeExtension(BC Gender History) (Complex Extension)
              Is Modifierfalse
              Must Supporttrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              LOINC Code
              70. 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
              This element is affected by the following invariants: ele-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()))
              LOINC Code21112-8
              72. Patient.birthDate.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..*
              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())
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingThis element introduces a set of slices on Patient.birthDate.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 74. Patient.birthDate.extension:birthDateEffectiveDates
                Slice NamebirthDateEffectiveDates
                Definition

                The effective dates for the parent element.

                ShortBC Business Dates
                Control0..1
                This element is affected by the following invariants: ele-1
                TypeExtension(BC Business Dates) (Extension Type: Period)
                Is Modifierfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                LOINC Code
                76. Patient.birthDate.extension:sourceID
                Slice NamesourceID
                Definition

                Identifiers for the source and user that modified the specific element that this extension is on.

                ShortBC SourceID and UserID
                Control0..1
                This element is affected by the following invariants: ele-1
                TypeExtension(BC SourceID and UserID) (Complex Extension)
                Is Modifierfalse
                Must Supporttrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                LOINC Code
                78. Patient.birthDate.extension:history
                Slice Namehistory
                Definition

                This extension allows the Client Registry to include historical birth dates in a single Patient resource.

                ShortBC Birth Date History
                Control0..*
                This element is affected by the following invariants: ele-1
                TypeExtension(BC Birth Date History) (Complex Extension)
                Is Modifierfalse
                Must Supporttrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                LOINC Code
                80. 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
                This element is affected by the following invariants: ele-1
                TypedateTime, boolean
                [x] NoteSee Choice of Data Types for further information about how to use [x]
                Is Modifiertrue because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                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()))
                82. Patient.deceased[x].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..*
                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())
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                SlicingThis element introduces a set of slices on Patient.deceased[x].extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 84. Patient.deceased[x].extension:deathDateEffectiveDates
                  Slice NamedeathDateEffectiveDates
                  Definition

                  The effective dates for the parent element.

                  ShortBC Business Dates
                  Control0..1
                  This element is affected by the following invariants: ele-1
                  TypeExtension(BC Business Dates) (Extension Type: Period)
                  Is Modifierfalse
                  Must Supporttrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  LOINC Code
                  86. Patient.deceased[x].extension:sourceID
                  Slice NamesourceID
                  Definition

                  Identifiers for the source and user that modified the specific element that this extension is on.

                  ShortBC SourceID and UserID
                  Control0..1
                  This element is affected by the following invariants: ele-1
                  TypeExtension(BC SourceID and UserID) (Complex Extension)
                  Is Modifierfalse
                  Must Supporttrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  LOINC Code
                  88. Patient.deceased[x].extension:deathDateHistory
                  Slice NamedeathDateHistory
                  Definition

                  This extension allows the Client Registry to include historical death dates and flags in a single Patient resource.

                  ShortBC Death Date History
                  Control0..*
                  This element is affected by the following invariants: ele-1
                  TypeExtension(BC Death Date History) (Complex Extension)
                  Is Modifierfalse
                  Must Supporttrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  LOINC Code
                  90. Patient.deceased[x].extension:verifiedDeathFlag
                  Slice NameverifiedDeathFlag
                  Definition

                  The Patients death is verified and as recorded in the Client Registry as a flag. This also includes death verified flag history as required.

                  ShortBC Death Verified Flag
                  Control0..1
                  This element is affected by the following invariants: ele-1
                  TypeExtension(BC Death Verified Flag) (Complex Extension)
                  Is Modifierfalse
                  Must Supporttrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  LOINC Code
                  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..*
                  This element is affected by the following invariants: ele-1
                  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:preferred
                  Slice Namepreferred
                  Definition

                  Flag denoting whether parent address item is preferred

                  ShortHL7 Preferred Address Flag extension
                  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(Preferred) (Extension Type: boolean)
                  Standards 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())
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  LOINC Code
                  96. Patient.address.extension:noFixedAddress
                  Slice NamenoFixedAddress
                  Definition

                  Flag indicating that there is an assertion that there is no fixed address

                  ShortNo Fixed Address indicator
                  Comments

                  An assertion that there is no fixed address

                  Control0..1
                  This element is affected by the following invariants: ele-1
                  TypeExtension(Extension: No fixed address flag) (Extension Type: boolean)
                  Is Modifierfalse
                  Standards 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())
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  LOINC Code
                  98. Patient.address.extension:sourceID
                  Slice NamesourceID
                  Definition

                  Identifiers for the source and user that modified the specific element that this extension is on.

