Onconova Implementation Guide
0.2.0 - ci-build

Onconova Implementation Guide - Local Development build (v0.2.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: OnconovaCancerPatient - Detailed Descriptions

Active as of 2026-03-18

Definitions for the onconova-cancer-patient resource profile.

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

0. Patient
Definition

-


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

ShortInformation about an individual or animal receiving health care services
Comments

-

Control0..*
Is Modifierfalse
Must Supporttrue
Summaryfalse
Alternate NamesSubjectOfCare Client Resident
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
o-pat-req-1: The identifier element must contain the identifier for the Onconova logical pseudoidentifier slice. (identifier.where(type.coding.code = 'ACSN' and system = 'Onconova').exists())
o-pat-req-2: The identifier element must contain the identifier for the clinical center's patient identifier slice. (identifier.where(type.coding.code = 'MR').exists(system.exists() and value.exists()))
o-pat-req-3: The gender element is required and must be provided (gender.exists())
o-pat-req-4: The birthDate element is required and must be provided (birthDate.exists() and birthDate.hasValue())
o-pat-req-5: The vital status extension is required and must be provided. (deceased.extension('http://hl7.org/fhir/StructureDefinition/onconova-ext-cancer-patient-vital-status').valueCodeableConcept.exists())
o-pat-req-6: If the patient is deceased, the date of death and cause of death must be provided. (deceasedDateTime.extension('http://hl7.org/fhir/StructureDefinition/onconova-ext-cancer-patient-vital-status').valueCodeableConcept.coding.code = '419099009' implies (deceasedDateTime.hasValue() and deceasedDateTime.extension('http://hl7.org/fhir/StructureDefinition/onconova-ext-cancer-patient-cause-of-death').valueCodeableConcept.exists()))
o-pat-req-7: If the patient vital status is unknown, the end of records must be provided. (deceasedDateTime.extension('http://hl7.org/fhir/StructureDefinition/onconova-ext-cancer-patient-vital-status').valueCodeableConcept.coding.code = '261665006' implies extension('http://hl7.org/fhir/StructureDefinition/onconova-ext-cancer-patient-end-of-records').valueDate.hasValue())
2. Patient.implicitRules
Definition

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

ShortA set of rules under which this content was created
Comments

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

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

An Extension


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

ShortExtensionAdditional content defined by implementations
Comments

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

Control20..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 6. Patient.extension:race
    Slice Namerace
    Definition

    Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The race codes used to represent these concepts are based upon the CDC Race and Ethnicity Code Set Version 1.0 which includes over 900 concepts for representing race and ethnicity of which 921 reference race. The race concepts are grouped by and pre-mapped to the 5 OMB race categories:

    • American Indian or Alaska Native
    • Asian
    • Black or African American
    • Native Hawaiian or Other Pacific Islander
    • White.
    ShortUS Core Race Extension
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(US Core Race Extension) (Complex Extension)
    Is Modifierfalse
    Must Supportfalse
    Obligations
      ObligationsActor
      SHOULD:populate-if-knownCreator (Onconova)
      MAY:persistConsumer (Onconova)
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      8. Patient.extension:ethnicity
      Slice Nameethnicity
      Definition

      Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The ethnicity codes used to represent these concepts are based upon the CDC ethnicity and Ethnicity Code Set Version 1.0 which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity. The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories: - Hispanic or Latino - Not Hispanic or Latino.

      Short(USCDI) US Core ethnicity Extension
      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(US Core Ethnicity Extension) (Complex Extension)
      Is Modifierfalse
      Must Supportfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      10. Patient.extension:tribalAffiliation
      Slice NametribalAffiliation
      Definition

      Not used in this profile

      ShortNot used in this profile
      Control0..*
      This element is affected by the following invariants: ele-1
      TypeExtension(US Core Tribal Affiliation Extension) (Complex Extension)
      Is Modifierfalse
      Must Supportfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      12. Patient.extension:birthsex
      Slice Namebirthsex
      Definition

      A code classifying the person's sex assigned at birth as specified by the Office of the National Coordinator for Health IT (ONC).

      ShortExtension
      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(US Core Birth Sex Extension) (Extension Type: code)
      Is Modifierfalse
      Must Supporttrue
      Obligations
        ObligationsActor
        SHOULD:populate-if-knownCreator (Onconova)
        MAY:persistConsumer (Onconova)
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        14. Patient.extension:sex
        Slice Namesex
        Definition

        Not used in this profile

        ShortNot used in this profile
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(US Core Sex Extension) (Extension Type: code)
        Is Modifierfalse
        Must Supportfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        16. Patient.extension:genderIdentity
        Slice NamegenderIdentity
        Definition

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

        ShortExtension
        Comments

        This represents an individual's identity, ascertained by asking them what that identity is.

        Control0..*
        This element is affected by the following invariants: ele-1
        TypeExtension(US Core Gender Identity Extension) (Extension Type: CodeableConcept)
        Is Modifierfalse
        Must Supportfalse
        Obligations
          ObligationsActor
          MAY:populate-if-knownCreator (Onconova)
          MAY:persistConsumer (Onconova)
          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())
          18. Patient.extension:consentStatus
          Slice NameconsentStatus
          Definition

          The status of whether the patient has given or revoked consent for research use.

          ShortCancer Patient Consent status
          Control1..1
          TypeExtension(Cancer Patient Consent status) (Extension Type: code)
          Is Modifierfalse
          Must Supporttrue
          Obligations
            ObligationsActor
            SHALL:populateCreator (Onconova)
            SHOULD:persistConsumer (Onconova)
            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())
            20. Patient.extension:clinicalCenter
            Slice NameclinicalCenter
            Definition

            The center or hospital where the patient case original records were recorded.

            ShortCancer Patient Clinical Center
            Control1..1
            TypeExtension(Cancer Patient Clinical Center) (Extension Type: string)
            Is Modifierfalse
            Must Supporttrue
            Obligations
              ObligationsActor
              SHALL:populateCreator (Onconova)
              SHOULD:persistConsumer (Onconova)
              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())
              22. Patient.extension:overallSurvival
              Slice NameoverallSurvival
              Definition

              The duration of time from either the date of diagnosis or the start of treatment for a disease, such as cancer, that patients diagnosed with the disease are still alive. In a clinical trial, measuring the overall survival is one way to see how well a new treatment works.

              ShortCancer Patient Overall Survival
              Control0..1
              TypeExtension(Cancer Patient Overall Survival) (Extension Type: Duration)
              Is Modifierfalse
              Obligations
                ObligationsActor
                MAY:ignoreCreator (Onconova)
                MAY:persistConsumer (Onconova)
                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())
                24. Patient.extension:dataCompletionRate
                Slice NamedataCompletionRate
                Definition

                The percentage of data elements categories that have been completed for a patient.

                ShortCancer Patient Data Completion Rate
                Control0..1
                TypeExtension(Cancer Patient Data Completion Rate) (Extension Type: decimal)
                Is Modifierfalse
                Obligations
                  ObligationsActor
                  MAY:ignoreCreator (Onconova)
                  MAY:persistConsumer (Onconova)
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  26. Patient.extension:contributors
                  Slice Namecontributors
                  Definition

                  The individuals or organizations that contributed to the patient's case data collection.

                  ShortCancer Patient Data Contributors
                  Control0..*
                  TypeExtension(Cancer Patient Data Contributors) (Extension Type: Reference)
                  Is Modifierfalse
                  Obligations
                    ObligationsActor
                    MAY:ignoreCreator (Onconova)
                    MAY:persistConsumer (Onconova)
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    28. Patient.extension:endOfRecords
                    Slice NameendOfRecords
                    Definition

                    Indicates the last known record date of a patient.

                    ShortCancer Patient End of Records
                    Control0..1
                    TypeExtension(Cancer Patient End of Records) (Extension Type: date)
                    Is Modifierfalse
                    Must Supporttrue
                    Obligations
                      ObligationsActor
                      SHALL:populate-if-knownCreator (Onconova)
                      SHOULD:persistConsumer (Onconova)
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      30. Patient.modifierExtension
                      Definition

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

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

                      ShortExtensions that cannot be ignored
                      Comments

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

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

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

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

                      An identifier for this patient.

                      Short(USCDI) An identifier for this patientAn identifier for this patient
                      NoteThis is a business identifier, not a resource identifier (see discussion)
                      Control20..*
                      TypeIdentifier
                      Is Modifierfalse
                      Must Supporttrue
                      Summarytrue
                      Requirements

                      Patients are almost always assigned specific numerical identifiers.

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

                        The purpose of this identifier.

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

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

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

                        Identifies the purpose for this identifier, if known .

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

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

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

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

                        Short(USCDI) The namespace for the identifier valueThe namespace for the identifier value
                        Comments

                        Identifier.system is always case sensitive.

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

                        ExampleGeneral: http://www.acme.com/identifiers/patient
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        38. Patient.identifier.value
                        Definition

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

                        Short(USCDI) The value that is unique within the system.The value that is unique
                        Comments

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

                        Control10..1
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        ExampleGeneral: 123456
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        40. Patient.identifier:onconovaIdentifier
                        Slice NameonconovaIdentifier
                        Definition

                        An identifier for this patient.

