MedNet interface implementation guide
0.20.0 - CI Build

MedNet interface implementation guide - Downloaded Version 0.20.0 See the Directory of published versions

Resource Profile: MNIPatient - Detailed Descriptions

Active as of 2025-12-19

Definitions for the mni-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.

ShortMedNet Interface (MNI) - PatientInformation about an individual or animal receiving health care services
Control0..*
Is Modifierfalse
Summaryfalse
Alternate NamesSubjectOfCare Client Resident
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. Patient.id
Definition

The id is unique within the space of all resources of the same type on the same server It can be any combination of upper- or lower-case ASCII letters 'A'..'Z', and 'a'..'z', numerals ('0'..'9'), '-', '.' with a length limit of 64 characters. (This might be an integer, an un-prefixed OID, UUID or any other identifier pattern that meets these constraints.)


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

ShortThe id is unique within the space of all resources of the same type on the same server It can be any combination of upper- or lower-case ASCII letters 'A'..'Z', and 'a'..'z', numerals ('0'..'9'), '-' and '.' with a length limit of 64 characters. (This might be an integer, an un-prefixed OID, UUID or any other identifier pattern that meets these constraints.)Logical id of this artifact
Comments

This id should corresponds to the id specified in the fullUrl of the entry containing this element


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
Typeidstring
Is Modifierfalse
Must Supporttrue
Summarytrue
4. 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..01
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
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. 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.

ShortIt is possible to include the generalPractitioner or a contact organization as embedded resource in this contained object. This way it is not needed to include it in the BundleContained, 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
Must Supporttrue
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
8. 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.

Control0..*
TypeExtension
Is Modifierfalse
Must Supporttrue
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
  • 10. Patient.extension:citizenship
    Slice Namecitizenship
    Definition

    The content of the country code element (if present) SHALL be selected EITHER from ValueSet ISO Country Alpha-2 http://hl7.org/fhir/ValueSet/iso3166-1-2 OR MAY be selected from ISO Country Alpha-3 Value Set http://hl7.org/fhir/ValueSet/iso3166-1-3, if the country is not specified in value Set ISO Country Alpha-2 http://hl7.org/fhir/ValueSet/iso3166-1-2

    ShortCitizenship(s) of patient
    Control0..*
    TypeExtension(Patient Citizenship) (Complex Extension)
    Is Modifierfalse
    Must Supporttrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ch-pat-3: ISO Country Alpha-2 or ISO Country Alpha-3 code ((extension.where(url='code').value.coding.code.length()=2 and extension.where(url='code').value.coding.code.memberOf('http://hl7.org/fhir/ValueSet/iso3166-1-2')) or (extension.where(url='code').value.coding.code.length()=3 and extension.where(url='code').value.coding.code.memberOf('http://hl7.org/fhir/ValueSet/iso3166-1-3')))
    12. Patient.modifierExtension
    Definition

    An Extension


    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).

    ShortExtensionExtensions 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..0*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
    Must Supportfalse
    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())
    14. Patient.identifier
    Definition

    An identifier for this patient.

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

    Patients are almost always assigned specific numerical identifiers.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    SlicingThis element introduces a set of slices on Patient.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ system
    • value @ type.coding.system
    • value @ type.coding.code
    • 16. Patient.identifier:AHVN13
      Slice NameAHVN13
      Definition

      The AHVN13 / NAVS13 - (abbreviation for new thirteen-digit Social Security number) - is an administrative identifier for natural persons in Switzerland. It is issued, announced and administered by the Central Compensation Office. It is available to all organisations and communities for which there is a legal basis.


      An identifier for this patient.

      ShortAHVN13 / NAVS13An identifier for this patient
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..1*
      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()))
      18. Patient.identifier:AHVN13.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()))
      20. Patient.identifier:AHVN13.system
      Definition

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

      ShortThe namespace for the identifier value
      Comments

      Identifier.system is always case sensitive.

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

      Fixed Valueurn:oid:2.16.756.5.32
      ExampleGeneral: http://www.acme.com/identifiers/patient
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. Patient.identifier:AHVN13.value
      Definition

      AHVN13 / NAVS13 of the patient (13 digits starting ith 756)


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

      ShortAHVN13 / NAVS13 of the patient (13 digits starting ith 756)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()))
      24. Patient.identifier:LocalPid
      Slice NameLocalPid
      Definition

      Local patient identifiers


      An identifier for this patient.

      ShortLocal patient identifiersAn identifier for this patient
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..1*
      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()))
      26. Patient.identifier:LocalPid.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()))
      28. Patient.identifier:LocalPid.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|4.0.1)

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

      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      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()))
      30. Patient.identifier:LocalPid.type.coding
      Definition

      A reference to a code defined by a terminology system.

      ShortCode defined by a terminology system
      Comments

      Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

      Control10..1*
      TypeCoding
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      Allows for alternative encodings within a code system, and translations to other code systems.

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

      The identification of the code system that defines the meaning of the symbol in the code.

      ShortIdentity of the terminology system
      Comments

      The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

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

      Need to be unambiguous about the source of the definition of the symbol.

      Fixed Valuehttp://terminology.hl7.org/CodeSystem/v2-0203
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      34. Patient.identifier:LocalPid.type.coding.code
      Definition

      A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

      ShortSymbol in syntax defined by the system
      Control10..1
      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Requirements

      Need to refer to a particular code in the system.

      Fixed ValueMR
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. Patient.identifier:LocalPid.type.coding.display
      Definition

      A representation of the meaning of the code in the system, following the rules of the system.

      ShortRepresentation defined by the system
      Control0..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Requirements

      Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

      Fixed ValueMedical record number
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      38. Patient.identifier:LocalPid.system
      Definition

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

      ShortUri that defines the Software that delivers the Patient ID. If possible this uri should be unique for each Patient database for example https://mysoftware.ch/patientDB/123456The namespace for the identifier value
      Comments

      Identifier.system is always case sensitive.

      Control0..1
      Typeuri
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      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()))
      40. Patient.identifier:LocalPid.value
      Definition

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

      ShortThe value that is unique
      Comments

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

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

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

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

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

      ShortWhether this patient's record is in active use
      Comments

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

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

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

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

      A name associated with the individual.

      ShortA name associated with the patient
      Comments

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

      Control0..*
      TypeHumanName(MedNet Interface (MNI) - Human Name)
      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()))
      46. Patient.telecom
      Definition

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

      ShortA contact detail for the individual
      Comments

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

      Control0..*
      TypeContactPoint(MedNet Interface (MNI) - ContactPoint)
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

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

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

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

      Shortmale | female | other | unknown
      Comments

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

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

      The gender of a person used for administrative purposes.

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

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

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

      A date, or partial date (e.g. just year or year + month) as used in human communication. The format is YYYY, YYYY-MM, or YYYY-MM-DD, e.g. 2018, 1973-06, or 1905-08-23. There SHALL be no time zone. Dates SHALL be valid dates


      The date of birth for the individual.

      ShortThe date of birth for the individual
      Comments

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

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

      Age of the individual drives many clinical processes.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      LOINC Code21112-8
      52. Patient.deceased[x]
      Definition

      Indicates if the individual is deceased or not.

      ShortIndicates if the individual is deceased or not
      Comments

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

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

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

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

      An address for the individual.

      ShortAn address for the individual
      Comments

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

      Control0..*
      TypeAddress(MedNet Interface (MNI) - Address)
      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()))
      56. Patient.maritalStatus
      Definition

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

      ShortMarital (civil) status of a patient
      Control0..1
      BindingThe codes SHALL be taken from Unless not suitable, these codes SHALL be taken from ChCoreMaritalStatushttp://hl7.org/fhir/ValueSet/marital-status|4.0.1
      (required to http://fhir.ch/ig/ch-core/ValueSet/ch-core-maritalstatus)
      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      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()))
      58. Patient.maritalStatus.coding
      Definition

      A reference to a code defined by a terminology system.

      ShortCode defined by a terminology system
      Comments

      Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

      Control0..*
      TypeCoding
      Is Modifierfalse
      Summarytrue
      Requirements

      Allows for alternative encodings within a code system, and translations to other code systems.

      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.maritalStatus.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ system
      • value @ code
      • 60. Patient.maritalStatus.coding:international
        Slice Nameinternational
        Definition

        A reference to a code defined by a terminology system.

