TRxHubPatient
type: StructureDefinition
node role: treeRoot
id:
  v: TRxHubPatient
text:
  status:
    v: extensions
  div:
    v: Generated Narrative: StructureDefinition TRxHubPatient Name Flags Card. Type Description & Constraints<img src="[binary]" alt="doco" style="background-color: inherit"/> Patient 0..* Patient Information about an individual or animal receiving health care services #xD; identifier S 1..1 Identifier An identifier for this patient #xD; name S 1..* HumanName A name associated with the patient #xD; gender S 0..1 code male | female | other | unknown #xD; birthDate S 0..1 date The date of birth for the individual #xD; <img src="[binary]" alt="doco" style="background-color: inherit"/> Documentation for this format
url:
  v: https://trxhub.mediservice.ch/fhir/StructureDefinition/TRxHubPatient
  l: TRxHubPatient
version:
  v: 0.1.0
name:
  v: TRxHubPatient
status:
  v: draft
date:
  v: 2026-04-14T09:29:30+00:00
fhir version:
  v: 4.0.1
mapping:
  identity:
    v: rim
  uri:
    v: http://hl7.org/v3
    l: v3
  name:
    v: RIM Mapping
mapping:
  identity:
    v: cda
  uri:
    v: http://hl7.org/v3/cda
    l: cda
  name:
    v: CDA (R2)
mapping:
  identity:
    v: w5
  uri:
    v: http://hl7.org/fhir/fivews
    l: fivews
  name:
    v: FiveWs Pattern Mapping
mapping:
  identity:
    v: v2
  uri:
    v: http://hl7.org/v2
    l: v2
  name:
    v: HL7 v2 Mapping
mapping:
  identity:
    v: loinc
  uri:
    v: http://loinc.org
    l: loinc.org
  name:
    v: LOINC code for the element
kind:
  v: resource
abstract:
  v: false
type:
  v: Patient
  l: Patient
base definition:
  v: http://hl7.org/fhir/StructureDefinition/Patient
  l: Patient
derivation:
  v: constraint
snapshot:
  extension:
    url:
      v: http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version
      l: snapshot-base-version
    value: String
      v: 4.0.1
  element:
    id:
      v: Patient
    path:
      v: Patient
    short:
      v: Information about an individual or animal receiving health care services
    definition:
      v: Demographics and other administrative information about an individual or animal receiving care or other health-related services.
    alias:
      v: SubjectOfCare Client Resident
    min:
      v: 0
    max:
      v: *
    base:
      path:
        v: Patient
      min:
        v: 0
      max:
        v: *
    constraint:
      key:
        v: dom-2
      severity:
        v: error
      human:
        v: If the resource is contained in another resource, it SHALL NOT contain nested Resources
      expression:
        v: contained.contained.empty()
      xpath:
        v: not(parent::f:contained and f:contained)
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        l: DomainResource
    constraint:
      key:
        v: dom-3
      severity:
        v: error
      human:
        v: 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
      expression:
        v: 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()
      xpath:
        v: not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        l: DomainResource
    constraint:
      key:
        v: dom-4
      severity:
        v: error
      human:
        v: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
      expression:
        v: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
      xpath:
        v: not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        l: DomainResource
    constraint:
      key:
        v: dom-5
      severity:
        v: error
      human:
        v: If a resource is contained in another resource, it SHALL NOT have a security label
      expression:
        v: contained.meta.security.empty()
      xpath:
        v: not(exists(f:contained/*/f:meta/f:security))
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        l: DomainResource
    constraint:
      extension:
        value: Boolean
      extension:
        value: Markdown
      key:
        v: dom-6
      severity:
        v: warning
      human:
        v: A resource should have narrative for robust management
      expression:
        v: text.`div`.exists()
      xpath:
        v: exists(f:text/h:div)
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        l: DomainResource
    is modifier:
      v: false
    is summary:
      v: false
    mapping:
      identity:
        v: rim
      map:
        v: Entity. Role, or Act
    mapping:
      identity:
        v: rim
      map:
        v: Patient[classCode=PAT]
    mapping:
      identity:
        v: cda
      map:
        v: ClinicalDocument.recordTarget.patientRole
  element:
    id:
      v: Patient.id
    path:
      v: Patient.id
    short:
      v: Logical id of this artifact

Boolean
v: true

Markdown
v: When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time.