                        ShortOnconova Logical PseudoidentifierAn identifier for this patient
                        NoteThis is a business identifier, not a resource identifier (see discussion)
                        Control10..*
                        TypeIdentifier
                        Is Modifierfalse
                        Must Supporttrue
                        Obligations
                          ObligationsActor
                          SHALL:populateCreator (Onconova)
                          SHOULD:persistConsumer (Onconova)
                          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()))
                          42. Patient.identifier:onconovaIdentifier.use
                          Definition

                          The purpose of this identifier.

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

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

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

                          Identifies the purpose for this identifier, if known .

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

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

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          44. Patient.identifier:onconovaIdentifier.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
                          BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type|4.0.1
                          (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.

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

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

                          Short(USCDI) The namespace for the identifier valueThe namespace for the identifier value
                          Comments

                          Identifier.system is always case sensitive.

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

                          Pattern ValueOnconova
                          ExampleGeneral: http://www.acme.com/identifiers/patient
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          48. Patient.identifier:onconovaIdentifier.value
                          Definition

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

                          Short(USCDI) The value that is unique within the system.The value that is unique
                          Comments

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

                          Control10..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          ExampleGeneral: 123456
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          50. Patient.identifier:clinicalIdentifier
                          Slice NameclinicalIdentifier
                          Definition

                          An identifier for this patient.

                          ShortClinical Identifier from Clinical CenterAn identifier for this patient
                          NoteThis is a business identifier, not a resource identifier (see discussion)
                          Control10..*
                          TypeIdentifier
                          Is Modifierfalse
                          Must Supporttrue
                          Obligations
                            ObligationsActor
                            SHALL:populateCreator (Onconova)
                            SHOULD:persistConsumer (Onconova)
                            Summarytrue
                            Requirements

                            Patients are almost always assigned specific numerical identifiers.

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

                            The purpose of this identifier.

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

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

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

                            Identifies the purpose for this identifier, if known .

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

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

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            54. Patient.identifier:clinicalIdentifier.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
                            BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type|4.0.1
                            (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.

                            Pattern Value{
                              "coding" : [{
                                "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                                "code" : "MR",
                                "display" : "Medical Record Number"
                              }]
                            }
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            56. Patient.identifier:clinicalIdentifier.system
                            Definition

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

                            Short(USCDI) The namespace for the identifier valueThe namespace for the identifier value
                            Comments

                            Identifier.system is always case sensitive.

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

                            ExampleGeneral: http://www.acme.com/identifiers/patient
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            58. Patient.identifier:clinicalIdentifier.value
                            Definition

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

                            Short(USCDI) The value that is unique within the system.The value that is unique
                            Comments

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

                            Control10..1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supporttrue
                            Summarytrue
                            ExampleGeneral: 123456
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            60. Patient.active
                            Definition

                            Whether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules.

                            It is often used to filter patient lists to exclude inactive patients

                            Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death.

                            ShortWhether this patient's record is in active use
                            Comments

                            If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient.

                            Control0..1
                            Typeboolean
                            Is Modifiertrue because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

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

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

                            Not used in this profile


                            A name associated with the individual.

                            ShortNot used in this profileA name associated with the patient
                            Comments

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

                            Control10..*
                            TypeHumanName
                            Is Modifierfalse
                            Must Supporttrue
                            Summarytrue
                            Requirements

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

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            us-core-6: At least name.given and/or name.family are present or, if neither is available, the Data Absent Reason Extension is present. ((family.exists() or given.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists())
                            64. Patient.name.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.

                            Control10..*
                            TypeExtension
                            Is Modifierfalse
                            Summaryfalse
                            Alternate Namesextensions, user content
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            SlicingThis element introduces a set of slices on Patient.name.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 66. Patient.name.extension:anonymizedEntry
                              Slice NameanonymizedEntry
                              Definition

                              Provides a reason why the expected value or elements in the element that is extended are missing.

                              Shortunknown | asked | temp | notasked | masked | unsupported | astext | error
                              Control1..1
                              TypeExtension(Data Absent Reason) (Extension Type: code)
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              68. Patient.name.extension:anonymizedEntry.extension
                              Definition

                              An Extension


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

                              ShortExtensionAdditional content defined by implementations
                              Comments

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

                              Control0..0*
                              TypeExtension
                              Is Modifierfalse
                              Summaryfalse
                              Alternate Namesextensions, user content
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              SlicingThis element introduces a set of slices on Patient.name.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 70. Patient.name.extension:anonymizedEntry.url
                                Definition

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

                                Shortidentifies the meaning of the extension
                                Comments

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

                                Control1..1
                                Typeuri
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                Fixed Valuehttp://hl7.org/fhir/StructureDefinition/data-absent-reason
                                72. Patient.name.extension:anonymizedEntry.value[x]
                                Definition

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


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

                                ShortValue of extension
                                Control10..1
                                This element is affected by the following invariants: ext-1
                                BindingThe codes SHALL be taken from For codes, see DataAbsentReason
                                (required to http://hl7.org/fhir/ValueSet/data-absent-reason)
                                Typecode, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summaryfalse
                                Pattern Valuemasked
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                74. Patient.name.use
                                Definition

                                Identifies the purpose for this name.

                                Short(USCDI) usual | official | temp | nickname | anonymous | old | maidenusual | official | temp | nickname | anonymous | old | maiden
                                Comments

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

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

                                The use of a human name.

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

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

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

                                Short(USCDI) Family name (often called 'Surname')Family 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: us-core-6
                                Typestring
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supporttrue
                                Summarytrue
                                Alternate Namessurname
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                78. Patient.name.given
                                Definition

                                Given name.

                                Short(USCDI) Given names (not always 'first'). Includes middle namesGiven 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: us-core-6
                                Typestring
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supporttrue
                                Summarytrue
                                Alternate Namesfirst name, middle name
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                80. Patient.telecom
                                Definition

                                Not used in this profile


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

                                ShortNot used in this profileA contact detail for the individual
                                Comments

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

                                Control0..*
                                TypeContactPoint
                                Is Modifierfalse
                                Must Supportfalse
                                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()))
                                82. Patient.telecom.system
                                Definition

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

                                Short(USCDI) phone | fax | email | pager | url | sms | otherphone | fax | email | pager | url | sms | other
                                Control10..1
                                This element is affected by the following invariants: cpt-2
                                BindingThe codes SHALL be taken from ContactPointSystemhttp://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
                                (required to http://hl7.org/fhir/ValueSet/contact-point-system)

                                Telecommunications form for contact point.

                                Typecode
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supporttrue
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                84. 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).

                                Short(USCDI) The actual contact point detailsThe 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
                                Typestring
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supporttrue
                                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()))
                                86. Patient.telecom.use
                                Definition

                                Identifies the purpose for the contact point.

                                Short(USCDI) home | work | temp | old | mobile - purpose of this contact pointhome | work | temp | old | mobile - purpose of this contact point
                                Comments

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

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

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

                                Short(USCDI) male | female | other | unknownmale | female | other | unknown
                                Comments

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

                                Control10..1
                                BindingThe codes SHALL be taken from AdministrativeGenderhttp://hl7.org/fhir/ValueSet/administrative-gender|4.0.1
                                (required to http://hl7.org/fhir/ValueSet/administrative-gender)
                                Typecode
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supporttrue
                                Obligations
                                  ObligationsActor
                                  SHALL:populateCreator (Onconova)
                                  SHOULD:persistConsumer (Onconova)
                                  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()))
                                  90. Patient.birthDate
                                  Definition

                                  The date of birth for the individual.

                                  ShortDate of birth of the patient normalized to the first day of the monthThe date of birth for the individual
                                  Comments

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

                                  Control10..1
                                  Typedate
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Obligations
                                    ObligationsActor
                                    SHALL:populateCreator (Onconova)
                                    SHOULD:persistConsumer (Onconova)
                                    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
                                    92. 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 areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 94. Patient.birthDate.extension:age
                                      Slice Nameage
                                      Definition

                                      The approximate age of the patient.

                                      ShortCancer Patient Age
                                      Control0..1
                                      This element is affected by the following invariants: ele-1
                                      TypeExtension(Cancer Patient Age) (Extension Type: integer)
                                      Is Modifierfalse
                                      Obligations
                                        ObligationsActor
                                        MAY:ignoreCreator (Onconova)
                                        MAY:persistConsumer (Onconova)
                                        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())
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        96. Patient.birthDate.extension:ageAtDiagnosis
                                        Slice NameageAtDiagnosis
                                        Definition

                                        The approximate age of the patient at the time of diagnosis of the disease.

                                        ShortCancer Patient Age at Diagnosis
                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        TypeExtension(Cancer Patient Age at Diagnosis) (Extension Type: integer)
                                        Is Modifierfalse
                                        Obligations
                                          ObligationsActor
                                          MAY:ignoreCreator (Onconova)
                                          MAY:persistConsumer (Onconova)
                                          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())
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          98. Patient.deceased[x]
                                          Definition

                                          Indicates if the individual is deceased or not.

                                          ShortDate of death of the patient, if applicableIndicates 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.

                                          Control10..1
                                          TypedateTime, boolean
                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                          Is Modifiertrue because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supporttrue
                                          Obligations
                                            ObligationsActor
                                            SHALL:populate-if-knownCreator (Onconova)
                                            SHOULD:persistConsumer (Onconova)
                                            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()))
                                            100. 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.