                  ShortBC SourceID and UserID
                  Control0..1
                  This element is affected by the following invariants: ele-1
                  TypeExtension(BC SourceID and UserID) (Complex Extension)
                  Must Supporttrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  LOINC Code
                  100. Patient.address.extension:validationStatus
                  Slice NamevalidationStatus
                  Definition

                  A code that represents the validation status of the address

                  ShortBC Address Validation Status Code
                  Control0..1
                  This element is affected by the following invariants: ele-1
                  TypeExtension(BC Address Validation Status Code) (Extension Type: code)
                  Must Supporttrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  LOINC Code
                  102. 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
                  This element is affected by the following invariants: ele-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()))
                  104. 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 | physicalpostal | 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).


                  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
                  This element is affected by the following invariants: ele-1
                  BindingThe codes SHALL be taken from AddressTypehttp://hl7.org/fhir/ValueSet/address-type|4.0.1
                  (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()))
                  106. 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
                  This element is affected by the following invariants: ele-1
                  TypeChoice of: boolean, integer
                  [x] NoteSee Choice of Data Types for further information about how to use [x]
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  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()))
                  108. Patient.multipleBirth[x].extension:multipleBirthEffectiveDates
                  Slice NamemultipleBirthEffectiveDates
                  Definition

                  The effective dates for the parent element.

                  ShortBC Business Dates
                  Control0..1
                  TypeExtension(BC Business Dates) (Extension Type: Period)
                  Is Modifierfalse
                  Must Supporttrue
                  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())
                  LOINC Code
                  110. Patient.multipleBirth[x].extension:sourceID
                  Slice NamesourceID
                  Definition

                  Identifiers for the source and user that modified the specific element that this extension is on.

                  ShortBC SourceID and UserID
                  Control0..1
                  TypeExtension(BC SourceID and UserID) (Complex Extension)
                  Is Modifierfalse
                  Must Supporttrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  LOINC Code
                  112. Patient.multipleBirth[x].extension:history
                  Slice Namehistory
                  Definition

                  This extension allows the Client Registry to include historical multiple birth values in a single Patient resource.

                  ShortBC Multiple Birth History
                  Control0..*
                  TypeExtension(BC Multiple Birth History) (Complex Extension)
                  Is Modifierfalse
                  Must Supporttrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  LOINC Code
                  114. Patient.link
                  Definition

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

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

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

                  Control0..*
                  This element is affected by the following invariants: ele-1
                  TypeBackboneElement
                  Is Modifiertrue because This element is labeled as a modifier because it might not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'
                  Must Supporttrue
                  Summarytrue
                  Requirements

                  There are multiple use cases:

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

                  A code that represents the Merge status of the Patient.

                  ShortBC Merge Status Code
                  Control0..*
                  This element is affected by the following invariants: ele-1
                  TypeExtension(BC Merge Status Code) (Extension Type: code)
                  Must Supporttrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  LOINC Code
                  118. 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..*
                  This element is affected by the following invariants: ele-1
                  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())
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  120. 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
                  This element is affected by the following invariants: ele-1
                  TypeReference(Patient, RelatedPerson)
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                  122. Patient.link.type
                  Definition

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

                  Shortreplaced-by | replaces | refer | seealso
                  Comments

                  Note that FHIR strings SHALL NOT exceed 1MB in size

                  Control1..1
                  This element is affected by the following invariants: ele-1
                  BindingThe codes SHALL be taken from LinkTypehttp://hl7.org/fhir/ValueSet/link-type|4.0.1
                  (required to http://hl7.org/fhir/ValueSet/link-type|4.0.1)

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

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

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

                  0. Patient
                  Definition

                  The Patient Profile is based upon the core FHIR Patient Resource

                  ShortPatient Profile
                  Control0..*
                  Is Modifierfalse
                  Alternate NamesSubjectOfCare Client Resident
                  Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.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-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-6: A resource should have narrative for robust management (text.`div`.exists())
                  dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                  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
                  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
                  This element is affected by the following invariants: ele-1
                  TypeMeta
                  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
                  This element is affected by the following invariants: ele-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
                  This element is affected by the following invariants: ele-1
                  BindingThe codes SHOULD be taken from CommonLanguages
                  (preferred to http://hl7.org/fhir/ValueSet/languages)

                  A human language.