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

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

v: 0

v: 1

path:
  v: Resource.id
min:
  v: 0
max:
  v: 1

extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
    l: structuredefinition-fhir-type
  value: Url
    v: id
    l: id
code:
  v: http://hl7.org/fhirpath/System.String
  l: System.String

v: false

v: true

id:
  v: Patient.meta
path:
  v: Patient.meta
short:
  v: Metadata about the resource
definition:
  v: 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.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Resource.meta
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Meta
    l: Meta
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true

id:
  v: Patient.implicitRules
path:
  v: Patient.implicitRules
short:
  v: A set of rules under which this content was created
definition:
  v: 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.
comment:
  v: 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.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Resource.implicitRules
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: uri
    l: uri
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: true
is modifier reason:
  v: 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
is summary:
  v: true

id:
  v: Patient.language
path:
  v: Patient.language
short:
  v: Language of the resource content
definition:
  v: The base language in which the resource is written.
comment:
  v: 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).
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Resource.language
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
    l: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet
      l: elementdefinition-maxValueSet
    value: Canonical
      v: http://hl7.org/fhir/ValueSet/all-languages
      l: all-languages
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: Language
  strength:
    v: preferred
  description:
    v: A human language.
  value set:
    v: http://hl7.org/fhir/ValueSet/languages|4.0.1
    l: http://hl7.org/fhir/ValueSet/languages

id:
  v: Patient.text
path:
  v: Patient.text
short:
  v: Text summary of the resource, for human interpretation
definition:
  v: 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.
comment:
  v: 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.
alias:
  v: narrative
alias:
  v: html
alias:
  v: xhtml
alias:
  v: display
min:
  v: 0
max:
  v: 1
base:
  path:
    v: DomainResource.text
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Narrative
    l: Narrative
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: Act.text?

id:
  v: Patient.contained
path:
  v: Patient.contained
short:
  v: Contained, inline Resources
definition:
  v: 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.
comment:
  v: 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.
alias:
  v: inline resources
alias:
  v: anonymous resources
alias:
  v: contained resources
min:
  v: 0
max:
  v: *
base:
  path:
    v: DomainResource.contained
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Resource
    l: Resource
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Patient.extension
path:
  v: Patient.extension
short:
  v: Additional content defined by implementations
definition:
  v: 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.
comment:
  v: 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.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: DomainResource.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Patient.modifierExtension
path:
  v: Patient.modifierExtension
short:
  v: Extensions that cannot be ignored
definition:
  v: 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).
comment:
  v: 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.
requirements:
  v: 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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: DomainResource.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Patient.identifier
path:
  v: Patient.identifier
short:
  v: An identifier for this patient
definition:
  v: An identifier for this patient.
requirements:
  v: Patients are almost always assigned specific numerical identifiers.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Patient.identifier
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Identifier
    l: Identifier
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: true
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.identifier
mapping:
  identity:
    v: v2
  map:
    v: PID-3
mapping:
  identity:
    v: rim
  map:
    v: id
mapping:
  identity:
    v: cda
  map:
    v: .id

id:
  v: Patient.active
path:
  v: Patient.active
short:
  v: Whether this patient's record is in active use
definition:
  v: 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.
comment:
  v: If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient.
requirements:
  v: Need to be able to mark a patient record as not to be used because it was created in error.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Patient.active
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: boolean
    l: boolean
meaning when missing:
  v: This resource is generally assumed to be active if no value is provided for the active element
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: true
is modifier reason:
  v: 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
is summary:
  v: true
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.status
mapping:
  identity:
    v: rim
  map:
    v: statusCode
mapping:
  identity:
    v: cda
  map:
    v: n/a

id:
  v: Patient.name
path:
  v: Patient.name
short:
  v: A name associated with the patient
definition:
  v: A name associated with the individual.
comment:
  v: 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.
requirements:
  v: Need to be able to track the patient by multiple names. Examples are your official name and a partner name.
min:
  v: 1
max:
  v: *
base:
  path:
    v: Patient.name
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: HumanName
    l: HumanName
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: true
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: PID-5, PID-9
mapping:
  identity:
    v: rim
  map:
    v: name
mapping:
  identity:
    v: cda
  map:
    v: .patient.name