        ShortCode defined by a terminology system
        Comments

        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

        Control0..1*
        TypeCoding
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Allows for alternative encodings within a code system, and translations to other code systems.

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

        The identification of the code system that defines the meaning of the symbol in the code.

        ShortIdentity of the terminology system
        Comments

        The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

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

        Need to be unambiguous about the source of the definition of the symbol.

        Fixed Valuehttp://terminology.hl7.org/CodeSystem/v3-MaritalStatus
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        64. Patient.maritalStatus.coding:international.code
        Definition

        A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

        ShortAuthorized values : S (Never Married) | M (Married) | W (Widowed) | D (Divorced) | U (unmarried) | T (Domestic partner) | L (Legally Separated) | A (Annulled) | I (Interlocutory) | P (Polygamous) | C (Common Law)Symbol in syntax defined by the system
        Control10..1
        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        Need to refer to a particular code in the system.

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

        A representation of the meaning of the code in the system, following the rules of the system.

        ShortAuthorized values : Never Married (S) | Married (M) | Widowed (W) | Divorced (D) | unmarried (U) | Domestic partner (T) | Legally Separated (L) | Annulled (A) | Interlocutory (I)) | Polygamous (P)) | Common Law (C)Representation defined by the system
        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        68. Patient.maritalStatus.coding:swiss
        Slice Nameswiss
        Definition

        A reference to a code defined by a terminology system.

        ShortCode defined by a terminology system
        Comments

        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

        Control0..1*
        TypeCoding
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Allows for alternative encodings within a code system, and translations to other code systems.

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

        The identification of the code system that defines the meaning of the symbol in the code.

        ShortIdentity of the terminology system
        Comments

        The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

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

        Need to be unambiguous about the source of the definition of the symbol.

        Fixed Valuehttp://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        72. Patient.maritalStatus.coding:swiss.code
        Definition

        A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

        ShortAuthorized values : 1 (Unmarried) | 2 (Married) | 3 (Widowed) | 4 (Divorced) | 5 (Unmarried) | 6 (Domestic partner) | 7 (Legally Separated) | 9 (Unknown)Symbol in syntax defined by the system
        Control10..1
        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        Need to refer to a particular code in the system.

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

        A representation of the meaning of the code in the system, following the rules of the system.

        ShortAuthorized values : Unmarried (1) | Married (2) | Widowed (3) | Divorced (4) | Unmarried (5) | Domestic partner (6) | Legally Separated (7) | Unknown (9).Representation defined by the system
        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

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

        Part of ch-core-patient that is currently ignored by MedNet, but could be usefull in the future


        Image of the patient.

        Shortcurrently ignored by MedNet, but could be implemented in the futureImage of the patient
        Comments

        Guidelines:

        • Use id photos, not clinical photos.
        • Limit dimensions to thumbnail.
        • Keep byte count low to ease resource updates.
        Control0..*
        TypeAttachment
        Is Modifierfalse
        Must Supporttrue
        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()))
        78. Patient.photo.contentType
        Definition

        Identifies the type of the data in the attachment and allows a method to be chosen to interpret or render the data. Includes mime type parameters such as charset where appropriate.

        ShortMime type of the content, with charset etc.
        Control10..1
        BindingThe codes SHALL be taken from Mime Typeshttp://hl7.org/fhir/ValueSet/mimetypes|4.0.1
        (required to http://hl7.org/fhir/ValueSet/mimetypes|4.0.1)

        The mime type of an attachment. Any valid mime type is allowed.

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

        Processors of the data need to be able to know how to interpret the data.

        ExampleGeneral: text/plain; charset=UTF-8, image/png
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        80. Patient.photo.data
        Definition

        The actual data of the attachment - a sequence of bytes, base64 encoded.

        ShortData inline, base64ed
        Comments

        The base64-encoded data SHALL be expressed in the same character set as the base resource XML or JSON.

        Control0..1
        Typebase64Binary
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summaryfalse
        Requirements

        The data needs to able to be transmitted inline.

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

        A location where the data can be accessed.

        ShortUri where the data can be found
        Comments

        If both data and url are provided, the url SHALL point to the same content as the data contains. Urls may be relative references or may reference transient locations such as a wrapping envelope using cid: though this has ramifications for using signatures. Relative URLs are interpreted relative to the service url, like a resource reference, rather than relative to the resource itself. If a URL is provided, it SHALL resolve to actual data.

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

        The data needs to be transmitted by reference.

        ExampleGeneral: http://www.acme.com/logo-small.png
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        84. Patient.photo.size
        Definition

        The number of bytes of data that make up this attachment (before base64 encoding, if that is done).

        ShortNumber of bytes of content (if url provided)
        Comments

        The number of bytes is redundant if the data is provided as a base64binary, but is useful if the data is provided as a url reference.

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

        Representing the size allows applications to determine whether they should fetch the content automatically in advance, or refuse to fetch it at all.

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

        The calculated hash of the data using SHA-1. Represented using base64.

        ShortHash of the data (sha-1, base64ed)
        Comments

        The hash is calculated on the data prior to base64 encoding, if the data is based64 encoded. The hash is not intended to support digital signatures. Where protection against malicious threats a digital signature should be considered, see Provenance.signature for mechanism to protect a resource with a digital signature.


        The hash is calculated on the data prior to base64 encoding, if the data is based64 encoded. The hash is not intended to support digital signatures. Where protection against malicious threats a digital signature should be considered, see Provenance.signature for mechanism to protect a resource with a digital signature.

        Control0..1
        Typebase64Binary
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        Included so that applications can verify that the contents of a location have not changed due to technical failures (e.g., storage rot, transport glitch, incorrect version).

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

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

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

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

        Control0..*
        TypeBackboneElement
        Is Modifierfalse
        Summaryfalse
        Requirements

        Need to track people you can contact about the patient.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        pat-1: SHALL at least contain a contact's details or a reference to an organization (name.exists() or telecom.exists() or address.exists() or organization.exists())
        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())
        SlicingThis element introduces a set of slices on Patient.contact. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ relationship.coding.system
        • value @ relationship.coding.code
        • 90. 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())
          92. Patient.contact:MNIContact
          Slice NameMNIContact
          Definition

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

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

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

          Control0..*
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          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())
          94. Patient.contact:MNIContact.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())
          96. Patient.contact:MNIContact.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 PatientContactRelationshiphttp://hl7.org/fhir/ValueSet/patient-contactrelationship|4.0.1
          (extensible to http://hl7.org/fhir/ValueSet/patient-contactrelationship|4.0.1)

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

          TypeCodeableConcept
          Is Modifierfalse
          Must Supporttrue
          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()))
          SlicingThis element introduces a set of slices on Patient.contact.relationship. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ coding.system
          • value @ coding.code
          • 98. Patient.contact:MNIContact.relationship:KIND
            Slice NameKIND
            Definition

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

            ShortKind of relation ship, for example Emergency contact, EmployerThe kind of relationship
            Control0..1*
            BindingThe codes SHALL be taken from Unless not suitable, these codes SHALL be taken from PatientContactRelationshiphttp://hl7.org/fhir/ValueSet/patient-contactrelationship|4.0.1
            (required to http://hl7.org/fhir/ValueSet/patient-contactrelationship)
            TypeCodeableConcept
            Is Modifierfalse
            Must Supporttrue
            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()))
            100. Patient.contact:MNIContact.relationship:KIND.coding
            Definition

            A reference to a code defined by a terminology system.

            ShortCode defined by a terminology system
            Comments

            Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

            Control0..*
            TypeCoding
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Allows for alternative encodings within a code system, and translations to other code systems.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            102. Patient.contact:MNIContact.relationship:KIND.coding.system
            Definition

            The identification of the code system that defines the meaning of the symbol in the code.

            ShortIdentity of the terminology system
            Comments

            The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

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

            Need to be unambiguous about the source of the definition of the symbol.