                  Additional BindingsPurpose
                  AllLanguagesMax Binding
                  Typecode
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  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
                  This element is affected by the following invariants: ele-1
                  TypeNarrative
                  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
                  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..*
                  This element is affected by the following invariants: ele-1
                  TypeExtension
                  Standards 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())
                  SlicingThis element introduces a set of slices on Patient.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 16. Patient.extension:aboriginalidentitygroup
                    Slice Nameaboriginalidentitygroup
                    Definition

                    A code classifying the person's aboriginal identity

                    ShortExtension: Aboriginal Identity Group
                    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: Aboriginal Identity Group) (Extension Type: Coding)
                    Is Modifierfalse
                    Must Supportfalse
                    Standards 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())
                    18. Patient.extension:aboriginalidentityindicator
                    Slice Nameaboriginalidentityindicator
                    Definition

                    A code classifying the person's self identity as an aboriginal person

                    ShortExtension: Aboriginal Identity Indicator
                    Comments

                    This attribute is based on the belief of the person or the person reporting the attribute, not on any formal analysis of genetic, geneological or historical relationships as these would need to be captured as observations.

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeExtension(Extension: Aboriginal Identity Indicator) (Extension Type: Coding)
                    Is Modifierfalse
                    Must Supportfalse
                    Standards 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())
                    20. Patient.extension:birthsex
                    Slice Namebirthsex
                    Definition

                    A code classifying the person's sex assigned at birth as specified by the [TODO: assigning authority]. This extension aligns with the C-CDA Birth Sex Observation (LOINC 76689-9)

                    ShortExtension: Sex at Birth
                    Comments

                    The codes required are intended to present birth sex (i.e., the sex recorded on the patient’s birth certificate) and not gender identity or reassigned sex.

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeExtension(Extension: Birth Sex) (Extension Type: Coding)
                    Is Modifierfalse
                    Must Supportfalse
                    Standards 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())
                    22. Patient.extension:ethnicity
                    Slice Nameethnicity
                    Definition

                    A code classifying the person's ethnic group or ethnicity as the category of people who identify with each other, usually on the basis of a presumed common genealogy or ancestry or on other similarities.

                    ShortExtension: ethnicity extension
                    Comments

                    This attribute is based on the belief of the person or the person reporting the attribute, not on any formal analysis of genetic, geneological or historical relationships as these would need to be captured as observations.

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeExtension(Extension: Ethnicity) (Extension Type: Coding)
                    Is Modifierfalse
                    Must Supportfalse
                    Standards 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:effectiveDates
                    Slice NameeffectiveDates
                    Definition

                    The effective dates for the parent element.

                    ShortBC Business Dates
                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeExtension(BC Business Dates) (Extension Type: Period)
                    Must Supporttrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    26. Patient.extension:genderIdentity
                    Slice NamegenderIdentity
                    Definition

                    Gender Identity with business dates.

                    ShortBC Gender Identity with business dates.
                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeExtension(BC Gender Identity with business dates.) (Complex Extension)
                    Must Supporttrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    28. Patient.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..*
                    This element is affected by the following invariants: ele-1
                    TypeExtension
                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                    Standards StatusNormative (from Normative)
                    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())
                    SlicingThis element introduces a set of slices on Patient.modifierExtension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 30. Patient.identifier
                      Definition

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

                      ShortAn identifier intended for computation
                      NoteThis is a business identifier, not a resource identifier (see discussion)
                      Control0..*
                      This element is affected by the following invariants: ele-1
                      TypeIdentifier(Identifier DataType Profile (CA Baseline))
                      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 are unordered and Open, and can be differentiated using the following discriminators:
                      • pattern @ type
                      • 32. 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
                        XML FormatIn the XML format, this property is represented as an attribute.
                        34. 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..*
                        This element is affected by the following invariants: ele-1
                        TypeExtension
                        Standards 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())
                        SlicingThis element introduces a set of slices on Patient.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 36. Patient.identifier.extension:sourceID
                          Slice NamesourceID
                          Definition

                          Identifiers for the source and user that modified the specific element that this extension is on.

                          ShortBC SourceID and UserID
                          Control0..1
                          This element is affected by the following invariants: ele-1
                          TypeExtension(BC SourceID and UserID) (Complex Extension)
                          Must Supporttrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          38. Patient.identifier.extension:idStatus
                          Slice NameidStatus
                          Definition

                          Identifier status.

                          ShortBC Identifier Status
                          Control0..1
                          This element is affected by the following invariants: ele-1
                          TypeExtension(BC Identifier Status) (Extension Type: code)
                          Must Supporttrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          40. 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
                          This element is affected by the following invariants: ele-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()))
                          42. 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

                          The slice provided below is one example of an identifier type and has been socialized because of a Canadian extension on that identifier type. It is not required, and the slicing is open meaning that other types can be provided.