                                            Control20..*
                                            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 areUnordered and Open, and can be differentiated using the following discriminators:
                                            • value @ url
                                            • 102. Patient.deceased[x].extension:vitalStatus
                                              Slice NamevitalStatus
                                              Definition

                                              The status of whether the patient is alive or deceased or unknown.

                                              ShortCancer Patient Vital status
                                              Control1..1
                                              This element is affected by the following invariants: ele-1
                                              TypeExtension(Cancer Patient Vital status) (Extension Type: CodeableConcept)
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Obligations
                                                ObligationsActor
                                                SHALL:populateCreator (Onconova)
                                                SHOULD:persistConsumer (Onconova)
                                                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())
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                104. Patient.deceased[x].extension:causeOfDeath
                                                Slice NamecauseOfDeath
                                                Definition

                                                The cause of death for the patient.

                                                ShortCancer Patient Cause of Death
                                                Control1..1
                                                This element is affected by the following invariants: ele-1
                                                TypeExtension(Cancer Patient Cause of Death) (Extension Type: CodeableConcept)
                                                Is Modifierfalse
                                                Must Supporttrue
                                                Obligations
                                                  ObligationsActor
                                                  SHALL:populateCreator (Onconova)
                                                  SHOULD:persistConsumer (Onconova)
                                                  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())
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  106. Patient.address
                                                  Definition

                                                  Not used in this profile


                                                  An address for the individual.

                                                  ShortNot used in this profileAn address for the individual
                                                  Comments

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

                                                  Control0..*
                                                  TypeAddress
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summarytrue
                                                  Requirements

                                                  May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.

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

                                                  The purpose of this address.

                                                  Short(USCDI) home | work | temp | old | billing - purpose of this addresshome | work | temp | old | billing - purpose of this address
                                                  Comments

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

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

                                                  The use of an address.

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

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

                                                  ExampleGeneral: home
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  110. 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.

                                                  Short(USCDI) Street name, number, direction & P.O. Box etc.Street name, number, direction & P.O. Box etc.
                                                  Control0..*
                                                  Typestring
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supporttrue
                                                  Summarytrue
                                                  ExampleGeneral: 137 Nowhere Street
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  112. Patient.address.city
                                                  Definition

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

                                                  Short(USCDI) Name of city, town etc.Name of city, town etc.
                                                  Control0..1
                                                  Typestring
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supporttrue
                                                  Summarytrue
                                                  Alternate NamesMunicpality
                                                  ExampleGeneral: Erewhon
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  114. 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).

                                                  Short(USCDI) Sub-unit of country (abbreviations ok)Sub-unit of country (abbreviations ok)
                                                  Control0..1
                                                  BindingUnless not suitable, these codes SHALL be taken from For codes, see USPS Two Letter Alphabetic Codes
                                                  (extensible to http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state)

                                                  Two Letter USPS alphabetic codes.

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

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

                                                  Short(USCDI) US Zip CodesPostal code for area
                                                  Control0..1
                                                  Typestring
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supporttrue
                                                  Summarytrue
                                                  Alternate NamesZip, Zip Code
                                                  ExampleGeneral: 9132
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  118. Patient.maritalStatus
                                                  Definition

                                                  Not used in this profile


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

                                                  ShortNot used in this profileMarital (civil) status of a patient
                                                  Control0..1
                                                  BindingUnless not suitable, these codes SHALL be taken from Marital Status Codeshttp://hl7.org/fhir/ValueSet/marital-status|4.0.1
                                                  (extensible to http://hl7.org/fhir/ValueSet/marital-status)

                                                  The domestic partnership status of a person.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Most, if not all systems capture it.

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

                                                  Not used in this profile


                                                  Image of the patient.

                                                  ShortNot used in this profileImage of the patient
                                                  Comments

                                                  Guidelines:

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

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

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

                                                  Not used in this profile


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

                                                  ShortNot used in this profileA contact party (e.g. guardian, partner, friend) for the patient
                                                  Comments

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

                                                  Control0..*
                                                  TypeBackboneElement
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Need to track people you can contact about the patient.

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

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

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

                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                  Comments

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

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

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

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

                                                  Not used in this profile


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

                                                  ShortNot used in this profileA language which may be used to communicate with the patient about his or her health
                                                  Comments

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

                                                  Control0..*
                                                  TypeBackboneElement
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

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

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

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

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

                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                  Comments

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

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

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

                                                  Alternate Namesextensions, user content, modifiers
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  130. 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.

                                                  Short(USCDI) The language which can be used to communicate with the patient about his or her healthThe language which can be used to communicate with the patient about his or her health
                                                  Comments

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

                                                  Control1..1
                                                  BindingUnless not suitable, these codes SHALL be taken from The codes SHOULD be taken from Language codes with language and optionally a region modifierhttp://hl7.org/fhir/ValueSet/languages|4.0.1
                                                  (extensible to http://hl7.org/fhir/us/core/ValueSet/simple-language)
                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summaryfalse
                                                  Requirements

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

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

                                                  Not used in this profile


                                                  Patient's nominated care provider.

                                                  ShortNot used in this profilePatient's nominated primary care provider
                                                  Comments

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

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

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

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

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

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

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

                                                  There are multiple use cases:

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

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

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

                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                  Comments

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

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

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

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

                                                  The other patient resource that the link refers to.

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

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

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

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

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

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

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

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

                                                  0. Patient
                                                  Invariantso-pat-req-1: The identifier element must contain the identifier for the Onconova logical pseudoidentifier slice. (identifier.where(type.coding.code = 'ACSN' and system = 'Onconova').exists())
                                                  o-pat-req-2: The identifier element must contain the identifier for the clinical center's patient identifier slice. (identifier.where(type.coding.code = 'MR').exists(system.exists() and value.exists()))
                                                  o-pat-req-3: The gender element is required and must be provided (gender.exists())
                                                  o-pat-req-4: The birthDate element is required and must be provided (birthDate.exists() and birthDate.hasValue())
                                                  o-pat-req-5: The vital status extension is required and must be provided. (deceased.extension('http://hl7.org/fhir/StructureDefinition/onconova-ext-cancer-patient-vital-status').valueCodeableConcept.exists())
                                                  o-pat-req-6: If the patient is deceased, the date of death and cause of death must be provided. (deceasedDateTime.extension('http://hl7.org/fhir/StructureDefinition/onconova-ext-cancer-patient-vital-status').valueCodeableConcept.coding.code = '419099009' implies (deceasedDateTime.hasValue() and deceasedDateTime.extension('http://hl7.org/fhir/StructureDefinition/onconova-ext-cancer-patient-cause-of-death').valueCodeableConcept.exists()))
                                                  o-pat-req-7: If the patient vital status is unknown, the end of records must be provided. (deceasedDateTime.extension('http://hl7.org/fhir/StructureDefinition/onconova-ext-cancer-patient-vital-status').valueCodeableConcept.coding.code = '261665006' implies extension('http://hl7.org/fhir/StructureDefinition/onconova-ext-cancer-patient-end-of-records').valueDate.hasValue())
                                                  2. Patient.extension
                                                  Control2..?
                                                  4. Patient.extension:race
                                                  Slice Namerace
                                                  Obligations
                                                    ObligationsActor
                                                    SHOULD:populate-if-knownCreator (Onconova)
                                                    MAY:persistConsumer (Onconova)
                                                    6. Patient.extension:tribalAffiliation
                                                    Slice NametribalAffiliation
                                                    Definition

                                                    Not used in this profile

                                                    ShortNot used in this profile
                                                    8. Patient.extension:birthsex
                                                    Slice Namebirthsex
                                                    Obligations
                                                      ObligationsActor
                                                      SHOULD:populate-if-knownCreator (Onconova)
                                                      MAY:persistConsumer (Onconova)
                                                      10. Patient.extension:sex
                                                      Slice Namesex
                                                      Definition