            Fixed Valuehttp://terminology.hl7.org/CodeSystem/v2-0131
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            104. Patient.contact:MNIContact.relationship:KIND.coding.code
            Definition

            A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

            ShortC (Emergency Contact) | E (Employer) | F (Federal Agency) | I (Insurance Company) | N (Next-of-Kin) | S (State Agency) | U (Unknown)Symbol in syntax defined by the system
            Control10..1
            Typecode
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Requirements

            Need to refer to a particular code in the system.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            106. Patient.contact:MNIContact.relationship:KIND.coding.display
            Definition

            A representation of the meaning of the code in the system, following the rules of the system.

            ShortRepresentation defined by the system
            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Requirements

            Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

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

            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

            ShortIf the relationship can not be coded, it can be described in plain text in this fieldPlain text representation of the concept
            Comments

            Very often the text is the same as a displayName of one of the codings.

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

            The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            110. Patient.contact:MNIContact.relationship:FamilyMember
            Slice NameFamilyMember
            Definition

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

            ShortFamilyMember relation ship, for example sisterThe kind of relationship
            Control0..1*
            BindingThe codes SHALL be taken from Unless not suitable, these codes SHALL be taken from FamilyMemberhttp://hl7.org/fhir/ValueSet/patient-contactrelationship|4.0.1
            (required to http://terminology.hl7.org/ValueSet/v3-FamilyMember)
            TypeCodeableConcept
            Is Modifierfalse
            Must Supporttrue
            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()))
            112. Patient.contact:MNIContact.relationship:FamilyMember.coding
            Definition

            A reference to a code defined by a terminology system.

            ShortCode defined by a terminology system
            Comments

            Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

            Control0..*
            TypeCoding
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Allows for alternative encodings within a code system, and translations to other code systems.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            114. Patient.contact:MNIContact.relationship:FamilyMember.coding.system
            Definition

            The identification of the code system that defines the meaning of the symbol in the code.

            ShortIdentity of the terminology system
            Comments

            The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

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

            Need to be unambiguous about the source of the definition of the symbol.

            Fixed Valuehttp://terminology.hl7.org/CodeSystem/v3-RoleCode
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            116. Patient.contact:MNIContact.relationship:FamilyMember.coding.code
            Definition

            A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

            ShortCHILD (child) | DAU (natural daugher) | SON (natural son) | FTH (father) | MTH (mother) | ...Symbol in syntax defined by the system
            Control10..1
            Typecode
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Requirements

            Need to refer to a particular code in the system.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            118. Patient.contact:MNIContact.relationship:FamilyMember.coding.display
            Definition

            A representation of the meaning of the code in the system, following the rules of the system.

            ShortRepresentation defined by the system
            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Requirements

            Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

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

            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

            ShortIf the relationship can not be coded, it can be described in plain text in this fieldPlain text representation of the concept
            Comments

            Very often the text is the same as a displayName of one of the codings.

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

            The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

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

            A name associated with the contact person.

            ShortA name associated with the contact person
            Control0..1
            TypeHumanName(MedNet Interface (MNI) - Human Name)
            Is Modifierfalse
            Must Supporttrue
            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()))
            124. Patient.contact:MNIContact.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(MedNet Interface (MNI) - ContactPoint)
            Is Modifierfalse
            Must Supporttrue
            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()))
            126. Patient.contact:MNIContact.address
            Definition

            Address for the contact person.

            ShortAddress for the contact person
            Control0..1
            TypeAddress(MedNet Interface (MNI) - Address)
            Is Modifierfalse
            Must Supporttrue
            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()))
            128. Patient.contact:MNIContact.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 AdministrativeGenderhttp://hl7.org/fhir/ValueSet/administrative-gender|4.0.1
            (required to http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1)

            The gender of a person used for administrative purposes.

            Typecode
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            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()))
            130. Patient.contact:MNIContact.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(MedNet Interface (MNI) - Organization, Organization)
            Is Modifierfalse
            Must Supporttrue
            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()))
            132. Patient.communication
            Definition

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

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

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

            Control0..*
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            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()))
            134. 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())
            136. Patient.communication.language
            Definition

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

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

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

            Control1..1
            BindingThe codes SHOULD be taken from CommonLanguageshttp://hl7.org/fhir/ValueSet/languages|4.0.1
            (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

            A human language.

            Additional BindingsPurpose
            AllLanguagesMax Binding
            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()))
            138. Patient.communication.language.coding
            Definition

            A reference to a code defined by a terminology system.

            ShortCode defined by a terminology system
            Comments

            Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

            Control10..*
            TypeCoding
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Allows for alternative encodings within a code system, and translations to other code systems.

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

            The identification of the code system that defines the meaning of the symbol in the code.

            ShortIdentity of the terminology system
            Comments

            The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

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

            Need to be unambiguous about the source of the definition of the symbol.

            Fixed Valueurn:ietf:bcp:47
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            142. Patient.communication.language.coding.code
            Definition

            A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

            ShortSymbol in syntax defined by the system
            Control10..1
            Typecode
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Requirements

            Need to refer to a particular code in the system.

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

            A representation of the meaning of the code in the system, following the rules of the system.

            ShortRepresentation defined by the system
            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Requirements

            Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

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

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

            ShortLanguage preference indicator
            Comments

            This language is specifically identified for communicating healthcare information.

            Control0..1
            Typeboolean
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            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()))
            148. Patient.generalPractitioner
            Definition

            Patient's nominated care provider.

            ShortPatient's nominated primary care provider. We allow multiple general practitioner, since gynecologist can also be listed as general practitioner
            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(MedNet Interface (MNI) - PractitionerRole, Organization, Practitioner, PractitionerRole)
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Alternate NamescareProvider
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            150. 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()))
            152. 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())
            154. 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()))
            156. 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
            ShortMedNet Interface (MNI) - Patient
            2. Patient.id
            Definition

            The id is unique within the space of all resources of the same type on the same server It can be any combination of upper- or lower-case ASCII letters 'A'..'Z', and 'a'..'z', numerals ('0'..'9'), '-', '.' with a length limit of 64 characters. (This might be an integer, an un-prefixed OID, UUID or any other identifier pattern that meets these constraints.)

            ShortThe id is unique within the space of all resources of the same type on the same server It can be any combination of upper- or lower-case ASCII letters 'A'..'Z', and 'a'..'z', numerals ('0'..'9'), '-' and '.' with a length limit of 64 characters. (This might be an integer, an un-prefixed OID, UUID or any other identifier pattern that meets these constraints.)
            Comments

            This id should corresponds to the id specified in the fullUrl of the entry containing this element

            Must Supporttrue
            4. Patient.implicitRules
            Control0..0
            Must Supportfalse
            6. Patient.contained
            ShortIt is possible to include the generalPractitioner or a contact organization as embedded resource in this contained object. This way it is not needed to include it in the Bundle
            Must Supporttrue
            8. Patient.extension
            Definition

            An Extension

            ShortExtension
            Control0..*
            TypeExtension
            Must Supporttrue
            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
            • 10. Patient.extension:citizenship
              Slice Namecitizenship
              Definition

              The content of the country code element (if present) SHALL be selected EITHER from ValueSet ISO Country Alpha-2 http://hl7.org/fhir/ValueSet/iso3166-1-2 OR MAY be selected from ISO Country Alpha-3 Value Set http://hl7.org/fhir/ValueSet/iso3166-1-3, if the country is not specified in value Set ISO Country Alpha-2 http://hl7.org/fhir/ValueSet/iso3166-1-2

              ShortCitizenship(s) of patient
              Control0..*
              TypeExtension(Patient Citizenship) (Complex Extension)
              Is Modifierfalse
              Must Supporttrue
              Invariantsch-pat-3: ISO Country Alpha-2 or ISO Country Alpha-3 code ((extension.where(url='code').value.coding.code.length()=2 and extension.where(url='code').value.coding.code.memberOf('http://hl7.org/fhir/ValueSet/iso3166-1-2')) or (extension.where(url='code').value.coding.code.length()=3 and extension.where(url='code').value.coding.code.memberOf('http://hl7.org/fhir/ValueSet/iso3166-1-3')))
              12. Patient.modifierExtension
              Control0..0
              Must Supportfalse
              14. Patient.identifier
              NoteThis is a business identifier, not a resource identifier (see discussion)
              Must Supporttrue
              SlicingThis element introduces a set of slices on Patient.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ system
              • value @ type.coding.system
              • value @ type.coding.code
              • 16. Patient.identifier:AHVN13
                Slice NameAHVN13
                Definition

                The AHVN13 / NAVS13 - (abbreviation for new thirteen-digit Social Security number) - is an administrative identifier for natural persons in Switzerland. It is issued, announced and administered by the Central Compensation Office. It is available to all organisations and communities for which there is a legal basis.