                          Control0..1
                          This element is affected by the following invariants: ele-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
                          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()))
                          44. 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.

                          Control1..1
                          This element is affected by the following invariants: ele-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()))
                          46. 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 within the system.
                          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
                          This element is affected by the following invariants: ele-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()))
                          48. Patient.identifier.period
                          Definition

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

                          ShortTime period when id is/was valid for use
                          Comments

                          A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                          Period is not used for a duration (a measure of elapsed time). See Duration.

                          Control0..1
                          This element is affected by the following invariants: ele-1
                          TypePeriod
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
                          50. 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
                          This element is affected by the following invariants: ele-1
                          TypeReference(Organization)
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                          52. Patient.identifier:JHN
                          Slice NameJHN
                          Definition

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

                          ShortAn identifier intended for computation
                          NoteThis is a business identifier, not a resource identifier (see discussion)
                          Control0..*
                          This element is affected by the following invariants: ele-1
                          TypeIdentifier(Identifier DataType Profile (CA Baseline))
                          Is Modifierfalse
                          Requirements

                          Patients are almost always assigned specific numerical identifiers.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          54. Patient.identifier:JHN.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
                          XML FormatIn the XML format, this property is represented as an attribute.
                          56. Patient.identifier:JHN.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..*
                          This element is affected by the following invariants: ele-1
                          TypeExtension
                          Standards 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())
                          SlicingThis element introduces a set of slices on Patient.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 58. Patient.identifier:JHN.extension:versionCode
                            Slice NameversionCode
                            Definition

                            A code indicating a specific version of an identifier credential

                            ShortHealth Number Version Code
                            Comments

                            For example, a health card version number, credit card version number, etc. Used to help verify the authenticity of a credential

                            Control0..1
                            This element is affected by the following invariants: ele-1
                            TypeExtension(Extension: Identifier Version) (Extension Type: string)
                            Must Supportfalse
                            Standards 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())
                            60. Patient.identifier:JHN.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
                            This element is affected by the following invariants: ele-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()))
                            62. Patient.identifier:JHN.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.

                            Control1..1
                            This element is affected by the following invariants: ele-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
                            Summarytrue
                            Requirements

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

                            Fixed Value{
                              "coding" : [{
                                "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                                "code" : "JHN"
                              }]
                            }
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            64. Patient.identifier:JHN.system
                            Definition

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

                            ShortA Health Number Naming System from the Canadian URI Registry
                            Comments

                            Identifier.system is always case sensitive.

                            Control1..1
                            This element is affected by the following invariants: ele-1
                            Typeuri
                            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()))
                            66. Patient.identifier:JHN.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
                            This element is affected by the following invariants: ele-1
                            Typestring
                            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()))
                            68. Patient.identifier:JHN.period
                            Definition

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

                            ShortTime period when id is/was valid for use
                            Comments

                            A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                            Period is not used for a duration (a measure of elapsed time). See Duration.

                            Control0..1
                            This element is affected by the following invariants: ele-1
                            TypePeriod
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
                            70. Patient.identifier:JHN.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
                            This element is affected by the following invariants: ele-1
                            TypeReference(Organization)
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                            72. 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
                            This element is affected by the following invariants: ele-1
                            Typeboolean
                            Is Modifiertrue because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            Need to be able to mark a patient record as not to be used because it was created in error.

                            Meaning if MissingThis resource is generally assumed to be active if no value is provided for the active element
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            74. Patient.name
                            Definition

                            A name associated with the individual.

                            ShortA name associated with the patient
                            Comments

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

                            Control0..*
                            This element is affected by the following invariants: ele-1
                            TypeHumanName
                            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()))
                            ca-baseline-name: Patient.name.given or Patient.name.family or both SHALL be present (family.exists() or given.exists())
                            76. 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
                            XML FormatIn the XML format, this property is represented as an attribute.
                            78. 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..*
                            This element is affected by the following invariants: ele-1
                            TypeExtension
                            Standards 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())
                            SlicingThis element introduces a set of slices on Patient.name.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 80. Patient.name.extension:sourceID
                              Slice NamesourceID
                              Definition

                              Identifiers for the source and user that modified the specific element that this extension is on.

                              ShortBC SourceID and UserID
                              Control0..1
                              This element is affected by the following invariants: ele-1
                              TypeExtension(BC SourceID and UserID) (Complex Extension)
                              Must Supporttrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              82. Patient.name.use
                              Definition

                              Identifies the purpose for this name.