                                                      Not used in this profile

                                                      ShortNot used in this profile
                                                      12. Patient.extension:genderIdentity
                                                      Slice NamegenderIdentity
                                                      Obligations
                                                        ObligationsActor
                                                        MAY:populate-if-knownCreator (Onconova)
                                                        MAY:persistConsumer (Onconova)
                                                        14. Patient.extension:consentStatus
                                                        Slice NameconsentStatus
                                                        Control1..1
                                                        TypeExtension(Cancer Patient Consent status) (Extension Type: code)
                                                        Must Supporttrue
                                                        Obligations
                                                          ObligationsActor
                                                          SHALL:populateCreator (Onconova)
                                                          SHOULD:persistConsumer (Onconova)
                                                          16. Patient.extension:clinicalCenter
                                                          Slice NameclinicalCenter
                                                          Control1..1
                                                          TypeExtension(Cancer Patient Clinical Center) (Extension Type: string)
                                                          Must Supporttrue
                                                          Obligations
                                                            ObligationsActor
                                                            SHALL:populateCreator (Onconova)
                                                            SHOULD:persistConsumer (Onconova)
                                                            18. Patient.extension:overallSurvival
                                                            Slice NameoverallSurvival
                                                            Control0..1
                                                            TypeExtension(Cancer Patient Overall Survival) (Extension Type: Duration)
                                                            Obligations
                                                              ObligationsActor
                                                              MAY:ignoreCreator (Onconova)
                                                              MAY:persistConsumer (Onconova)
                                                              20. Patient.extension:dataCompletionRate
                                                              Slice NamedataCompletionRate
                                                              Control0..1
                                                              TypeExtension(Cancer Patient Data Completion Rate) (Extension Type: decimal)
                                                              Obligations
                                                                ObligationsActor
                                                                MAY:ignoreCreator (Onconova)
                                                                MAY:persistConsumer (Onconova)
                                                                22. Patient.extension:contributors
                                                                Slice Namecontributors
                                                                Control0..*
                                                                TypeExtension(Cancer Patient Data Contributors) (Extension Type: Reference)
                                                                Obligations
                                                                  ObligationsActor
                                                                  MAY:ignoreCreator (Onconova)
                                                                  MAY:persistConsumer (Onconova)
                                                                  24. Patient.extension:endOfRecords
                                                                  Slice NameendOfRecords
                                                                  Control0..1
                                                                  TypeExtension(Cancer Patient End of Records) (Extension Type: date)
                                                                  Must Supporttrue
                                                                  Obligations
                                                                    ObligationsActor
                                                                    SHALL:populate-if-knownCreator (Onconova)
                                                                    SHOULD:persistConsumer (Onconova)
                                                                    26. Patient.identifier
                                                                    NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                    Control2..?
                                                                    SlicingThis element introduces a set of slices on Patient.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                    • pattern @ type
                                                                    • 28. Patient.identifier:onconovaIdentifier
                                                                      Slice NameonconovaIdentifier
                                                                      ShortOnconova Logical Pseudoidentifier
                                                                      NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                      Control1..*
                                                                      Must Supporttrue
                                                                      Obligations
                                                                        ObligationsActor
                                                                        SHALL:populateCreator (Onconova)
                                                                        SHOULD:persistConsumer (Onconova)
                                                                        30. Patient.identifier:onconovaIdentifier.type
                                                                        Control1..?
                                                                        Pattern Value{
                                                                          "coding" : [{
                                                                            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                                                                            "code" : "ACSN",
                                                                            "display" : "Accession Identifier"
                                                                          }]
                                                                        }
                                                                        32. Patient.identifier:onconovaIdentifier.system
                                                                        Pattern ValueOnconova
                                                                        34. Patient.identifier:clinicalIdentifier
                                                                        Slice NameclinicalIdentifier
                                                                        ShortClinical Identifier from Clinical Center
                                                                        NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                        Control1..*
                                                                        Must Supporttrue
                                                                        Obligations
                                                                          ObligationsActor
                                                                          SHALL:populateCreator (Onconova)
                                                                          SHOULD:persistConsumer (Onconova)
                                                                          36. Patient.identifier:clinicalIdentifier.type
                                                                          Control1..?
                                                                          Pattern Value{
                                                                            "coding" : [{
                                                                              "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                                                                              "code" : "MR",
                                                                              "display" : "Medical Record Number"
                                                                            }]
                                                                          }
                                                                          38. Patient.name
                                                                          Definition

                                                                          Not used in this profile

                                                                          ShortNot used in this profile
                                                                          40. Patient.name.extension
                                                                          Control1..?
                                                                          42. Patient.name.extension:anonymizedEntry
                                                                          Slice NameanonymizedEntry
                                                                          Control1..*
                                                                          TypeExtension(Data Absent Reason) (Extension Type: code)
                                                                          44. Patient.name.extension:anonymizedEntry.value[x]
                                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                          Pattern Valuemasked
                                                                          46. Patient.telecom
                                                                          Definition

                                                                          Not used in this profile

                                                                          ShortNot used in this profile
                                                                          48. Patient.gender
                                                                          Obligations
                                                                            ObligationsActor
                                                                            SHALL:populateCreator (Onconova)
                                                                            SHOULD:persistConsumer (Onconova)
                                                                            50. Patient.birthDate
                                                                            ShortDate of birth of the patient normalized to the first day of the month
                                                                            Control1..?
                                                                            Obligations
                                                                              ObligationsActor
                                                                              SHALL:populateCreator (Onconova)
                                                                              SHOULD:persistConsumer (Onconova)
                                                                              LOINC Code
                                                                              52. Patient.birthDate.extension
                                                                              SlicingThis element introduces a set of slices on Patient.birthDate.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                              • value @ url
                                                                              • 54. Patient.birthDate.extension:age
                                                                                Slice Nameage
                                                                                Control0..1
                                                                                TypeExtension(Cancer Patient Age) (Extension Type: integer)
                                                                                Obligations
                                                                                  ObligationsActor
                                                                                  MAY:ignoreCreator (Onconova)
                                                                                  MAY:persistConsumer (Onconova)
                                                                                  56. Patient.birthDate.extension:ageAtDiagnosis
                                                                                  Slice NameageAtDiagnosis
                                                                                  Control0..1
                                                                                  TypeExtension(Cancer Patient Age at Diagnosis) (Extension Type: integer)
                                                                                  Obligations
                                                                                    ObligationsActor
                                                                                    MAY:ignoreCreator (Onconova)
                                                                                    MAY:persistConsumer (Onconova)
                                                                                    58. Patient.deceased[x]
                                                                                    ShortDate of death of the patient, if applicable
                                                                                    Control1..?
                                                                                    TypedateTime, boolean
                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Obligations
                                                                                      ObligationsActor
                                                                                      SHALL:populate-if-knownCreator (Onconova)
                                                                                      SHOULD:persistConsumer (Onconova)
                                                                                      60. Patient.deceased[x].extension
                                                                                      Control2..?
                                                                                      SlicingThis element introduces a set of slices on Patient.deceased[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                      • value @ url
                                                                                      • 62. Patient.deceased[x].extension:vitalStatus
                                                                                        Slice NamevitalStatus
                                                                                        Control1..1
                                                                                        TypeExtension(Cancer Patient Vital status) (Extension Type: CodeableConcept)
                                                                                        Must Supporttrue
                                                                                        Obligations
                                                                                          ObligationsActor
                                                                                          SHALL:populateCreator (Onconova)
                                                                                          SHOULD:persistConsumer (Onconova)
                                                                                          64. Patient.deceased[x].extension:causeOfDeath
                                                                                          Slice NamecauseOfDeath
                                                                                          Control1..1
                                                                                          TypeExtension(Cancer Patient Cause of Death) (Extension Type: CodeableConcept)
                                                                                          Must Supporttrue
                                                                                          Obligations
                                                                                            ObligationsActor
                                                                                            SHALL:populateCreator (Onconova)
                                                                                            SHOULD:persistConsumer (Onconova)
                                                                                            66. Patient.address
                                                                                            Definition

                                                                                            Not used in this profile

                                                                                            ShortNot used in this profile
                                                                                            68. Patient.maritalStatus
                                                                                            Definition

                                                                                            Not used in this profile

                                                                                            ShortNot used in this profile
                                                                                            70. Patient.photo
                                                                                            Definition

                                                                                            Not used in this profile

                                                                                            ShortNot used in this profile
                                                                                            72. Patient.contact
                                                                                            Definition

                                                                                            Not used in this profile

                                                                                            ShortNot used in this profile
                                                                                            74. Patient.communication
                                                                                            Definition

                                                                                            Not used in this profile

                                                                                            ShortNot used in this profile
                                                                                            76. Patient.generalPractitioner
                                                                                            Definition

                                                                                            Not used in this profile

                                                                                            ShortNot used in this profile

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

                                                                                            0. Patient
                                                                                            Definition

                                                                                            -

                                                                                            ShortInformation about an individual or animal receiving health care services
                                                                                            Comments

                                                                                            -

                                                                                            Control0..*
                                                                                            Is Modifierfalse
                                                                                            Must Supporttrue
                                                                                            Summaryfalse
                                                                                            Alternate NamesSubjectOfCare Client Resident
                                                                                            Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                                                                                            dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
                                                                                            dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                                                                                            dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                                                                                            dom-6: A resource should have narrative for robust management (text.`div`.exists())
                                                                                            o-pat-req-1: The identifier element must contain the identifier for the Onconova logical pseudoidentifier slice. (identifier.where(type.coding.code = 'ACSN' and system = 'Onconova').exists())
                                                                                            o-pat-req-2: The identifier element must contain the identifier for the clinical center's patient identifier slice. (identifier.where(type.coding.code = 'MR').exists(system.exists() and value.exists()))
                                                                                            o-pat-req-3: The gender element is required and must be provided (gender.exists())
                                                                                            o-pat-req-4: The birthDate element is required and must be provided (birthDate.exists() and birthDate.hasValue())
                                                                                            o-pat-req-5: The vital status extension is required and must be provided. (deceased.extension('http://hl7.org/fhir/StructureDefinition/onconova-ext-cancer-patient-vital-status').valueCodeableConcept.exists())
                                                                                            o-pat-req-6: If the patient is deceased, the date of death and cause of death must be provided. (deceasedDateTime.extension('http://hl7.org/fhir/StructureDefinition/onconova-ext-cancer-patient-vital-status').valueCodeableConcept.coding.code = '419099009' implies (deceasedDateTime.hasValue() and deceasedDateTime.extension('http://hl7.org/fhir/StructureDefinition/onconova-ext-cancer-patient-cause-of-death').valueCodeableConcept.exists()))
                                                                                            o-pat-req-7: If the patient vital status is unknown, the end of records must be provided. (deceasedDateTime.extension('http://hl7.org/fhir/StructureDefinition/onconova-ext-cancer-patient-vital-status').valueCodeableConcept.coding.code = '261665006' implies extension('http://hl7.org/fhir/StructureDefinition/onconova-ext-cancer-patient-end-of-records').valueDate.hasValue())
                                                                                            2. Patient.id
                                                                                            Definition

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

                                                                                            ShortLogical id of this artifact
                                                                                            Comments

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

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

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

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

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

                                                                                            ShortA set of rules under which this content was created
                                                                                            Comments

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

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

                                                                                            The base language in which the resource is written.