                ShortAHVN13 / NAVS13
                NoteThis is a business identifier, not a resource identifier (see discussion)
                Control0..1
                Must Supporttrue
                18. Patient.identifier:AHVN13.system
                Control1..1
                Must Supporttrue
                Fixed Valueurn:oid:2.16.756.5.32
                20. Patient.identifier:AHVN13.value
                Definition

                AHVN13 / NAVS13 of the patient (13 digits starting ith 756)

                ShortAHVN13 / NAVS13 of the patient (13 digits starting ith 756)
                Control1..?
                Must Supporttrue
                22. Patient.identifier:LocalPid
                Slice NameLocalPid
                Definition

                Local patient identifiers

                ShortLocal patient identifiers
                NoteThis is a business identifier, not a resource identifier (see discussion)
                Control0..1
                Must Supporttrue
                24. Patient.identifier:LocalPid.type
                Control1..1
                Must Supporttrue
                26. Patient.identifier:LocalPid.type.coding
                Control1..1
                Must Supporttrue
                28. Patient.identifier:LocalPid.type.coding.system
                Control1..?
                Must Supporttrue
                Fixed Valuehttp://terminology.hl7.org/CodeSystem/v2-0203
                30. Patient.identifier:LocalPid.type.coding.code
                Control1..?
                Must Supporttrue
                Fixed ValueMR
                32. Patient.identifier:LocalPid.type.coding.display
                Must Supporttrue
                Fixed ValueMedical record number
                34. Patient.identifier:LocalPid.system
                ShortUri that defines the Software that delivers the Patient ID. If possible this uri should be unique for each Patient database for example https://mysoftware.ch/patientDB/123456
                Control0..1
                Must Supporttrue
                36. Patient.identifier:LocalPid.value
                Control1..?
                Must Supporttrue
                38. Patient.name
                TypeHumanName(MedNet Interface (MNI) - Human Name)
                Must Supporttrue
                40. Patient.telecom
                TypeContactPoint(MedNet Interface (MNI) - ContactPoint)
                Must Supporttrue
                42. Patient.gender
                Must Supporttrue
                44. Patient.birthDate
                Definition

                A date, or partial date (e.g. just year or year + month) as used in human communication. The format is YYYY, YYYY-MM, or YYYY-MM-DD, e.g. 2018, 1973-06, or 1905-08-23. There SHALL be no time zone. Dates SHALL be valid dates

                Must Supporttrue
                LOINC Code
                46. Patient.address
                TypeAddress(MedNet Interface (MNI) - Address)
                Must Supporttrue
                48. Patient.maritalStatus
                BindingThe codes SHALL be taken from ChCoreMaritalStatus
                (required to http://fhir.ch/ig/ch-core/ValueSet/ch-core-maritalstatus)
                Must Supporttrue
                50. Patient.maritalStatus.coding
                SlicingThis element introduces a set of slices on Patient.maritalStatus.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ system
                • value @ code
                • 52. Patient.maritalStatus.coding:international
                  Slice Nameinternational
                  Control0..1
                  Must Supporttrue
                  54. Patient.maritalStatus.coding:international.system
                  Control1..1
                  Must Supporttrue
                  Fixed Valuehttp://terminology.hl7.org/CodeSystem/v3-MaritalStatus
                  56. Patient.maritalStatus.coding:international.code
                  ShortAuthorized values : S (Never Married) | M (Married) | W (Widowed) | D (Divorced) | U (unmarried) | T (Domestic partner) | L (Legally Separated) | A (Annulled) | I (Interlocutory) | P (Polygamous) | C (Common Law)
                  Control1..1
                  Must Supporttrue
                  58. Patient.maritalStatus.coding:international.display
                  ShortAuthorized values : Never Married (S) | Married (M) | Widowed (W) | Divorced (D) | unmarried (U) | Domestic partner (T) | Legally Separated (L) | Annulled (A) | Interlocutory (I)) | Polygamous (P)) | Common Law (C)
                  Must Supporttrue
                  60. Patient.maritalStatus.coding:swiss
                  Slice Nameswiss
                  Control0..1
                  Must Supporttrue
                  62. Patient.maritalStatus.coding:swiss.system
                  Control1..1
                  Must Supporttrue
                  Fixed Valuehttp://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus
                  64. Patient.maritalStatus.coding:swiss.code
                  ShortAuthorized values : 1 (Unmarried) | 2 (Married) | 3 (Widowed) | 4 (Divorced) | 5 (Unmarried) | 6 (Domestic partner) | 7 (Legally Separated) | 9 (Unknown)
                  Control1..1
                  Must Supporttrue
                  66. Patient.maritalStatus.coding:swiss.display
                  ShortAuthorized values : Unmarried (1) | Married (2) | Widowed (3) | Divorced (4) | Unmarried (5) | Domestic partner (6) | Legally Separated (7) | Unknown (9).
                  Must Supporttrue
                  68. Patient.photo
                  Definition

                  Part of ch-core-patient that is currently ignored by MedNet, but could be usefull in the future

                  Shortcurrently ignored by MedNet, but could be implemented in the future
                  Must Supporttrue
                  70. Patient.photo.contentType
                  Control1..1
                  Must Supporttrue
                  72. Patient.photo.data
                  Must Supporttrue
                  74. Patient.photo.url
                  Must Supporttrue
                  76. Patient.photo.size
                  Must Supporttrue
                  78. Patient.photo.hash
                  Must Supporttrue
                  80. Patient.contact
                  SlicingThis element introduces a set of slices on Patient.contact. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ relationship.coding.system
                  • value @ relationship.coding.code
                  • 82. Patient.contact:MNIContact
                    Slice NameMNIContact
                    Must Supporttrue
                    84. Patient.contact:MNIContact.relationship
                    Must Supporttrue
                    SlicingThis element introduces a set of slices on Patient.contact.relationship. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ coding.system
                    • value @ coding.code
                    • 86. Patient.contact:MNIContact.relationship:KIND
                      Slice NameKIND
                      ShortKind of relation ship, for example Emergency contact, Employer
                      Control0..1
                      BindingThe codes SHALL be taken from PatientContactRelationship
                      (required to http://hl7.org/fhir/ValueSet/patient-contactrelationship)
                      Must Supporttrue
                      88. Patient.contact:MNIContact.relationship:KIND.coding
                      Must Supporttrue
                      90. Patient.contact:MNIContact.relationship:KIND.coding.system
                      Control1..1
                      Must Supporttrue
                      Fixed Valuehttp://terminology.hl7.org/CodeSystem/v2-0131
                      92. Patient.contact:MNIContact.relationship:KIND.coding.code
                      ShortC (Emergency Contact) | E (Employer) | F (Federal Agency) | I (Insurance Company) | N (Next-of-Kin) | S (State Agency) | U (Unknown)
                      Control1..?
                      Must Supporttrue
                      94. Patient.contact:MNIContact.relationship:KIND.coding.display
                      Must Supporttrue
                      96. Patient.contact:MNIContact.relationship:KIND.text
                      ShortIf the relationship can not be coded, it can be described in plain text in this field
                      Must Supporttrue
                      98. Patient.contact:MNIContact.relationship:FamilyMember
                      Slice NameFamilyMember
                      ShortFamilyMember relation ship, for example sister
                      Control0..1
                      BindingThe codes SHALL be taken from FamilyMember
                      (required to http://terminology.hl7.org/ValueSet/v3-FamilyMember)
                      Must Supporttrue
                      100. Patient.contact:MNIContact.relationship:FamilyMember.coding
                      Must Supporttrue
                      102. Patient.contact:MNIContact.relationship:FamilyMember.coding.system
                      Control1..1
                      Must Supporttrue
                      Fixed Valuehttp://terminology.hl7.org/CodeSystem/v3-RoleCode
                      104. Patient.contact:MNIContact.relationship:FamilyMember.coding.code
                      ShortCHILD (child) | DAU (natural daugher) | SON (natural son) | FTH (father) | MTH (mother) | ...
                      Control1..?
                      Must Supporttrue
                      106. Patient.contact:MNIContact.relationship:FamilyMember.coding.display
                      Must Supporttrue
                      108. Patient.contact:MNIContact.relationship:FamilyMember.text
                      ShortIf the relationship can not be coded, it can be described in plain text in this field
                      Must Supporttrue
                      110. Patient.contact:MNIContact.name
                      TypeHumanName(MedNet Interface (MNI) - Human Name)
                      Must Supporttrue
                      112. Patient.contact:MNIContact.telecom
                      TypeContactPoint(MedNet Interface (MNI) - ContactPoint)
                      Must Supporttrue
                      114. Patient.contact:MNIContact.address
                      TypeAddress(MedNet Interface (MNI) - Address)
                      Must Supporttrue
                      116. Patient.contact:MNIContact.gender
                      Must Supporttrue
                      118. Patient.contact:MNIContact.organization
                      TypeReference(MedNet Interface (MNI) - Organization)
                      Must Supporttrue
                      120. Patient.communication
                      Must Supporttrue
                      122. Patient.communication.language
                      Must Supporttrue
                      124. Patient.communication.language.coding
                      Control1..?
                      Must Supporttrue
                      126. Patient.communication.language.coding.system
                      Control1..?
                      Must Supporttrue
                      Fixed Valueurn:ietf:bcp:47
                      128. Patient.communication.language.coding.code
                      Control1..?
                      Must Supporttrue
                      130. Patient.communication.language.coding.display
                      Must Supporttrue
                      132. Patient.communication.preferred
                      Must Supporttrue
                      134. Patient.generalPractitioner
                      ShortPatient's nominated primary care provider. We allow multiple general practitioner, since gynecologist can also be listed as general practitioner
                      TypeReference(MedNet Interface (MNI) - PractitionerRole)
                      Must Supporttrue