                              Shortusual | official | nickname
                              Comments

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

                              Control0..1
                              This element is affected by the following invariants: ele-1
                              BindingThe codes SHALL be taken from BC Name Use value set.
                              (required to https://terminology.hlth.gov.bc.ca/ClientRegistry/ValueSet/bc-name-use-value-set)
                              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()))
                              84. 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
                              This element is affected by the following invariants: ele-1
                              Typestring
                              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()))
                              86. 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
                              This element is affected by the following invariants: ele-1
                              Typestring
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Alternate Namessurname
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              88. 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..*
                              This element is affected by the following invariants: ele-1
                              Typestring
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Alternate Namesfirst name, middle name
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              90. 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
                              Comments

                              Note that FHIR strings SHALL NOT exceed 1MB in size

                              Control0..*
                              This element is affected by the following invariants: ele-1
                              Typestring
                              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()))
                              92. 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
                              Comments

                              Note that FHIR strings SHALL NOT exceed 1MB in size

                              Control0..*
                              This element is affected by the following invariants: ele-1
                              Typestring
                              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()))
                              94. 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
                              Comments

                              A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                              Period is not used for a duration (a measure of elapsed time). See Duration.

                              Control0..1
                              This element is affected by the following invariants: ele-1
                              TypePeriod
                              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()))
                              per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
                              96. 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..*
                              This element is affected by the following invariants: ele-1
                              TypeContactPoint
                              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()))
                              cpt-2: A system is required if a value is provided. (value.empty() or system.exists())
                              98. 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
                              XML FormatIn the XML format, this property is represented as an attribute.
                              100. 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..*
                              This element is affected by the following invariants: ele-1
                              TypeExtension
                              Standards 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())
                              SlicingThis element introduces a set of slices on Patient.telecom.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 102. Patient.telecom.extension:sourceID
                                Slice NamesourceID
                                Definition

                                Identifiers for the source and user that modified the specific element that this extension is on.

                                ShortBC SourceID and UserID
                                Control0..1
                                This element is affected by the following invariants: ele-1
                                TypeExtension(BC SourceID and UserID) (Complex Extension)
                                Must Supporttrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                104. Patient.telecom.system
                                Definition

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

                                Shortphone | email
                                Comments

                                Note that FHIR strings SHALL NOT exceed 1MB in size

                                Control1..1
                                This element is affected by the following invariants: ele-1, cpt-2
                                BindingThe codes SHALL be taken from BC Contact Point System Value Set
                                (required to https://terminology.hlth.gov.bc.ca/ClientRegistry/ValueSet/bc-contact-point-system-value-set)
                                Typecode
                                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()))
                                106. 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.

                                Control1..1
                                This element is affected by the following invariants: ele-1
                                Typestring
                                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()))
                                108. Patient.telecom.use
                                Definition

                                Identifies the purpose for the contact point.

                                Shorthome | work | mobile
                                Comments

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

                                Control0..1
                                This element is affected by the following invariants: ele-1
                                BindingThe codes SHALL be taken from BC Contact Point Use Value Set
                                (required to https://terminology.hlth.gov.bc.ca/ClientRegistry/ValueSet/bc-contact-point-use-value-set)
                                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()))
                                110. 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
                                This element is affected by the following invariants: ele-1
                                TypepositiveInt
                                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()))
                                112. Patient.telecom.period
                                Definition

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

                                ShortTime period when the contact point was/is in use
                                Comments

                                A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                                Period is not used for a duration (a measure of elapsed time). See Duration.

                                Control0..1
                                This element is affected by the following invariants: ele-1
                                TypePeriod
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
                                114. Patient.gender
                                Definition

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

                                Shortmale | female | other | unknown
                                Comments

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

                                Control0..1
                                This element is affected by the following invariants: ele-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
                                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()))
                                116. Patient.gender.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
                                118. Patient.gender.extension
                                Definition

                                An Extension

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

                                  The effective dates for the parent element.

                                  ShortBC Business Dates
                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  TypeExtension(BC Business Dates) (Extension Type: Period)
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  122. Patient.gender.extension:sourceID
                                  Slice NamesourceID
                                  Definition

                                  Identifiers for the source and user that modified the specific element that this extension is on.

                                  ShortBC SourceID and UserID
                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  TypeExtension(BC SourceID and UserID) (Complex Extension)
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  124. Patient.gender.extension:history
                                  Slice Namehistory
                                  Definition

                                  This extension allows the Client Registry to include historical gender codes in a single Patient resource.