id:
  v: Patient.telecom
path:
  v: Patient.telecom
short:
  v: A contact detail for the individual
definition:
  v: A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted.
comment:
  v: 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).
requirements:
  v: People have (primary) ways to contact them in some way such as phone, email.
min:
  v: 0
max:
  v: *
base:
  path:
    v: Patient.telecom
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: ContactPoint
    l: ContactPoint
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: PID-13, PID-14, PID-40
mapping:
  identity:
    v: rim
  map:
    v: telecom
mapping:
  identity:
    v: cda
  map:
    v: .telecom

id:
  v: Patient.gender
path:
  v: Patient.gender
short:
  v: male | female | other | unknown
definition:
  v: Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes.
comment:
  v: 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.
requirements:
  v: Needed for identification of the individual, in combination with (at least) name and birth date.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Patient.gender
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
    l: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: true
is modifier:
  v: false
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: AdministrativeGender
  strength:
    v: required
  description:
    v: The gender of a person used for administrative purposes.
  value set:
    v: http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1
    l: http://hl7.org/fhir/ValueSet/administrative-gender
mapping:
  identity:
    v: v2
  map:
    v: PID-8
mapping:
  identity:
    v: rim
  map:
    v: player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender
mapping:
  identity:
    v: cda
  map:
    v: .patient.administrativeGenderCode

id:
  v: Patient.birthDate
path:
  v: Patient.birthDate
short:
  v: The date of birth for the individual
definition:
  v: The date of birth for the individual.
comment:
  v: 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).
requirements:
  v: Age of the individual drives many clinical processes.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Patient.birthDate
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: date
    l: date
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: true
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: PID-7
mapping:
  identity:
    v: rim
  map:
    v: player[classCode=PSN|ANM and determinerCode=INSTANCE]/birthTime
mapping:
  identity:
    v: cda
  map:
    v: .patient.birthTime
mapping:
  identity:
    v: loinc
  map:
    v: 21112-8

id:
  v: Patient.deceased[x]
path:
  v: Patient.deceased[x]
short:
  v: Indicates if the individual is deceased or not
definition:
  v: Indicates if the individual is deceased or not.
comment:
  v: 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.
requirements:
  v: 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.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Patient.deceased[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: boolean
    l: boolean
type:
  code:
    v: dateTime
    l: dateTime
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: true
is modifier reason:
  v: 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.
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: PID-30 (bool) and PID-29 (datetime)
mapping:
  identity:
    v: rim
  map:
    v: player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedTime
mapping:
  identity:
    v: cda
  map:
    v: n/a

id:
  v: Patient.address
path:
  v: Patient.address
short:
  v: An address for the individual
definition:
  v: An address for the individual.
comment:
  v: Patient may have multiple addresses with different uses or applicable periods.
requirements:
  v: May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.
min:
  v: 0
max:
  v: *
base:
  path:
    v: Patient.address
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Address
    l: Address
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: PID-11
mapping:
  identity:
    v: rim
  map:
    v: addr
mapping:
  identity:
    v: cda
  map:
    v: .addr

id:
  v: Patient.maritalStatus
path:
  v: Patient.maritalStatus
short:
  v: Marital (civil) status of a patient
definition:
  v: This field contains a patient's most recent marital (civil) status.
requirements:
  v: Most, if not all systems capture it.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Patient.maritalStatus
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: MaritalStatus
  strength:
    v: extensible
  description:
    v: The domestic partnership status of a person.
  value set:
    v: http://hl7.org/fhir/ValueSet/marital-status|4.0.1
    l: http://hl7.org/fhir/ValueSet/marital-status
mapping:
  identity:
    v: v2
  map:
    v: PID-16
mapping:
  identity:
    v: rim
  map:
    v: player[classCode=PSN]/maritalStatusCode
mapping:
  identity:
    v: cda
  map:
    v: .patient.maritalStatusCode

id:
  v: Patient.multipleBirth[x]
path:
  v: Patient.multipleBirth[x]
short:
  v: Whether patient is part of a multiple birth
definition:
  v: Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer).
comment:
  v: 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).
requirements:
  v: For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Patient.multipleBirth[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: boolean
    l: boolean
type:
  code:
    v: integer
    l: integer
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: v2
  map:
    v: PID-24 (bool), PID-25 (integer)
mapping:
  identity:
    v: rim
  map:
    v: player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber
mapping:
  identity:
    v: cda
  map:
    v: n/a