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

                      0. Patient
                      Definition

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

                      ShortMedNet Interface (MNI) - Patient
                      Control0..*
                      Is Modifierfalse
                      Summaryfalse
                      Alternate NamesSubjectOfCare Client Resident
                      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                      dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
                      dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                      dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                      dom-6: A resource should have narrative for robust management (text.`div`.exists())
                      2. Patient.id
                      Definition

                      The id is unique within the space of all resources of the same type on the same server It can be any combination of upper- or lower-case ASCII letters 'A'..'Z', and 'a'..'z', numerals ('0'..'9'), '-', '.' with a length limit of 64 characters. (This might be an integer, an un-prefixed OID, UUID or any other identifier pattern that meets these constraints.)

                      ShortThe id is unique within the space of all resources of the same type on the same server It can be any combination of upper- or lower-case ASCII letters 'A'..'Z', and 'a'..'z', numerals ('0'..'9'), '-' and '.' with a length limit of 64 characters. (This might be an integer, an un-prefixed OID, UUID or any other identifier pattern that meets these constraints.)
                      Comments

                      This id should corresponds to the id specified in the fullUrl of the entry containing this element

                      Control0..1
                      Typeid
                      Is Modifierfalse
                      Must Supporttrue
                      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..0
                      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
                      Must Supportfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      8. Patient.language
                      Definition

                      The base language in which the resource is written.

                      ShortLanguage of the resource content
                      Comments

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

                      Control0..1
                      BindingThe codes SHOULD be taken from CommonLanguages
                      (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

                      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.

                      ShortIt is possible to include the generalPractitioner or a contact organization as embedded resource in this contained object. This way it is not needed to include it in the Bundle
                      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
                      Must Supporttrue
                      Summaryfalse
                      Alternate Namesinline resources, anonymous resources, contained resources
                      14. Patient.extension
                      Definition

                      An Extension

                      ShortExtension
                      Control0..*
                      TypeExtension
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      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:citizenship
                        Slice Namecitizenship
                        Definition

                        The content of the country code element (if present) SHALL be selected EITHER from ValueSet ISO Country Alpha-2 http://hl7.org/fhir/ValueSet/iso3166-1-2 OR MAY be selected from ISO Country Alpha-3 Value Set http://hl7.org/fhir/ValueSet/iso3166-1-3, if the country is not specified in value Set ISO Country Alpha-2 http://hl7.org/fhir/ValueSet/iso3166-1-2

                        ShortCitizenship(s) of patient
                        Control0..*
                        TypeExtension(Patient Citizenship) (Complex Extension)
                        Is Modifierfalse
                        Must Supporttrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        ch-pat-3: ISO Country Alpha-2 or ISO Country Alpha-3 code ((extension.where(url='code').value.coding.code.length()=2 and extension.where(url='code').value.coding.code.memberOf('http://hl7.org/fhir/ValueSet/iso3166-1-2')) or (extension.where(url='code').value.coding.code.length()=3 and extension.where(url='code').value.coding.code.memberOf('http://hl7.org/fhir/ValueSet/iso3166-1-3')))
                        18. Patient.modifierExtension
                        Definition

                        An Extension

                        ShortExtension
                        Control0..0
                        TypeExtension
                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                        Must Supportfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        20. Patient.identifier
                        Definition

                        An identifier for this patient.

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

                        Patients are almost always assigned specific numerical identifiers.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        SlicingThis element introduces a set of slices on Patient.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ system
                        • value @ type.coding.system
                        • value @ type.coding.code
                        • 22. Patient.identifier:AHVN13
                          Slice NameAHVN13
                          Definition

                          The AHVN13 / NAVS13 - (abbreviation for new thirteen-digit Social Security number) - is an administrative identifier for natural persons in Switzerland. It is issued, announced and administered by the Central Compensation Office. It is available to all organisations and communities for which there is a legal basis.

                          ShortAHVN13 / NAVS13
                          NoteThis is a business identifier, not a resource identifier (see discussion)
                          Control0..1
                          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()))
                          24. Patient.identifier:AHVN13.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
                          26. Patient.identifier:AHVN13.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
                          • 28. Patient.identifier:AHVN13.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()))
                            30. Patient.identifier:AHVN13.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|4.0.1)

                            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()))
                            32. Patient.identifier:AHVN13.system
                            Definition

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

                            ShortThe namespace for the identifier value
                            Comments

                            Identifier.system is always case sensitive.

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

                            Fixed Valueurn:oid:2.16.756.5.32
                            ExampleGeneral: http://www.acme.com/identifiers/patient
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            34. Patient.identifier:AHVN13.value
                            Definition

                            AHVN13 / NAVS13 of the patient (13 digits starting ith 756)

                            ShortAHVN13 / NAVS13 of the patient (13 digits starting ith 756)
                            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()))
                            36. Patient.identifier:AHVN13.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()))
                            38. Patient.identifier:AHVN13.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()))
                            40. Patient.identifier:LocalPid
                            Slice NameLocalPid
                            Definition

                            Local patient identifiers

                            ShortLocal patient identifiers
                            NoteThis is a business identifier, not a resource identifier (see discussion)
                            Control0..1
                            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()))
                            42. Patient.identifier:LocalPid.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
                            44. Patient.identifier:LocalPid.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
                            • 46. Patient.identifier:LocalPid.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()))
                              48. Patient.identifier:LocalPid.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|4.0.1)

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

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supporttrue
                              Summarytrue
                              Requirements

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

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

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

                              ShortUnique id for inter-element referencing
                              Control0..1
                              Typestring
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              52. Patient.identifier:LocalPid.type.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.type.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 54. Patient.identifier:LocalPid.type.coding
                                Definition

                                A reference to a code defined by a terminology system.

                                ShortCode defined by a terminology system
                                Comments

                                Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                Control1..1
                                TypeCoding
                                Is Modifierfalse
                                Must Supporttrue
                                Summarytrue
                                Requirements

                                Allows for alternative encodings within a code system, and translations to other code systems.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                56. Patient.identifier:LocalPid.type.coding.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
                                58. Patient.identifier:LocalPid.type.coding.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.type.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 60. Patient.identifier:LocalPid.type.coding.system
                                  Definition

                                  The identification of the code system that defines the meaning of the symbol in the code.

                                  ShortIdentity of the terminology system
                                  Comments

                                  The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

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

                                  Need to be unambiguous about the source of the definition of the symbol.