                                  ShortBC Gender History
                                  Control0..*
                                  This element is affected by the following invariants: ele-1
                                  TypeExtension(BC Gender History) (Complex Extension)
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  126. Patient.gender.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
                                  128. 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
                                  This element is affected by the following invariants: ele-1
                                  Typedate
                                  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()))
                                  LOINC Code21112-8
                                  130. 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
                                  132. Patient.birthDate.extension
                                  Definition

                                  An Extension

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

                                    The effective dates for the parent element.

                                    ShortBC Business Dates
                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    TypeExtension(BC Business Dates) (Extension Type: Period)
                                    Is Modifierfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    136. Patient.birthDate.extension:sourceID
                                    Slice NamesourceID
                                    Definition

                                    Identifiers for the source and user that modified the specific element that this extension is on.

                                    ShortBC SourceID and UserID
                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    TypeExtension(BC SourceID and UserID) (Complex Extension)
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    138. Patient.birthDate.extension:history
                                    Slice Namehistory
                                    Definition

                                    This extension allows the Client Registry to include historical birth dates in a single Patient resource.

                                    ShortBC Birth Date History
                                    Control0..*
                                    This element is affected by the following invariants: ele-1
                                    TypeExtension(BC Birth Date History) (Complex Extension)
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    140. 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
                                    142. 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
                                    This element is affected by the following invariants: ele-1
                                    TypedateTime
                                    [x] NoteSee Choice of Data Types for further information about how to use [x]
                                    Is Modifiertrue because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    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()))
                                    144. Patient.deceased[x].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
                                    146. Patient.deceased[x].extension
                                    Definition

                                    An Extension

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

                                      The effective dates for the parent element.

                                      ShortBC Business Dates
                                      Control0..1
                                      This element is affected by the following invariants: ele-1
                                      TypeExtension(BC Business Dates) (Extension Type: Period)
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      150. Patient.deceased[x].extension:sourceID
                                      Slice NamesourceID
                                      Definition

                                      Identifiers for the source and user that modified the specific element that this extension is on.

                                      ShortBC SourceID and UserID
                                      Control0..1
                                      This element is affected by the following invariants: ele-1
                                      TypeExtension(BC SourceID and UserID) (Complex Extension)
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      152. Patient.deceased[x].extension:deathDateHistory
                                      Slice NamedeathDateHistory
                                      Definition

                                      This extension allows the Client Registry to include historical death dates and flags in a single Patient resource.

                                      ShortBC Death Date History
                                      Control0..*
                                      This element is affected by the following invariants: ele-1
                                      TypeExtension(BC Death Date History) (Complex Extension)
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      154. Patient.deceased[x].extension:verifiedDeathFlag
                                      Slice NameverifiedDeathFlag
                                      Definition

                                      The Patients death is verified and as recorded in the Client Registry as a flag. This also includes death verified flag history as required.

                                      ShortBC Death Verified Flag
                                      Control0..1
                                      This element is affected by the following invariants: ele-1
                                      TypeExtension(BC Death Verified Flag) (Complex Extension)
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      156. Patient.deceased[x].value
                                      Definition

                                      The actual value

                                      ShortPrimitive value for dateTime
                                      Control0..1
                                      TypedateTime
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      158. 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..*
                                      This element is affected by the following invariants: ele-1
                                      TypeAddress
                                      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()))
                                      160. 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
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      162. 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..*
                                      This element is affected by the following invariants: ele-1
                                      TypeExtension
                                      Standards 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())
                                      SlicingThis element introduces a set of slices on Patient.address.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 164. Patient.address.extension:preferred
                                        Slice Namepreferred
                                        Definition

                                        Flag denoting whether parent address item is preferred

                                        ShortHL7 Preferred Address Flag extension
                                        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(Preferred) (Extension Type: boolean)
                                        Standards 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())
                                        166. Patient.address.extension:noFixedAddress
                                        Slice NamenoFixedAddress
                                        Definition

                                        Flag indicating that there is an assertion that there is no fixed address

                                        ShortNo Fixed Address indicator
                                        Comments

                                        An assertion that there is no fixed address

                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        TypeExtension(Extension: No fixed address flag) (Extension Type: boolean)
                                        Is Modifierfalse
                                        Standards 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())
                                        168. Patient.address.extension:sourceID
                                        Slice NamesourceID
                                        Definition

                                        Identifiers for the source and user that modified the specific element that this extension is on.