id:
  v: Patient.photo
path:
  v: Patient.photo
short:
  v: Image of the patient
definition:
  v: Image of the patient.
comment:
  v: Guidelines: * Use id photos, not clinical photos. * Limit dimensions to thumbnail. * Keep byte count low to ease resource updates.
requirements:
  v: Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too.
min:
  v: 0
max:
  v: *
base:
  path:
    v: Patient.photo
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Attachment
    l: Attachment
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: v2
  map:
    v: OBX-5 - needs a profile
mapping:
  identity:
    v: rim
  map:
    v: player[classCode=PSN|ANM and determinerCode=INSTANCE]/desc
mapping:
  identity:
    v: cda
  map:
    v: n/a

id:
  v: Patient.contact
path:
  v: Patient.contact
short:
  v: A contact party (e.g. guardian, partner, friend) for the patient
definition:
  v: A contact party (e.g. guardian, partner, friend) for the patient.
comment:
  v: 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.
requirements:
  v: Need to track people you can contact about the patient.
min:
  v: 0
max:
  v: *
base:
  path:
    v: Patient.contact
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: BackboneElement
    l: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: pat-1
  severity:
    v: error
  human:
    v: SHALL at least contain a contact's details or a reference to an organization
  expression:
    v: name.exists() or telecom.exists() or address.exists() or organization.exists()
  xpath:
    v: exists(f:name) or exists(f:telecom) or exists(f:address) or exists(f:organization)
  source:
    v: http://hl7.org/fhir/StructureDefinition/Patient
    l: Patient
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: player[classCode=PSN|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON]
mapping:
  identity:
    v: cda
  map:
    v: n/a

id:
  v: Patient.contact.id
path:
  v: Patient.contact.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Patient.contact.extension
path:
  v: Patient.contact.extension
short:
  v: Additional content defined by implementations
definition:
  v: 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.
comment:
  v: 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.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Patient.contact.modifierExtension
path:
  v: Patient.contact.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: 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).
comment:
  v: 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.
requirements:
  v: 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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Patient.contact.relationship
path:
  v: Patient.contact.relationship
short:
  v: The kind of relationship
definition:
  v: The nature of the relationship between the patient and the contact person.
requirements:
  v: Used to determine which contact person is the most relevant to approach, depending on circumstances.
min:
  v: 0
max:
  v: *
base:
  path:
    v: Patient.contact.relationship
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: ContactRelationship
  strength:
    v: extensible
  description:
    v: The nature of the relationship between a patient and a contact person for that patient.
  value set:
    v: http://hl7.org/fhir/ValueSet/patient-contactrelationship|4.0.1
    l: http://hl7.org/fhir/ValueSet/patient-contactrelationship
mapping:
  identity:
    v: v2
  map:
    v: NK1-7, NK1-3
mapping:
  identity:
    v: rim
  map:
    v: code
mapping:
  identity:
    v: cda
  map:
    v: n/a

id:
  v: Patient.contact.name
path:
  v: Patient.contact.name
short:
  v: A name associated with the contact person
definition:
  v: A name associated with the contact person.
requirements:
  v: Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Patient.contact.name
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: HumanName
    l: HumanName
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: v2
  map:
    v: NK1-2
mapping:
  identity:
    v: rim
  map:
    v: name
mapping:
  identity:
    v: cda
  map:
    v: n/a

id:
  v: Patient.contact.telecom
path:
  v: Patient.contact.telecom
short:
  v: A contact detail for the person
definition:
  v: A contact detail for the person, e.g. a telephone number or an email address.
comment:
  v: 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.
requirements:
  v: People have (primary) ways to contact them in some way such as phone, email.
min:
  v: 0
max:
  v: *
base:
  path:
    v: Patient.contact.telecom
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: ContactPoint
    l: ContactPoint
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: v2
  map:
    v: NK1-5, NK1-6, NK1-40
mapping:
  identity:
    v: rim
  map:
    v: telecom
mapping:
  identity:
    v: cda
  map:
    v: n/a