                                  Fixed Valuehttp://terminology.hl7.org/CodeSystem/v2-0203
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  62. Patient.identifier:LocalPid.type.coding.version
                                  Definition

                                  The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                  ShortVersion of the system - if relevant
                                  Comments

                                  Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                  NoteThis is a business version Id, not a resource version Id (see discussion)
                                  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()))
                                  64. Patient.identifier:LocalPid.type.coding.code
                                  Definition

                                  A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                  ShortSymbol in syntax defined by the system
                                  Control1..1
                                  Typecode
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Summarytrue
                                  Requirements

                                  Need to refer to a particular code in the system.

                                  Fixed ValueMR
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  66. Patient.identifier:LocalPid.type.coding.display
                                  Definition

                                  A representation of the meaning of the code in the system, following the rules of the system.

                                  ShortRepresentation defined by the system
                                  Control0..1
                                  Typestring
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Summarytrue
                                  Requirements

                                  Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                  Fixed ValueMedical record number
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  68. Patient.identifier:LocalPid.type.coding.userSelected
                                  Definition

                                  Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                  ShortIf this coding was chosen directly by the user
                                  Comments

                                  Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

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

                                  This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

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

                                  A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                  ShortPlain text representation of the concept
                                  Comments

                                  Very often the text is the same as a displayName of one of the codings.

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

                                  The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

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

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

                                  ShortUri that defines the Software that delivers the Patient ID. If possible this uri should be unique for each Patient database for example https://mysoftware.ch/patientDB/123456
                                  Comments

                                  Identifier.system is always case sensitive.

                                  Control0..1
                                  Typeuri
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  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()))
                                  74. Patient.identifier:LocalPid.value
                                  Definition

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

                                  ShortThe value that is unique
                                  Comments

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

                                  Control1..1
                                  Typestring
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Summarytrue
                                  ExampleGeneral: 123456
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  76. Patient.identifier:LocalPid.period
                                  Definition

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

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

                                  Organization that issued/manages the identifier.

                                  ShortOrganization that issued id (may be just text)
                                  Comments

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

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

                                  A name associated with the individual.

                                  ShortA name associated with the patient
                                  Comments

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

                                  Control0..*
                                  TypeHumanName(MedNet Interface (MNI) - Human Name)
                                  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()))
                                  84. Patient.telecom
                                  Definition

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

                                  ShortA contact detail for the individual
                                  Comments

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

                                  Control0..*
                                  TypeContactPoint(MedNet Interface (MNI) - ContactPoint)
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summarytrue
                                  Requirements

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

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

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

                                  Shortmale | female | other | unknown
                                  Comments

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

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

                                  The gender of a person used for administrative purposes.

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

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

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

                                  A date, or partial date (e.g. just year or year + month) as used in human communication. The format is YYYY, YYYY-MM, or YYYY-MM-DD, e.g. 2018, 1973-06, or 1905-08-23. There SHALL be no time zone. Dates SHALL be valid dates

                                  ShortThe date of birth for the individual
                                  Comments

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

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

                                  Age of the individual drives many clinical processes.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  LOINC Code21112-8
                                  90. Patient.deceased[x]
                                  Definition

                                  Indicates if the individual is deceased or not.

                                  ShortIndicates if the individual is deceased or not
                                  Comments

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

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

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

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

                                  An address for the individual.

                                  ShortAn address for the individual
                                  Comments

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

                                  Control0..*
                                  TypeAddress(MedNet Interface (MNI) - Address)
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summarytrue
                                  Requirements

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

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

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

                                  ShortMarital (civil) status of a patient
                                  Control0..1
                                  BindingThe codes SHALL be taken from ChCoreMaritalStatus
                                  (required to http://fhir.ch/ig/ch-core/ValueSet/ch-core-maritalstatus)
                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Must Supporttrue
                                  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()))
                                  96. Patient.maritalStatus.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
                                  98. Patient.maritalStatus.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.maritalStatus.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 100. Patient.maritalStatus.coding
                                    Definition

                                    A reference to a code defined by a terminology system.

                                    ShortCode defined by a terminology system
                                    Comments

                                    Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                    Control0..*
                                    TypeCoding
                                    Is Modifierfalse
                                    Summarytrue
                                    Requirements

                                    Allows for alternative encodings within a code system, and translations to other code systems.

                                    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.maritalStatus.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ system
                                    • value @ code
                                    • 102. Patient.maritalStatus.coding:international
                                      Slice Nameinternational
                                      Definition

                                      A reference to a code defined by a terminology system.

                                      ShortCode defined by a terminology system
                                      Comments

                                      Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                      Control0..1
                                      TypeCoding
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summarytrue
                                      Requirements

                                      Allows for alternative encodings within a code system, and translations to other code systems.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      104. Patient.maritalStatus.coding:international.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
                                      106. Patient.maritalStatus.coding:international.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.maritalStatus.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 108. Patient.maritalStatus.coding:international.system
                                        Definition

                                        The identification of the code system that defines the meaning of the symbol in the code.

                                        ShortIdentity of the terminology system
                                        Comments

                                        The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

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

                                        Need to be unambiguous about the source of the definition of the symbol.

                                        Fixed Valuehttp://terminology.hl7.org/CodeSystem/v3-MaritalStatus
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        110. Patient.maritalStatus.coding:international.version
                                        Definition

                                        The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                        ShortVersion of the system - if relevant
                                        Comments

                                        Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                        NoteThis is a business version Id, not a resource version Id (see discussion)
                                        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()))
                                        112. Patient.maritalStatus.coding:international.code
                                        Definition

                                        A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                        ShortAuthorized values : S (Never Married) | M (Married) | W (Widowed) | D (Divorced) | U (unmarried) | T (Domestic partner) | L (Legally Separated) | A (Annulled) | I (Interlocutory) | P (Polygamous) | C (Common Law)
                                        Control1..1
                                        Typecode
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supporttrue
                                        Summarytrue
                                        Requirements

                                        Need to refer to a particular code in the system.

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

                                        A representation of the meaning of the code in the system, following the rules of the system.

                                        ShortAuthorized values : Never Married (S) | Married (M) | Widowed (W) | Divorced (D) | unmarried (U) | Domestic partner (T) | Legally Separated (L) | Annulled (A) | Interlocutory (I)) | Polygamous (P)) | Common Law (C)
                                        Control0..1
                                        Typestring
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supporttrue
                                        Summarytrue
                                        Requirements

                                        Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

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

                                        Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                        ShortIf this coding was chosen directly by the user
                                        Comments

                                        Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

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

                                        This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        118. Patient.maritalStatus.coding:swiss
                                        Slice Nameswiss
                                        Definition

                                        A reference to a code defined by a terminology system.

                                        ShortCode defined by a terminology system
                                        Comments

                                        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                        Control0..1
                                        TypeCoding
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Summarytrue
                                        Requirements

                                        Allows for alternative encodings within a code system, and translations to other code systems.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        120. Patient.maritalStatus.coding:swiss.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
                                        122. Patient.maritalStatus.coding:swiss.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.maritalStatus.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • value @ url
                                        • 124. Patient.maritalStatus.coding:swiss.system
                                          Definition

                                          The identification of the code system that defines the meaning of the symbol in the code.

                                          ShortIdentity of the terminology system
                                          Comments

                                          The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

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

                                          Need to be unambiguous about the source of the definition of the symbol.

                                          Fixed Valuehttp://fhir.ch/ig/ch-core/CodeSystem/ech-11-maritalstatus
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          126. Patient.maritalStatus.coding:swiss.version
                                          Definition

                                          The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                          ShortVersion of the system - if relevant
                                          Comments

                                          Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                          NoteThis is a business version Id, not a resource version Id (see discussion)
                                          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()))
                                          128. Patient.maritalStatus.coding:swiss.code
                                          Definition

                                          A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                          ShortAuthorized values : 1 (Unmarried) | 2 (Married) | 3 (Widowed) | 4 (Divorced) | 5 (Unmarried) | 6 (Domestic partner) | 7 (Legally Separated) | 9 (Unknown)
                                          Control1..1
                                          Typecode
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supporttrue
                                          Summarytrue
                                          Requirements

                                          Need to refer to a particular code in the system.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          130. Patient.maritalStatus.coding:swiss.display
                                          Definition

                                          A representation of the meaning of the code in the system, following the rules of the system.