                                        ShortBC SourceID and UserID
                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        TypeExtension(BC SourceID and UserID) (Complex Extension)
                                        Must Supporttrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        170. Patient.address.extension:validationStatus
                                        Slice NamevalidationStatus
                                        Definition

                                        A code that represents the validation status of the address

                                        ShortBC Address Validation Status Code
                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        TypeExtension(BC Address Validation Status Code) (Extension Type: code)
                                        Must Supporttrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        172. 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
                                        This element is affected by the following invariants: ele-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()))
                                        174. 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
                                        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
                                        This element is affected by the following invariants: ele-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
                                        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()))
                                        176. 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
                                        This element is affected by the following invariants: ele-1
                                        Typestring
                                        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()))
                                        178. 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.
                                        Comments

                                        Note that FHIR strings SHALL NOT exceed 1MB in size

                                        Control0..*
                                        This element is affected by the following invariants: ele-1
                                        Typestring
                                        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()))
                                        180. Patient.address.city
                                        Definition

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

                                        ShortName of city, town etc.
                                        Comments

                                        Note that FHIR strings SHALL NOT exceed 1MB in size

                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        Typestring
                                        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()))
                                        182. 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
                                        This element is affected by the following invariants: ele-1
                                        Typestring
                                        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()))
                                        184. 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)
                                        Comments

                                        Note that FHIR strings SHALL NOT exceed 1MB in size

                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        Typestring
                                        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()))
                                        186. Patient.address.postalCode
                                        Definition

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

                                        ShortPostal code for area
                                        Comments

                                        Note that FHIR strings SHALL NOT exceed 1MB in size

                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        Typestring
                                        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()))
                                        188. 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
                                        This element is affected by the following invariants: ele-1
                                        Typestring
                                        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()))
                                        190. Patient.address.period
                                        Definition

                                        Time period when address was/is in use.

                                        ShortTime period when address was/is in use
                                        Comments

                                        A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                                        Period is not used for a duration (a measure of elapsed time). See Duration.

                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        TypePeriod
                                        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()))
                                        per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
                                        192. Patient.maritalStatus
                                        Definition

                                        This field contains a patient's most recent marital (civil) status.

                                        ShortMarital (civil) status of a patient
                                        Comments

                                        Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        BindingUnless not suitable, these codes SHALL be taken from Marital Status Codes
                                        (extensible to http://hl7.org/fhir/ValueSet/marital-status)

                                        The domestic partnership status of a person.

                                        TypeCodeableConcept
                                        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()))
                                        194. 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
                                        This element is affected by the following invariants: ele-1
                                        TypeChoice of: boolean, integer
                                        [x] NoteSee Choice of Data Types for further information about how to use [x]
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        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()))
                                        196. Patient.multipleBirth[x].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
                                        198. Patient.multipleBirth[x].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.multipleBirth[x].extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                        • value @ url
                                        • 200. Patient.multipleBirth[x].extension:multipleBirthEffectiveDates
                                          Slice NamemultipleBirthEffectiveDates
                                          Definition

                                          The effective dates for the parent element.

                                          ShortBC Business Dates
                                          Control0..1
                                          TypeExtension(BC Business Dates) (Extension Type: Period)
                                          Is Modifierfalse
                                          Must Supporttrue
                                          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())
                                          202. Patient.multipleBirth[x].extension:sourceID
                                          Slice NamesourceID
                                          Definition

                                          Identifiers for the source and user that modified the specific element that this extension is on.

                                          ShortBC SourceID and UserID
                                          Control0..1
                                          TypeExtension(BC SourceID and UserID) (Complex Extension)
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          204. Patient.multipleBirth[x].extension:history
                                          Slice Namehistory
                                          Definition

                                          This extension allows the Client Registry to include historical multiple birth values in a single Patient resource.

                                          ShortBC Multiple Birth History
                                          Control0..*
                                          TypeExtension(BC Multiple Birth History) (Complex Extension)
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          206. 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..*
                                          This element is affected by the following invariants: ele-1
                                          TypeAttachment
                                          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()))
                                          att-1: If the Attachment has data, it SHALL have a contentType (data.empty() or contentType.exists())
                                          208. 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..*
                                          This element is affected by the following invariants: ele-1
                                          TypeBackboneElement
                                          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())
                                          210. 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
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          212. 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..*
                                          This element is affected by the following invariants: ele-1
                                          TypeExtension
                                          Standards 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())
                                          SlicingThis element introduces a set of slices on Patient.contact.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                          • value @ url
                                          • 214. 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..*
                                            This element is affected by the following invariants: ele-1
                                            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())
                                            216. Patient.contact.relationship
                                            Definition

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

                                            ShortThe kind of relationship
                                            Comments

                                            Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                                            Control0..*
                                            This element is affected by the following invariants: ele-1
                                            BindingUnless not suitable, these codes SHALL be taken from PatientContactRelationship
                                            (extensible to http://hl7.org/fhir/ValueSet/patient-contactrelationship)

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

                                            TypeCodeableConcept
                                            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()))
                                            218. Patient.contact.name
                                            Definition

                                            A name associated with the contact person.