                                                                                            ShortLanguage of the resource content
                                                                                            Comments

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

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

                                                                                            A human language.

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

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

                                                                                            ShortText summary of the resource, for human interpretation
                                                                                            Comments

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

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

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

                                                                                            ShortContained, inline Resources
                                                                                            Comments

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

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

                                                                                            An Extension

                                                                                            ShortExtension
                                                                                            Control2..*
                                                                                            TypeExtension
                                                                                            Is Modifierfalse
                                                                                            Summaryfalse
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                            SlicingThis element introduces a set of slices on Patient.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                            • value @ url
                                                                                            • 16. Patient.extension:race
                                                                                              Slice Namerace
                                                                                              Definition

                                                                                              Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The race codes used to represent these concepts are based upon the CDC Race and Ethnicity Code Set Version 1.0 which includes over 900 concepts for representing race and ethnicity of which 921 reference race. The race concepts are grouped by and pre-mapped to the 5 OMB race categories:

                                                                                              • American Indian or Alaska Native
                                                                                              • Asian
                                                                                              • Black or African American
                                                                                              • Native Hawaiian or Other Pacific Islander
                                                                                              • White.
                                                                                              ShortUS Core Race Extension
                                                                                              Control0..1
                                                                                              This element is affected by the following invariants: ele-1
                                                                                              TypeExtension(US Core Race Extension) (Complex Extension)
                                                                                              Is Modifierfalse
                                                                                              Must Supportfalse
                                                                                              Obligations
                                                                                                ObligationsActor
                                                                                                SHOULD:populate-if-knownCreator (Onconova)
                                                                                                MAY:persistConsumer (Onconova)
                                                                                                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:ethnicity
                                                                                                Slice Nameethnicity
                                                                                                Definition

                                                                                                Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The ethnicity codes used to represent these concepts are based upon the CDC ethnicity and Ethnicity Code Set Version 1.0 which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity. The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories: - Hispanic or Latino - Not Hispanic or Latino.

                                                                                                Short(USCDI) US Core ethnicity Extension
                                                                                                Control0..1
                                                                                                This element is affected by the following invariants: ele-1
                                                                                                TypeExtension(US Core Ethnicity Extension) (Complex Extension)
                                                                                                Is Modifierfalse
                                                                                                Must Supportfalse
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                20. Patient.extension:tribalAffiliation
                                                                                                Slice NametribalAffiliation
                                                                                                Definition

                                                                                                Not used in this profile

                                                                                                ShortNot used in this profile
                                                                                                Control0..*
                                                                                                This element is affected by the following invariants: ele-1
                                                                                                TypeExtension(US Core Tribal Affiliation Extension) (Complex Extension)
                                                                                                Is Modifierfalse
                                                                                                Must Supportfalse
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                22. Patient.extension:birthsex
                                                                                                Slice Namebirthsex
                                                                                                Definition

                                                                                                A code classifying the person's sex assigned at birth as specified by the Office of the National Coordinator for Health IT (ONC).

                                                                                                ShortExtension
                                                                                                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(US Core Birth Sex Extension) (Extension Type: code)
                                                                                                Is Modifierfalse
                                                                                                Must Supporttrue
                                                                                                Obligations
                                                                                                  ObligationsActor
                                                                                                  SHOULD:populate-if-knownCreator (Onconova)
                                                                                                  MAY:persistConsumer (Onconova)
                                                                                                  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:sex
                                                                                                  Slice Namesex
                                                                                                  Definition

                                                                                                  Not used in this profile

                                                                                                  ShortNot used in this profile
                                                                                                  Control0..1
                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                  TypeExtension(US Core Sex Extension) (Extension Type: code)
                                                                                                  Is Modifierfalse
                                                                                                  Must Supportfalse
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                  26. Patient.extension:genderIdentity
                                                                                                  Slice NamegenderIdentity
                                                                                                  Definition

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

                                                                                                  ShortExtension
                                                                                                  Comments

                                                                                                  This represents an individual's identity, ascertained by asking them what that identity is.

                                                                                                  Control0..*
                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                  TypeExtension(US Core Gender Identity Extension) (Extension Type: CodeableConcept)
                                                                                                  Is Modifierfalse
                                                                                                  Must Supportfalse
                                                                                                  Obligations
                                                                                                    ObligationsActor
                                                                                                    MAY:populate-if-knownCreator (Onconova)
                                                                                                    MAY:persistConsumer (Onconova)
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                    28. Patient.extension:consentStatus
                                                                                                    Slice NameconsentStatus
                                                                                                    Definition

                                                                                                    The status of whether the patient has given or revoked consent for research use.

                                                                                                    ShortCancer Patient Consent status
                                                                                                    Control1..1
                                                                                                    TypeExtension(Cancer Patient Consent status) (Extension Type: code)
                                                                                                    Is Modifierfalse
                                                                                                    Must Supporttrue
                                                                                                    Obligations
                                                                                                      ObligationsActor
                                                                                                      SHALL:populateCreator (Onconova)
                                                                                                      SHOULD:persistConsumer (Onconova)
                                                                                                      Summaryfalse
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                      30. Patient.extension:clinicalCenter
                                                                                                      Slice NameclinicalCenter
                                                                                                      Definition

                                                                                                      The center or hospital where the patient case original records were recorded.

                                                                                                      ShortCancer Patient Clinical Center
                                                                                                      Control1..1
                                                                                                      TypeExtension(Cancer Patient Clinical Center) (Extension Type: string)
                                                                                                      Is Modifierfalse
                                                                                                      Must Supporttrue
                                                                                                      Obligations
                                                                                                        ObligationsActor
                                                                                                        SHALL:populateCreator (Onconova)
                                                                                                        SHOULD:persistConsumer (Onconova)
                                                                                                        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())
                                                                                                        32. Patient.extension:overallSurvival
                                                                                                        Slice NameoverallSurvival
                                                                                                        Definition

                                                                                                        The duration of time from either the date of diagnosis or the start of treatment for a disease, such as cancer, that patients diagnosed with the disease are still alive. In a clinical trial, measuring the overall survival is one way to see how well a new treatment works.

                                                                                                        ShortCancer Patient Overall Survival
                                                                                                        Control0..1
                                                                                                        TypeExtension(Cancer Patient Overall Survival) (Extension Type: Duration)
                                                                                                        Is Modifierfalse
                                                                                                        Obligations
                                                                                                          ObligationsActor
                                                                                                          MAY:ignoreCreator (Onconova)
                                                                                                          MAY:persistConsumer (Onconova)
                                                                                                          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())
                                                                                                          34. Patient.extension:dataCompletionRate
                                                                                                          Slice NamedataCompletionRate
                                                                                                          Definition

                                                                                                          The percentage of data elements categories that have been completed for a patient.

                                                                                                          ShortCancer Patient Data Completion Rate
                                                                                                          Control0..1
                                                                                                          TypeExtension(Cancer Patient Data Completion Rate) (Extension Type: decimal)
                                                                                                          Is Modifierfalse
                                                                                                          Obligations
                                                                                                            ObligationsActor
                                                                                                            MAY:ignoreCreator (Onconova)
                                                                                                            MAY:persistConsumer (Onconova)
                                                                                                            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())
                                                                                                            36. Patient.extension:contributors
                                                                                                            Slice Namecontributors
                                                                                                            Definition

                                                                                                            The individuals or organizations that contributed to the patient's case data collection.

                                                                                                            ShortCancer Patient Data Contributors
                                                                                                            Control0..*
                                                                                                            TypeExtension(Cancer Patient Data Contributors) (Extension Type: Reference)
                                                                                                            Is Modifierfalse
                                                                                                            Obligations
                                                                                                              ObligationsActor
                                                                                                              MAY:ignoreCreator (Onconova)
                                                                                                              MAY:persistConsumer (Onconova)
                                                                                                              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())
                                                                                                              38. Patient.extension:endOfRecords
                                                                                                              Slice NameendOfRecords
                                                                                                              Definition

                                                                                                              Indicates the last known record date of a patient.

                                                                                                              ShortCancer Patient End of Records
                                                                                                              Control0..1
                                                                                                              TypeExtension(Cancer Patient End of Records) (Extension Type: date)
                                                                                                              Is Modifierfalse
                                                                                                              Must Supporttrue
                                                                                                              Obligations
                                                                                                                ObligationsActor
                                                                                                                SHALL:populate-if-knownCreator (Onconova)
                                                                                                                SHOULD:persistConsumer (Onconova)
                                                                                                                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())
                                                                                                                40. Patient.modifierExtension
                                                                                                                Definition

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

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

                                                                                                                ShortExtensions that cannot be ignored
                                                                                                                Comments

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

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

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

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

                                                                                                                An identifier for this patient.

                                                                                                                Short(USCDI) An identifier for this patient
                                                                                                                NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                                                                Control2..*
                                                                                                                TypeIdentifier
                                                                                                                Is Modifierfalse
                                                                                                                Must Supporttrue
                                                                                                                Summarytrue
                                                                                                                Requirements

                                                                                                                Patients are almost always assigned specific numerical identifiers.