                                          ShortAuthorized values : Unmarried (1) | Married (2) | Widowed (3) | Divorced (4) | Unmarried (5) | Domestic partner (6) | Legally Separated (7) | Unknown (9).
                                          Control0..1
                                          Typestring
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supporttrue
                                          Summarytrue
                                          Requirements

                                          Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

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

                                          Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                          ShortIf this coding was chosen directly by the user
                                          Comments

                                          Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

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

                                          This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

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

                                          A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                          ShortPlain text representation of the concept
                                          Comments

                                          Very often the text is the same as a displayName of one of the codings.

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

                                          The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          136. 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()))
                                          138. Patient.photo
                                          Definition

                                          Part of ch-core-patient that is currently ignored by MedNet, but could be usefull in the future

                                          Shortcurrently ignored by MedNet, but could be implemented in the future
                                          Comments

                                          Guidelines:

                                          • Use id photos, not clinical photos.
                                          • Limit dimensions to thumbnail.
                                          • Keep byte count low to ease resource updates.
                                          Control0..*
                                          TypeAttachment
                                          Is Modifierfalse
                                          Must Supporttrue
                                          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()))
                                          140. Patient.photo.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
                                          142. Patient.photo.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.photo.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                          • value @ url
                                          • 144. Patient.photo.contentType
                                            Definition

                                            Identifies the type of the data in the attachment and allows a method to be chosen to interpret or render the data. Includes mime type parameters such as charset where appropriate.

                                            ShortMime type of the content, with charset etc.
                                            Control1..1
                                            BindingThe codes SHALL be taken from Mime Types
                                            (required to http://hl7.org/fhir/ValueSet/mimetypes|4.0.1)

                                            The mime type of an attachment. Any valid mime type is allowed.

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

                                            Processors of the data need to be able to know how to interpret the data.

                                            ExampleGeneral: text/plain; charset=UTF-8, image/png
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            146. Patient.photo.language
                                            Definition

                                            The human language of the content. The value can be any valid value according to BCP 47.

                                            ShortHuman language of the content (BCP-47)
                                            Control0..1
                                            BindingThe codes SHOULD be taken from CommonLanguages
                                            (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

                                            A human language.

                                            Additional BindingsPurpose
                                            AllLanguagesMax Binding
                                            Typecode
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summarytrue
                                            Requirements

                                            Users need to be able to choose between the languages in a set of attachments.

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

                                            The actual data of the attachment - a sequence of bytes, base64 encoded.

                                            ShortData inline, base64ed
                                            Comments

                                            The base64-encoded data SHALL be expressed in the same character set as the base resource XML or JSON.

                                            Control0..1
                                            Typebase64Binary
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Must Supporttrue
                                            Summaryfalse
                                            Requirements

                                            The data needs to able to be transmitted inline.

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

                                            A location where the data can be accessed.

                                            ShortUri where the data can be found
                                            Comments

                                            If both data and url are provided, the url SHALL point to the same content as the data contains. Urls may be relative references or may reference transient locations such as a wrapping envelope using cid: though this has ramifications for using signatures. Relative URLs are interpreted relative to the service url, like a resource reference, rather than relative to the resource itself. If a URL is provided, it SHALL resolve to actual data.

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

                                            The data needs to be transmitted by reference.

                                            ExampleGeneral: http://www.acme.com/logo-small.png
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            152. Patient.photo.size
                                            Definition

                                            The number of bytes of data that make up this attachment (before base64 encoding, if that is done).

                                            ShortNumber of bytes of content (if url provided)
                                            Comments

                                            The number of bytes is redundant if the data is provided as a base64binary, but is useful if the data is provided as a url reference.

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

                                            Representing the size allows applications to determine whether they should fetch the content automatically in advance, or refuse to fetch it at all.

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

                                            The calculated hash of the data using SHA-1. Represented using base64.

                                            ShortHash of the data (sha-1, base64ed)
                                            Comments

                                            The hash is calculated on the data prior to base64 encoding, if the data is based64 encoded. The hash is not intended to support digital signatures. Where protection against malicious threats a digital signature should be considered, see Provenance.signature for mechanism to protect a resource with a digital signature.

                                            Control0..1
                                            Typebase64Binary
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Must Supporttrue
                                            Summarytrue
                                            Requirements

                                            Included so that applications can verify that the contents of a location have not changed due to technical failures (e.g., storage rot, transport glitch, incorrect version).

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

                                            A label or set of text to display in place of the data.

                                            ShortLabel to display in place of the data
                                            Control0..1
                                            Typestring
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summarytrue
                                            Requirements

                                            Applications need a label to display to a human user in place of the actual data if the data cannot be rendered or perceived by the viewer.

                                            ExampleGeneral: Official Corporate Logo
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            158. Patient.photo.creation
                                            Definition

                                            The date that the attachment was first created.

                                            ShortDate attachment was first created
                                            Control0..1
                                            TypedateTime
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summarytrue
                                            Requirements

                                            This is often tracked as an integrity issue for use of the attachment.

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

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

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

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

                                            Control0..*
                                            TypeBackboneElement
                                            Is Modifierfalse
                                            Summaryfalse
                                            Requirements

                                            Need to track people you can contact about the patient.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            pat-1: SHALL at least contain a contact's details or a reference to an organization (name.exists() or telecom.exists() or address.exists() or organization.exists())
                                            SlicingThis element introduces a set of slices on Patient.contact. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • value @ relationship.coding.system
                                            • value @ relationship.coding.code
                                            • 162. 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
                                              164. 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())
                                              166. 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())
                                              168. 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|4.0.1)

                                              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()))
                                              170. 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()))
                                              172. 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()))
                                              174. 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()))
                                              176. 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()))
                                              178. 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()))
                                              180. 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()))
                                              182. Patient.contact:MNIContact
                                              Slice NameMNIContact
                                              Definition

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

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

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

                                              Control0..*
                                              TypeBackboneElement
                                              Is Modifierfalse
                                              Must Supporttrue
                                              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())
                                              184. Patient.contact:MNIContact.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
                                              186. Patient.contact:MNIContact.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())
                                              188. Patient.contact:MNIContact.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())
                                              190. Patient.contact:MNIContact.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|4.0.1)

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

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Must Supporttrue
                                              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()))
                                              SlicingThis element introduces a set of slices on Patient.contact.relationship. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • value @ coding.system
                                              • value @ coding.code
                                              • 192. Patient.contact:MNIContact.relationship:KIND
                                                Slice NameKIND
                                                Definition

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

                                                ShortKind of relation ship, for example Emergency contact, Employer
                                                Control0..1
                                                BindingThe codes SHALL be taken from PatientContactRelationship
                                                (required to http://hl7.org/fhir/ValueSet/patient-contactrelationship)
                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Must Supporttrue
                                                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()))
                                                194. Patient.contact:MNIContact.relationship:KIND.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
                                                196. Patient.contact:MNIContact.relationship:KIND.extension
                                                Definition

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

                                                ShortAdditional content defined by implementations
                                                Comments

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

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

                                                  A reference to a code defined by a terminology system.

                                                  ShortCode defined by a terminology system
                                                  Comments

                                                  Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                  Control0..*
                                                  TypeCoding
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summarytrue
                                                  Requirements

                                                  Allows for alternative encodings within a code system, and translations to other code systems.

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

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

                                                  ShortAdditional content defined by implementations
                                                  Comments

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

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

                                                    The identification of the code system that defines the meaning of the symbol in the code.

                                                    ShortIdentity of the terminology system
                                                    Comments

                                                    The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

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

                                                    Need to be unambiguous about the source of the definition of the symbol.

                                                    Fixed Valuehttp://terminology.hl7.org/CodeSystem/v2-0131
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    206. Patient.contact:MNIContact.relationship:KIND.coding.version
                                                    Definition

                                                    The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                                    ShortVersion of the system - if relevant
                                                    Comments

                                                    Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                                    NoteThis is a business version Id, not a resource version Id (see discussion)
                                                    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()))
                                                    208. Patient.contact:MNIContact.relationship:KIND.coding.code
                                                    Definition

                                                    A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                                    ShortC (Emergency Contact) | E (Employer) | F (Federal Agency) | I (Insurance Company) | N (Next-of-Kin) | S (State Agency) | U (Unknown)
                                                    Control1..1
                                                    Typecode
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Must Supporttrue
                                                    Summarytrue
                                                    Requirements

                                                    Need to refer to a particular code in the system.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    210. Patient.contact:MNIContact.relationship:KIND.coding.display
                                                    Definition

                                                    A representation of the meaning of the code in the system, following the rules of the system.