                                            ShortA name associated with the contact person
                                            Comments

                                            Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts might or might not be imbued with some implicit meaning; various cultures associate different importance with the name parts and the degree to which systems must care about name parts around the world varies widely.

                                            Control0..1
                                            This element is affected by the following invariants: ele-1
                                            TypeHumanName
                                            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()))
                                            220. 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..*
                                            This element is affected by the following invariants: ele-1
                                            TypeContactPoint
                                            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()))
                                            cpt-2: A system is required if a value is provided. (value.empty() or system.exists())
                                            222. Patient.contact.address
                                            Definition

                                            Address for the contact person.

                                            ShortAddress for the contact person
                                            Comments

                                            Note: address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource).

                                            Control0..1
                                            This element is affected by the following invariants: ele-1
                                            TypeAddress
                                            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()))
                                            224. 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
                                            Comments

                                            Note that FHIR strings SHALL NOT exceed 1MB in size

                                            Control0..1
                                            This element is affected by the following invariants: ele-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
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Requirements

                                            Needed to address the person correctly.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            226. 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
                                            Comments

                                            References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                            Control0..1
                                            This element is affected by the following invariants: ele-1, pat-1
                                            TypeReference(Organization)
                                            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()))
                                            ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                            228. 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
                                            Comments

                                            A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                                            Period is not used for a duration (a measure of elapsed time). See Duration.

                                            Control0..1
                                            This element is affected by the following invariants: ele-1
                                            TypePeriod
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
                                            230. 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..*
                                            This element is affected by the following invariants: ele-1
                                            TypeBackboneElement
                                            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()))
                                            232. 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
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            234. 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..*
                                            This element is affected by the following invariants: ele-1
                                            TypeExtension
                                            Standards 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())
                                            SlicingThis element introduces a set of slices on Patient.communication.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                            • value @ url
                                            • 236. 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..*
                                              This element is affected by the following invariants: ele-1
                                              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())
                                              238. Patient.communication.language
                                              Definition

                                              The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English.

                                              ShortThe language which can be used to communicate with the patient about his or her health
                                              Comments

                                              The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.

                                              Control1..1
                                              This element is affected by the following invariants: ele-1
                                              BindingThe codes SHOULD be taken from CommonLanguages
                                              (preferred to http://hl7.org/fhir/ValueSet/languages)

                                              A human language.

                                              Additional BindingsPurpose
                                              AllLanguagesMax Binding
                                              TypeCodeableConcept
                                              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()))
                                              240. 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
                                              This element is affected by the following invariants: ele-1
                                              Typeboolean
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              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()))
                                              242. 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..*
                                              This element is affected by the following invariants: ele-1
                                              TypeReference(Organization, Practitioner, PractitionerRole)
                                              Alternate NamescareProvider
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                              244. 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
                                              This element is affected by the following invariants: ele-1
                                              TypeReference(Organization)
                                              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()))
                                              ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                              246. 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..*
                                              This element is affected by the following invariants: ele-1
                                              TypeBackboneElement
                                              Is Modifiertrue because This element is labeled as a modifier because it might not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'
                                              Must Supporttrue
                                              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()))
                                              248. 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
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              250. 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..*
                                              This element is affected by the following invariants: ele-1
                                              TypeExtension
                                              Standards 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())
                                              SlicingThis element introduces a set of slices on Patient.link.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                              • value @ url
                                              • 252. Patient.link.extension:mergeStatus
                                                Slice NamemergeStatus
                                                Definition

                                                A code that represents the Merge status of the Patient.

                                                ShortBC Merge Status Code
                                                Control0..*
                                                This element is affected by the following invariants: ele-1
                                                TypeExtension(BC Merge Status Code) (Extension Type: code)
                                                Must Supporttrue
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                254. 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..*
                                                This element is affected by the following invariants: ele-1
                                                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())
                                                256. 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
                                                This element is affected by the following invariants: ele-1
                                                TypeReference(Patient, RelatedPerson)
                                                Summarytrue
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                                258. Patient.link.type
                                                Definition

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

                                                Shortreplaced-by | replaces | refer | seealso
                                                Comments

                                                Note that FHIR strings SHALL NOT exceed 1MB in size

                                                Control1..1
                                                This element is affected by the following invariants: ele-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
                                                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()))