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

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

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

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

                                                                                                                  ShortAdditional content defined by implementations
                                                                                                                  Comments

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

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

                                                                                                                    The purpose of this identifier.

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

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

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

                                                                                                                    Identifies the purpose for this identifier, if known .

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

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

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

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

                                                                                                                    ShortDescription of identifier
                                                                                                                    Comments

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

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

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

                                                                                                                    TypeCodeableConcept
                                                                                                                    Is Modifierfalse
                                                                                                                    Summarytrue
                                                                                                                    Requirements

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

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

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

                                                                                                                    Short(USCDI) The namespace for the identifier value
                                                                                                                    Comments

                                                                                                                    Identifier.system is always case sensitive.

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

                                                                                                                    ExampleGeneral: http://www.acme.com/identifiers/patient
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    54. Patient.identifier.value
                                                                                                                    Definition

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

                                                                                                                    Short(USCDI) The 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
                                                                                                                    Typestring
                                                                                                                    Is Modifierfalse
                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                    Must Supporttrue
                                                                                                                    Summarytrue
                                                                                                                    ExampleGeneral: 123456
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    56. Patient.identifier.period
                                                                                                                    Definition

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

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

                                                                                                                    Organization that issued/manages the identifier.

                                                                                                                    ShortOrganization that issued id (may be just text)
                                                                                                                    Comments

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

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

                                                                                                                    An identifier for this patient.

                                                                                                                    ShortOnconova Logical Pseudoidentifier
                                                                                                                    NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                                                                    Control1..*
                                                                                                                    TypeIdentifier
                                                                                                                    Is Modifierfalse
                                                                                                                    Must Supporttrue
                                                                                                                    Obligations
                                                                                                                      ObligationsActor
                                                                                                                      SHALL:populateCreator (Onconova)
                                                                                                                      SHOULD:persistConsumer (Onconova)
                                                                                                                      Summarytrue
                                                                                                                      Requirements

                                                                                                                      Patients are almost always assigned specific numerical identifiers.

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

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

                                                                                                                      ShortAdditional content defined by implementations
                                                                                                                      Comments

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

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

                                                                                                                        The purpose of this identifier.

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

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

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

                                                                                                                        Identifies the purpose for this identifier, if known .

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

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

                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        68. Patient.identifier:onconovaIdentifier.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
                                                                                                                        BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                                                                                                        (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

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

                                                                                                                        TypeCodeableConcept
                                                                                                                        Is Modifierfalse
                                                                                                                        Summarytrue
                                                                                                                        Requirements

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

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

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

                                                                                                                        Short(USCDI) The namespace for the identifier value
                                                                                                                        Comments

                                                                                                                        Identifier.system is always case sensitive.

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

                                                                                                                        Pattern ValueOnconova
                                                                                                                        ExampleGeneral: http://www.acme.com/identifiers/patient
                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        72. Patient.identifier:onconovaIdentifier.value
                                                                                                                        Definition

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

                                                                                                                        Short(USCDI) The 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
                                                                                                                        Typestring
                                                                                                                        Is Modifierfalse
                                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                        Must Supporttrue
                                                                                                                        Summarytrue
                                                                                                                        ExampleGeneral: 123456
                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        74. Patient.identifier:onconovaIdentifier.period
                                                                                                                        Definition

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

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

                                                                                                                        Organization that issued/manages the identifier.

                                                                                                                        ShortOrganization that issued id (may be just text)
                                                                                                                        Comments

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

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

                                                                                                                        An identifier for this patient.

                                                                                                                        ShortClinical Identifier from Clinical Center
                                                                                                                        NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                                                                        Control1..*
                                                                                                                        TypeIdentifier
                                                                                                                        Is Modifierfalse
                                                                                                                        Must Supporttrue
                                                                                                                        Obligations
                                                                                                                          ObligationsActor
                                                                                                                          SHALL:populateCreator (Onconova)
                                                                                                                          SHOULD:persistConsumer (Onconova)
                                                                                                                          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()))
                                                                                                                          80. Patient.identifier:clinicalIdentifier.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
                                                                                                                          82. Patient.identifier:clinicalIdentifier.extension
                                                                                                                          Definition

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

                                                                                                                          ShortAdditional content defined by implementations
                                                                                                                          Comments

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

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

                                                                                                                            The purpose of this identifier.

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

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

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

                                                                                                                            Identifies the purpose for this identifier, if known .

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

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

                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            86. Patient.identifier:clinicalIdentifier.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
                                                                                                                            BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                                                                                                            (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

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

                                                                                                                            TypeCodeableConcept
                                                                                                                            Is Modifierfalse
                                                                                                                            Summarytrue
                                                                                                                            Requirements

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

                                                                                                                            Pattern Value{
                                                                                                                              "coding" : [{
                                                                                                                                "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                                                                                                                                "code" : "MR",
                                                                                                                                "display" : "Medical Record Number"
                                                                                                                              }]
                                                                                                                            }
                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            88. Patient.identifier:clinicalIdentifier.system
                                                                                                                            Definition

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

                                                                                                                            Short(USCDI) The namespace for the identifier value
                                                                                                                            Comments

                                                                                                                            Identifier.system is always case sensitive.

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

                                                                                                                            ExampleGeneral: http://www.acme.com/identifiers/patient
                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            90. Patient.identifier:clinicalIdentifier.value
                                                                                                                            Definition

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

                                                                                                                            Short(USCDI) The 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
                                                                                                                            Typestring
                                                                                                                            Is Modifierfalse
                                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                            Must Supporttrue
                                                                                                                            Summarytrue
                                                                                                                            ExampleGeneral: 123456
                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            92. Patient.identifier:clinicalIdentifier.period
                                                                                                                            Definition

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

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

                                                                                                                            Organization that issued/manages the identifier.

                                                                                                                            ShortOrganization that issued id (may be just text)
                                                                                                                            Comments

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

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

                                                                                                                            Whether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules.

                                                                                                                            It is often used to filter patient lists to exclude inactive patients

                                                                                                                            Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death.

                                                                                                                            ShortWhether this patient's record is in active use
                                                                                                                            Comments

                                                                                                                            If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient.

                                                                                                                            Control0..1
                                                                                                                            Typeboolean
                                                                                                                            Is Modifiertrue because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid
                                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                            Summarytrue
                                                                                                                            Requirements

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

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

                                                                                                                            Not used in this profile

                                                                                                                            ShortNot used in this profile
                                                                                                                            Comments

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

                                                                                                                            Control1..*
                                                                                                                            TypeHumanName
                                                                                                                            Is Modifierfalse
                                                                                                                            Must Supporttrue
                                                                                                                            Summarytrue
                                                                                                                            Requirements

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

                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            us-core-6: At least name.given and/or name.family are present or, if neither is available, the Data Absent Reason Extension is present. ((family.exists() or given.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists())
                                                                                                                            100. Patient.name.id
                                                                                                                            Definition

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

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

                                                                                                                            An Extension

                                                                                                                            ShortExtension
                                                                                                                            Control1..*
                                                                                                                            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.name.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                            • value @ url
                                                                                                                            • 104. Patient.name.extension:anonymizedEntry
                                                                                                                              Slice NameanonymizedEntry
                                                                                                                              Definition

                                                                                                                              Provides a reason why the expected value or elements in the element that is extended are missing.

                                                                                                                              Shortunknown | asked | temp | notasked | masked | unsupported | astext | error
                                                                                                                              Control1..1
                                                                                                                              TypeExtension(Data Absent Reason) (Extension Type: code)
                                                                                                                              Is Modifierfalse
                                                                                                                              Summaryfalse
                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                              106. Patient.name.extension:anonymizedEntry.id
                                                                                                                              Definition

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

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

                                                                                                                              An Extension

                                                                                                                              ShortExtension
                                                                                                                              Control0..0
                                                                                                                              TypeExtension
                                                                                                                              Is Modifierfalse
                                                                                                                              Summaryfalse
                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                              SlicingThis element introduces a set of slices on Patient.name.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                              • value @ url
                                                                                                                              • 110. Patient.name.extension:anonymizedEntry.url
                                                                                                                                Definition

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

                                                                                                                                Shortidentifies the meaning of the extension
                                                                                                                                Comments

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

                                                                                                                                Control1..1
                                                                                                                                Typeuri
                                                                                                                                Is Modifierfalse
                                                                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                Summaryfalse
                                                                                                                                Fixed Valuehttp://hl7.org/fhir/StructureDefinition/data-absent-reason
                                                                                                                                112. Patient.name.extension:anonymizedEntry.value[x]
                                                                                                                                Definition

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

                                                                                                                                ShortValue of extension
                                                                                                                                Control1..1
                                                                                                                                This element is affected by the following invariants: ext-1
                                                                                                                                BindingThe codes SHALL be taken from DataAbsentReason
                                                                                                                                (required to http://hl7.org/fhir/ValueSet/data-absent-reason)
                                                                                                                                Typecode
                                                                                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                Is Modifierfalse
                                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                Summaryfalse
                                                                                                                                Pattern Valuemasked
                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                114. Patient.name.use
                                                                                                                                Definition

                                                                                                                                Identifies the purpose for this name.