                                                    ShortRepresentation defined by the system
                                                    Control0..1
                                                    Typestring
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Must Supporttrue
                                                    Summarytrue
                                                    Requirements

                                                    Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

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

                                                    Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                                    ShortIf this coding was chosen directly by the user
                                                    Comments

                                                    Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

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

                                                    This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

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

                                                    A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                    ShortIf the relationship can not be coded, it can be described in plain text in this field
                                                    Comments

                                                    Very often the text is the same as a displayName of one of the codings.

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

                                                    The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

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

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

                                                    ShortFamilyMember relation ship, for example sister
                                                    Control0..1
                                                    BindingThe codes SHALL be taken from FamilyMember
                                                    (required to http://terminology.hl7.org/ValueSet/v3-FamilyMember)
                                                    TypeCodeableConcept
                                                    Is Modifierfalse
                                                    Must Supporttrue
                                                    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()))
                                                    218. Patient.contact:MNIContact.relationship:FamilyMember.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
                                                    220. Patient.contact:MNIContact.relationship:FamilyMember.extension
                                                    Definition

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

                                                    ShortAdditional content defined by implementations
                                                    Comments

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

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

                                                      A reference to a code defined by a terminology system.

                                                      ShortCode defined by a terminology system
                                                      Comments

                                                      Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                      Control0..*
                                                      TypeCoding
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Summarytrue
                                                      Requirements

                                                      Allows for alternative encodings within a code system, and translations to other code systems.

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

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

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

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

                                                      ShortAdditional content defined by implementations
                                                      Comments

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

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

                                                        The identification of the code system that defines the meaning of the symbol in the code.

                                                        ShortIdentity of the terminology system
                                                        Comments

                                                        The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

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

                                                        Need to be unambiguous about the source of the definition of the symbol.

                                                        Fixed Valuehttp://terminology.hl7.org/CodeSystem/v3-RoleCode
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        230. Patient.contact:MNIContact.relationship:FamilyMember.coding.version
                                                        Definition

                                                        The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                                        ShortVersion of the system - if relevant
                                                        Comments

                                                        Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                                        NoteThis is a business version Id, not a resource version Id (see discussion)
                                                        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()))
                                                        232. Patient.contact:MNIContact.relationship:FamilyMember.coding.code
                                                        Definition

                                                        A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                                        ShortCHILD (child) | DAU (natural daugher) | SON (natural son) | FTH (father) | MTH (mother) | ...
                                                        Control1..1
                                                        Typecode
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Must Supporttrue
                                                        Summarytrue
                                                        Requirements

                                                        Need to refer to a particular code in the system.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        234. Patient.contact:MNIContact.relationship:FamilyMember.coding.display
                                                        Definition

                                                        A representation of the meaning of the code in the system, following the rules of the system.

                                                        ShortRepresentation defined by the system
                                                        Control0..1
                                                        Typestring
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Must Supporttrue
                                                        Summarytrue
                                                        Requirements

                                                        Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        236. Patient.contact:MNIContact.relationship:FamilyMember.coding.userSelected
                                                        Definition

                                                        Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                                        ShortIf this coding was chosen directly by the user
                                                        Comments

                                                        Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

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

                                                        This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

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

                                                        A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                        ShortIf the relationship can not be coded, it can be described in plain text in this field
                                                        Comments

                                                        Very often the text is the same as a displayName of one of the codings.

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

                                                        The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

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

                                                        A name associated with the contact person.

                                                        ShortA name associated with the contact person
                                                        Control0..1
                                                        TypeHumanName(MedNet Interface (MNI) - Human Name)
                                                        Is Modifierfalse
                                                        Must Supporttrue
                                                        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()))
                                                        242. Patient.contact:MNIContact.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(MedNet Interface (MNI) - ContactPoint)
                                                        Is Modifierfalse
                                                        Must Supporttrue
                                                        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()))
                                                        244. Patient.contact:MNIContact.address
                                                        Definition

                                                        Address for the contact person.

                                                        ShortAddress for the contact person
                                                        Control0..1
                                                        TypeAddress(MedNet Interface (MNI) - Address)
                                                        Is Modifierfalse
                                                        Must Supporttrue
                                                        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()))
                                                        246. Patient.contact:MNIContact.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
                                                        Must Supporttrue
                                                        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()))
                                                        248. Patient.contact:MNIContact.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(MedNet Interface (MNI) - Organization)
                                                        Is Modifierfalse
                                                        Must Supporttrue
                                                        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()))
                                                        250. Patient.contact:MNIContact.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()))
                                                        252. Patient.communication
                                                        Definition

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

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

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

                                                        Control0..*
                                                        TypeBackboneElement
                                                        Is Modifierfalse
                                                        Must Supporttrue
                                                        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()))
                                                        254. 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
                                                        256. 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())
                                                        258. 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())
                                                        260. Patient.communication.language
                                                        Definition

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

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

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

                                                        Control1..1
                                                        BindingThe codes SHOULD be taken from CommonLanguages
                                                        (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

                                                        A human language.

                                                        Additional BindingsPurpose
                                                        AllLanguagesMax Binding
                                                        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()))
                                                        262. Patient.communication.language.id
                                                        Definition

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

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

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

                                                        ShortAdditional content defined by implementations
                                                        Comments

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

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

                                                          A reference to a code defined by a terminology system.

                                                          ShortCode defined by a terminology system
                                                          Comments

                                                          Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                          Control1..*
                                                          TypeCoding
                                                          Is Modifierfalse
                                                          Must Supporttrue
                                                          Summarytrue
                                                          Requirements

                                                          Allows for alternative encodings within a code system, and translations to other code systems.

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

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

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

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

                                                          ShortAdditional content defined by implementations
                                                          Comments

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

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

                                                            The identification of the code system that defines the meaning of the symbol in the code.

                                                            ShortIdentity of the terminology system
                                                            Comments

                                                            The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

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

                                                            Need to be unambiguous about the source of the definition of the symbol.

                                                            Fixed Valueurn:ietf:bcp:47
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            274. Patient.communication.language.coding.version
                                                            Definition

                                                            The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                                            ShortVersion of the system - if relevant
                                                            Comments

                                                            Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                                            NoteThis is a business version Id, not a resource version Id (see discussion)
                                                            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()))
                                                            276. Patient.communication.language.coding.code
                                                            Definition

                                                            A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                                            ShortSymbol in syntax defined by the system
                                                            Control1..1
                                                            Typecode
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Must Supporttrue
                                                            Summarytrue
                                                            Requirements

                                                            Need to refer to a particular code in the system.

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

                                                            A representation of the meaning of the code in the system, following the rules of the system.

                                                            ShortRepresentation defined by the system
                                                            Control0..1
                                                            Typestring
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Must Supporttrue
                                                            Summarytrue
                                                            Requirements

                                                            Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

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

                                                            Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                                            ShortIf this coding was chosen directly by the user
                                                            Comments

                                                            Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

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

                                                            This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

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

                                                            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                            ShortPlain text representation of the concept
                                                            Comments

                                                            Very often the text is the same as a displayName of one of the codings.

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

                                                            The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

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

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

                                                            ShortLanguage preference indicator
                                                            Comments

                                                            This language is specifically identified for communicating healthcare information.

                                                            Control0..1
                                                            Typeboolean
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Must Supporttrue
                                                            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()))
                                                            286. Patient.generalPractitioner
                                                            Definition

                                                            Patient's nominated care provider.

                                                            ShortPatient's nominated primary care provider. We allow multiple general practitioner, since gynecologist can also be listed as general practitioner
                                                            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(MedNet Interface (MNI) - PractitionerRole)
                                                            Is Modifierfalse
                                                            Must Supporttrue
                                                            Summaryfalse
                                                            Alternate NamescareProvider
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            288. 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()))
                                                            290. 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()))
                                                            292. 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
                                                            294. 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())
                                                            296. 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())
                                                            298. 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()))
                                                            300. 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()))