id:
  v: Patient.contact.address
path:
  v: Patient.contact.address
short:
  v: Address for the contact person
definition:
  v: Address for the contact person.
requirements:
  v: Need to keep track where the contact person can be contacted per postal mail or visited.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Patient.contact.address
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Address
    l: Address
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: v2
  map:
    v: NK1-4
mapping:
  identity:
    v: rim
  map:
    v: addr
mapping:
  identity:
    v: cda
  map:
    v: n/a

id:
  v: Patient.contact.gender
path:
  v: Patient.contact.gender
short:
  v: male | female | other | unknown
definition:
  v: Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes.
requirements:
  v: Needed to address the person correctly.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Patient.contact.gender
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
    l: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: AdministrativeGender
  strength:
    v: required
  description:
    v: The gender of a person used for administrative purposes.
  value set:
    v: http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1
    l: http://hl7.org/fhir/ValueSet/administrative-gender
mapping:
  identity:
    v: v2
  map:
    v: NK1-15
mapping:
  identity:
    v: rim
  map:
    v: player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender
mapping:
  identity:
    v: cda
  map:
    v: n/a

id:
  v: Patient.contact.organization
path:
  v: Patient.contact.organization
short:
  v: Organization that is associated with the contact
definition:
  v: Organization on behalf of which the contact is acting or for which the contact is working.
requirements:
  v: For guardians or business related contacts, the organization is relevant.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Patient.contact.organization
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Organization|4.0.1
    l: http://hl7.org/fhir/StructureDefinition/Organization
condition:
  v: pat-1
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: v2
  map:
    v: NK1-13, NK1-30, NK1-31, NK1-32, NK1-41
mapping:
  identity:
    v: rim
  map:
    v: scoper
mapping:
  identity:
    v: cda
  map:
    v: n/a

id:
  v: Patient.contact.period
path:
  v: Patient.contact.period
short:
  v: The period during which this contact person or organization is valid to be contacted relating to this patient
definition:
  v: The period during which this contact person or organization is valid to be contacted relating to this patient.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Patient.contact.period
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Period
    l: Period
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: effectiveTime
mapping:
  identity:
    v: cda
  map:
    v: n/a

id:
  v: Patient.communication
path:
  v: Patient.communication
short:
  v: A language which may be used to communicate with the patient about his or her health
definition:
  v: A language which may be used to communicate with the patient about his or her health.
comment:
  v: 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.
requirements:
  v: 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.
min:
  v: 0
max:
  v: *
base:
  path:
    v: Patient.communication
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: BackboneElement
    l: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: LanguageCommunication
mapping:
  identity:
    v: cda
  map:
    v: patient.languageCommunication

id:
  v: Patient.communication.id
path:
  v: Patient.communication.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Patient.communication.extension
path:
  v: Patient.communication.extension
short:
  v: Additional content defined by implementations
definition:
  v: 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.
comment:
  v: 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.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Patient.communication.modifierExtension
path:
  v: Patient.communication.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: 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).
comment:
  v: 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.
requirements:
  v: 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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Patient.communication.language
path:
  v: Patient.communication.language
short:
  v: The language which can be used to communicate with the patient about his or her health
definition:
  v: 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.
comment:
  v: 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.
requirements:
  v: Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Patient.communication.language
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet
      l: elementdefinition-maxValueSet
    value: Canonical
      v: http://hl7.org/fhir/ValueSet/all-languages
      l: all-languages
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: Language
  strength:
    v: preferred
  description:
    v: A human language.
  value set:
    v: http://hl7.org/fhir/ValueSet/languages|4.0.1
    l: http://hl7.org/fhir/ValueSet/languages
mapping:
  identity:
    v: v2
  map:
    v: PID-15, LAN-2
mapping:
  identity:
    v: rim
  map:
    v: player[classCode=PSN|ANM and determinerCode=INSTANCE]/languageCommunication/code
mapping:
  identity:
    v: cda
  map:
    v: .languageCode

id:
  v: Patient.communication.preferred
path:
  v: Patient.communication.preferred
short:
  v: Language preference indicator
definition:
  v: Indicates whether or not the patient prefers this language (over other languages he masters up a certain level).
comment:
  v: This language is specifically identified for communicating healthcare information.
requirements:
  v: 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.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Patient.communication.preferred
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: boolean
    l: boolean
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: v2
  map:
    v: PID-15
mapping:
  identity:
    v: rim
  map:
    v: preferenceInd
mapping:
  identity:
    v: cda
  map:
    v: .preferenceInd