                                                                                                                                Short(USCDI) usual | official | temp | nickname | anonymous | old | maiden
                                                                                                                                Comments

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

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

                                                                                                                                The use of a human name.

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

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

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

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

                                                                                                                                ShortText representation of the full name
                                                                                                                                Comments

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

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

                                                                                                                                A renderable, unencoded form.

                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                118. 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.

                                                                                                                                Short(USCDI) Family 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: us-core-6
                                                                                                                                Typestring
                                                                                                                                Is Modifierfalse
                                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                Must Supporttrue
                                                                                                                                Summarytrue
                                                                                                                                Alternate Namessurname
                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                120. Patient.name.given
                                                                                                                                Definition

                                                                                                                                Given name.

                                                                                                                                Short(USCDI) Given 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: us-core-6
                                                                                                                                Typestring
                                                                                                                                Is Modifierfalse
                                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                Must Supporttrue
                                                                                                                                Summarytrue
                                                                                                                                Alternate Namesfirst name, middle name
                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                122. Patient.name.prefix
                                                                                                                                Definition

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

                                                                                                                                ShortParts that come before the name
                                                                                                                                Control0..*
                                                                                                                                Typestring
                                                                                                                                Is Modifierfalse
                                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                Summarytrue
                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                124. 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.

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

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

                                                                                                                                Short(USCDI) Time period when name was/is in use
                                                                                                                                Control0..1
                                                                                                                                TypePeriod
                                                                                                                                Is Modifierfalse
                                                                                                                                Must Supportfalse
                                                                                                                                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()))
                                                                                                                                128. Patient.telecom
                                                                                                                                Definition

                                                                                                                                Not used in this profile

                                                                                                                                ShortNot used in this profile
                                                                                                                                Comments

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

                                                                                                                                Control0..*
                                                                                                                                TypeContactPoint
                                                                                                                                Is Modifierfalse
                                                                                                                                Must Supportfalse
                                                                                                                                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()))
                                                                                                                                130. Patient.telecom.id
                                                                                                                                Definition

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

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

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

                                                                                                                                ShortAdditional content defined by implementations
                                                                                                                                Comments

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

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

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

                                                                                                                                  Short(USCDI) phone | fax | email | pager | url | sms | other
                                                                                                                                  Control1..1
                                                                                                                                  This element is affected by the following invariants: cpt-2
                                                                                                                                  BindingThe codes SHALL be taken from ContactPointSystem
                                                                                                                                  (required to http://hl7.org/fhir/ValueSet/contact-point-system)

                                                                                                                                  Telecommunications form for contact point.

                                                                                                                                  Typecode
                                                                                                                                  Is Modifierfalse
                                                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                  Must Supporttrue
                                                                                                                                  Summarytrue
                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                  136. 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).

                                                                                                                                  Short(USCDI) The 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
                                                                                                                                  Typestring
                                                                                                                                  Is Modifierfalse
                                                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                  Must Supporttrue
                                                                                                                                  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()))
                                                                                                                                  138. Patient.telecom.use
                                                                                                                                  Definition

                                                                                                                                  Identifies the purpose for the contact point.

                                                                                                                                  Short(USCDI) home | work | temp | old | mobile - purpose of this contact point
                                                                                                                                  Comments

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

                                                                                                                                  Control0..1
                                                                                                                                  BindingThe codes SHALL be taken from ContactPointUse
                                                                                                                                  (required to http://hl7.org/fhir/ValueSet/contact-point-use)
                                                                                                                                  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
                                                                                                                                  Must Supporttrue
                                                                                                                                  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()))
                                                                                                                                  140. Patient.telecom.rank
                                                                                                                                  Definition

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

                                                                                                                                  ShortSpecify preferred order of use (1 = highest)
                                                                                                                                  Comments

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

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

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

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

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

                                                                                                                                  Short(USCDI) male | female | other | unknown
                                                                                                                                  Comments

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

                                                                                                                                  Control1..1
                                                                                                                                  BindingThe codes SHALL be taken from AdministrativeGender
                                                                                                                                  (required to http://hl7.org/fhir/ValueSet/administrative-gender)
                                                                                                                                  Typecode
                                                                                                                                  Is Modifierfalse
                                                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                  Must Supporttrue
                                                                                                                                  Obligations
                                                                                                                                    ObligationsActor
                                                                                                                                    SHALL:populateCreator (Onconova)
                                                                                                                                    SHOULD:persistConsumer (Onconova)
                                                                                                                                    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()))
                                                                                                                                    146. Patient.birthDate
                                                                                                                                    Definition

                                                                                                                                    The date of birth for the individual.

                                                                                                                                    ShortDate of birth of the patient normalized to the first day of the month
                                                                                                                                    Comments

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

                                                                                                                                    Control1..1
                                                                                                                                    Typedate
                                                                                                                                    Is Modifierfalse
                                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                    Must Supporttrue
                                                                                                                                    Obligations
                                                                                                                                      ObligationsActor
                                                                                                                                      SHALL:populateCreator (Onconova)
                                                                                                                                      SHOULD:persistConsumer (Onconova)
                                                                                                                                      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
                                                                                                                                      148. 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
                                                                                                                                      150. Patient.birthDate.extension
                                                                                                                                      Definition

                                                                                                                                      An Extension

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

                                                                                                                                        The approximate age of the patient.

                                                                                                                                        ShortCancer Patient Age
                                                                                                                                        Control0..1
                                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                                        TypeExtension(Cancer Patient Age) (Extension Type: integer)
                                                                                                                                        Is Modifierfalse
                                                                                                                                        Obligations
                                                                                                                                          ObligationsActor
                                                                                                                                          MAY:ignoreCreator (Onconova)
                                                                                                                                          MAY:persistConsumer (Onconova)
                                                                                                                                          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())
                                                                                                                                          154. Patient.birthDate.extension:ageAtDiagnosis
                                                                                                                                          Slice NameageAtDiagnosis
                                                                                                                                          Definition

                                                                                                                                          The approximate age of the patient at the time of diagnosis of the disease.

                                                                                                                                          ShortCancer Patient Age at Diagnosis
                                                                                                                                          Control0..1
                                                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                                                          TypeExtension(Cancer Patient Age at Diagnosis) (Extension Type: integer)
                                                                                                                                          Is Modifierfalse
                                                                                                                                          Obligations
                                                                                                                                            ObligationsActor
                                                                                                                                            MAY:ignoreCreator (Onconova)
                                                                                                                                            MAY:persistConsumer (Onconova)
                                                                                                                                            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())
                                                                                                                                            156. 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
                                                                                                                                            158. Patient.deceased[x]
                                                                                                                                            Definition

                                                                                                                                            Indicates if the individual is deceased or not.

                                                                                                                                            ShortDate of death of the patient, if applicable
                                                                                                                                            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.

                                                                                                                                            Control1..1
                                                                                                                                            TypedateTime
                                                                                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                            Is Modifiertrue because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
                                                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                            Must Supporttrue
                                                                                                                                            Obligations
                                                                                                                                              ObligationsActor
                                                                                                                                              SHALL:populate-if-knownCreator (Onconova)
                                                                                                                                              SHOULD:persistConsumer (Onconova)
                                                                                                                                              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()))
                                                                                                                                              160. 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
                                                                                                                                              162. Patient.deceased[x].extension
                                                                                                                                              Definition

                                                                                                                                              An Extension

                                                                                                                                              ShortExtension
                                                                                                                                              Control2..*
                                                                                                                                              TypeExtension
                                                                                                                                              Is Modifierfalse
                                                                                                                                              Summaryfalse
                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                              SlicingThis element introduces a set of slices on Patient.deceased[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                              • value @ url
                                                                                                                                              • 164. Patient.deceased[x].extension:vitalStatus
                                                                                                                                                Slice NamevitalStatus
                                                                                                                                                Definition

                                                                                                                                                The status of whether the patient is alive or deceased or unknown.

                                                                                                                                                ShortCancer Patient Vital status
                                                                                                                                                Control1..1
                                                                                                                                                This element is affected by the following invariants: ele-1
                                                                                                                                                TypeExtension(Cancer Patient Vital status) (Extension Type: CodeableConcept)
                                                                                                                                                Is Modifierfalse
                                                                                                                                                Must Supporttrue
                                                                                                                                                Obligations
                                                                                                                                                  ObligationsActor
                                                                                                                                                  SHALL:populateCreator (Onconova)
                                                                                                                                                  SHOULD:persistConsumer (Onconova)
                                                                                                                                                  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())
                                                                                                                                                  166. Patient.deceased[x].extension:causeOfDeath
                                                                                                                                                  Slice NamecauseOfDeath
                                                                                                                                                  Definition

                                                                                                                                                  The cause of death for the patient.

                                                                                                                                                  ShortCancer Patient Cause of Death
                                                                                                                                                  Control1..1
                                                                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                                                                  TypeExtension(Cancer Patient Cause of Death) (Extension Type: CodeableConcept)
                                                                                                                                                  Is Modifierfalse
                                                                                                                                                  Must Supporttrue
                                                                                                                                                  Obligations
                                                                                                                                                    ObligationsActor
                                                                                                                                                    SHALL:populateCreator (Onconova)
                                                                                                                                                    SHOULD:persistConsumer (Onconova)
                                                                                                                                                    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())
                                                                                                                                                    168. 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
                                                                                                                                                    170. Patient.address
                                                                                                                                                    Definition

                                                                                                                                                    Not used in this profile

                                                                                                                                                    ShortNot used in this profile
                                                                                                                                                    Comments

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

                                                                                                                                                    Control0..*
                                                                                                                                                    TypeAddress
                                                                                                                                                    Is Modifierfalse
                                                                                                                                                    Must Supporttrue
                                                                                                                                                    Summarytrue
                                                                                                                                                    Requirements

                                                                                                                                                    May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.

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

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

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

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

                                                                                                                                                    ShortAdditional content defined by implementations
                                                                                                                                                    Comments

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

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

                                                                                                                                                      The purpose of this address.

                                                                                                                                                      Short(USCDI) home | work | temp | old | billing - purpose of this address
                                                                                                                                                      Comments

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

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

                                                                                                                                                      The use of an address.

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

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

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

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

                                                                                                                                                      Shortpostal | physical | both
                                                                                                                                                      Comments

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

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

                                                                                                                                                      The type of an address (physical / postal).

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

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

                                                                                                                                                      ShortText representation of the address
                                                                                                                                                      Comments

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

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

                                                                                                                                                      A renderable, unencoded form.

                                                                                                                                                      ExampleGeneral: 137 Nowhere Street, Erewhon 9132
                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                      182. 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.

                                                                                                                                                      Short(USCDI) Street name, number, direction & P.O. Box etc.
                                                                                                                                                      Control0..*
                                                                                                                                                      Typestring
                                                                                                                                                      Is Modifierfalse
                                                                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                      Must Supporttrue
                                                                                                                                                      Summarytrue
                                                                                                                                                      ExampleGeneral: 137 Nowhere Street
                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                      184. Patient.address.city
                                                                                                                                                      Definition

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

                                                                                                                                                      Short(USCDI) Name of city, town etc.
                                                                                                                                                      Control0..1
                                                                                                                                                      Typestring
                                                                                                                                                      Is Modifierfalse
                                                                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                      Must Supporttrue
                                                                                                                                                      Summarytrue
                                                                                                                                                      Alternate NamesMunicpality
                                                                                                                                                      ExampleGeneral: Erewhon
                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                      186. Patient.address.district
                                                                                                                                                      Definition

                                                                                                                                                      The name of the administrative area (county).

                                                                                                                                                      ShortDistrict name (aka county)
                                                                                                                                                      Comments

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

                                                                                                                                                      Control0..1
                                                                                                                                                      Typestring
                                                                                                                                                      Is Modifierfalse
                                                                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                      Summarytrue
                                                                                                                                                      Alternate NamesCounty
                                                                                                                                                      ExampleGeneral: Madison
                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                      188. 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).

                                                                                                                                                      Short(USCDI) Sub-unit of country (abbreviations ok)
                                                                                                                                                      Control0..1
                                                                                                                                                      BindingUnless not suitable, these codes SHALL be taken from USPS Two Letter Alphabetic Codes
                                                                                                                                                      (extensible to http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state)

                                                                                                                                                      Two Letter USPS alphabetic codes.

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

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

                                                                                                                                                      Short(USCDI) US Zip Codes
                                                                                                                                                      Control0..1
                                                                                                                                                      Typestring
                                                                                                                                                      Is Modifierfalse
                                                                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                      Must Supporttrue
                                                                                                                                                      Summarytrue
                                                                                                                                                      Alternate NamesZip, Zip Code
                                                                                                                                                      ExampleGeneral: 9132
                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                      192. Patient.address.country
                                                                                                                                                      Definition

                                                                                                                                                      Country - a nation as commonly understood or generally accepted.

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

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

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

                                                                                                                                                      Time period when address was/is in use.

                                                                                                                                                      Short(USCDI) Time period when address was/is in use
                                                                                                                                                      Control0..1
                                                                                                                                                      TypePeriod
                                                                                                                                                      Is Modifierfalse
                                                                                                                                                      Summarytrue
                                                                                                                                                      Requirements

                                                                                                                                                      Allows addresses to be placed in historical context.

                                                                                                                                                      ExampleGeneral: { "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()))
                                                                                                                                                      196. Patient.maritalStatus
                                                                                                                                                      Definition

                                                                                                                                                      Not used in this profile

                                                                                                                                                      ShortNot used in this profile
                                                                                                                                                      Control0..1
                                                                                                                                                      BindingUnless not suitable, these codes SHALL be taken from Marital Status Codes
                                                                                                                                                      (extensible to http://hl7.org/fhir/ValueSet/marital-status)

                                                                                                                                                      The domestic partnership status of a person.

                                                                                                                                                      TypeCodeableConcept
                                                                                                                                                      Is Modifierfalse
                                                                                                                                                      Summaryfalse
                                                                                                                                                      Requirements

                                                                                                                                                      Most, if not all systems capture it.

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

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

                                                                                                                                                      ShortWhether patient is part of a multiple birth
                                                                                                                                                      Comments

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

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

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

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

                                                                                                                                                      Not used in this profile

                                                                                                                                                      ShortNot used in this profile
                                                                                                                                                      Comments

                                                                                                                                                      Guidelines:

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

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

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

                                                                                                                                                      Not used in this profile

                                                                                                                                                      ShortNot used in this profile
                                                                                                                                                      Comments

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

                                                                                                                                                      Control0..*
                                                                                                                                                      TypeBackboneElement
                                                                                                                                                      Is Modifierfalse
                                                                                                                                                      Summaryfalse
                                                                                                                                                      Requirements

                                                                                                                                                      Need to track people you can contact about the patient.

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

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

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

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

                                                                                                                                                      ShortAdditional content defined by implementations
                                                                                                                                                      Comments

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

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

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

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

                                                                                                                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                      Comments

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

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

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

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

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

                                                                                                                                                      ShortThe kind of relationship
                                                                                                                                                      Control0..*
                                                                                                                                                      BindingUnless not suitable, these codes SHALL be taken from PatientContactRelationship
                                                                                                                                                      (extensible to http://hl7.org/fhir/ValueSet/patient-contactrelationship)

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

                                                                                                                                                      TypeCodeableConcept
                                                                                                                                                      Is Modifierfalse
                                                                                                                                                      Summaryfalse
                                                                                                                                                      Requirements

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

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

                                                                                                                                                      A name associated with the contact person.

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

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

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

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

                                                                                                                                                      ShortA contact detail for the person
                                                                                                                                                      Comments

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

                                                                                                                                                      Control0..*
                                                                                                                                                      TypeContactPoint
                                                                                                                                                      Is Modifierfalse
                                                                                                                                                      Summaryfalse
                                                                                                                                                      Requirements

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

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

                                                                                                                                                      Address for the contact person.

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

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

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

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

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

                                                                                                                                                      The gender of a person used for administrative purposes.

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

                                                                                                                                                      Needed to address the person correctly.

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

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

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

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

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

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

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

                                                                                                                                                      Not used in this profile

                                                                                                                                                      ShortNot used in this profile
                                                                                                                                                      Comments

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

                                                                                                                                                      Control0..*
                                                                                                                                                      TypeBackboneElement
                                                                                                                                                      Is Modifierfalse
                                                                                                                                                      Must Supportfalse
                                                                                                                                                      Summaryfalse
                                                                                                                                                      Requirements

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

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

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

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

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

                                                                                                                                                      ShortAdditional content defined by implementations
                                                                                                                                                      Comments

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

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

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

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

                                                                                                                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                      Comments

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

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

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

                                                                                                                                                      Alternate Namesextensions, user content, modifiers
                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                      232. 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.

                                                                                                                                                      Short(USCDI) The language which can be used to communicate with the patient about his or her health
                                                                                                                                                      Comments

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

                                                                                                                                                      Control1..1
                                                                                                                                                      BindingUnless not suitable, these codes SHALL be taken from Language codes with language and optionally a region modifier
                                                                                                                                                      (extensible to http://hl7.org/fhir/us/core/ValueSet/simple-language)
                                                                                                                                                      TypeCodeableConcept
                                                                                                                                                      Is Modifierfalse
                                                                                                                                                      Must Supporttrue
                                                                                                                                                      Summaryfalse
                                                                                                                                                      Requirements

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

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

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

                                                                                                                                                      ShortLanguage preference indicator
                                                                                                                                                      Comments

                                                                                                                                                      This language is specifically identified for communicating healthcare information.

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

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

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

                                                                                                                                                      Not used in this profile

                                                                                                                                                      ShortNot used in this profile
                                                                                                                                                      Comments

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

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

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

                                                                                                                                                      Organization that is the custodian of the patient record.

                                                                                                                                                      ShortOrganization that is the custodian of the patient record
                                                                                                                                                      Comments

                                                                                                                                                      There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association).

                                                                                                                                                      Control0..1
                                                                                                                                                      TypeReference(Organization)
                                                                                                                                                      Is Modifierfalse
                                                                                                                                                      Summarytrue
                                                                                                                                                      Requirements

                                                                                                                                                      Need to know who recognizes this patient record, manages and updates it.

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

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

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

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

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

                                                                                                                                                      There are multiple use cases:

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

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

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

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

                                                                                                                                                      ShortAdditional content defined by implementations
                                                                                                                                                      Comments

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

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

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

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

                                                                                                                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                      Comments

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

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

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

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

                                                                                                                                                      The other patient resource that the link refers to.

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

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

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

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

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

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

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