id:
  v: Patient.generalPractitioner
path:
  v: Patient.generalPractitioner
short:
  v: Patient's nominated primary care provider
definition:
  v: Patient's nominated care provider.
comment:
  v: 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.
alias:
  v: careProvider
min:
  v: 0
max:
  v: *
base:
  path:
    v: Patient.generalPractitioner
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Organization|4.0.1
    l: http://hl7.org/fhir/StructureDefinition/Organization
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Practitioner|4.0.1
    l: http://hl7.org/fhir/StructureDefinition/Practitioner
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1
    l: http://hl7.org/fhir/StructureDefinition/PractitionerRole
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: v2
  map:
    v: PD1-4
mapping:
  identity:
    v: rim
  map:
    v: subjectOf.CareEvent.performer.AssignedEntity
mapping:
  identity:
    v: cda
  map:
    v: n/a

id:
  v: Patient.managingOrganization
path:
  v: Patient.managingOrganization
short:
  v: Organization that is the custodian of the patient record
definition:
  v: Organization that is the custodian of the patient record.
comment:
  v: 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).
requirements:
  v: Need to know who recognizes this patient record, manages and updates it.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Patient.managingOrganization
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Organization|4.0.1
    l: http://hl7.org/fhir/StructureDefinition/Organization
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: scoper
mapping:
  identity:
    v: cda
  map:
    v: .providerOrganization

id:
  v: Patient.link
path:
  v: Patient.link
short:
  v: Link to another patient resource that concerns the same actual person
definition:
  v: Link to another patient resource that concerns the same actual patient.
comment:
  v: There is no assumption that linked patient records have mutual links.
requirements:
  v: 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.
min:
  v: 0
max:
  v: *
base:
  path:
    v: Patient.link
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: BackboneElement
    l: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: true
is modifier reason:
  v: 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'
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: outboundLink
mapping:
  identity:
    v: cda
  map:
    v: n/a

id:
  v: Patient.link.id
path:
  v: Patient.link.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Patient.link.extension
path:
  v: Patient.link.extension
short:
  v: Additional content defined by implementations
definition:
  v: 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.
comment:
  v: 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.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Patient.link.modifierExtension
path:
  v: Patient.link.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: 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).
comment:
  v: 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.
requirements:
  v: 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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Patient.link.other
path:
  v: Patient.link.other
short:
  v: The other patient or related person resource that the link refers to
definition:
  v: The other patient resource that the link refers to.
comment:
  v: Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Patient.link.other
  min:
    v: 1
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-hierarchy
      l: structuredefinition-hierarchy
    value: Boolean
      v: false
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Patient|4.0.1
    l: http://hl7.org/fhir/StructureDefinition/Patient
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/RelatedPerson|4.0.1
    l: http://hl7.org/fhir/StructureDefinition/RelatedPerson
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: PID-3, MRG-1
mapping:
  identity:
    v: rim
  map:
    v: id
mapping:
  identity:
    v: cda
  map:
    v: n/a

id:
  v: Patient.link.type
path:
  v: Patient.link.type
short:
  v: replaced-by | replaces | refer | seealso
definition:
  v: The type of link between this patient resource and another patient resource.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Patient.link.type
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: code
    l: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: LinkType
  strength:
    v: required
  description:
    v: The type of link between this patient resource and another patient resource.
  value set:
    v: http://hl7.org/fhir/ValueSet/link-type|4.0.1
    l: http://hl7.org/fhir/ValueSet/link-type
mapping:
  identity:
    v: rim
  map:
    v: typeCode
mapping:
  identity:
    v: cda
  map:
    v: n/a

element:
  id:
    v: Patient
  path:
    v: Patient
element:
  id:
    v: Patient.identifier
  path:
    v: Patient.identifier
  min:
    v: 1
  max:
    v: 1
  must support:
    v: true
element:
  id:
    v: Patient.name
  path:
    v: Patient.name
  min:
    v: 1
  must support:
    v: true
element:
  id:
    v: Patient.gender
  path:
    v: Patient.gender
  must support:
    v: true
element:
  id:
    v: Patient.birthDate
  path:
    v: Patient.birthDate
  must support:
    v: true