New Zealand MWS IG
1.0.6 - Release
New Zealand MWS IG - Local Development build (v1.0.6) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
Active as of 2024-06-05 |
Definitions for the MwsPatient resource profile.
Guidance on how to interpret the contents of this table can be found here
0. Patient | |
2. Patient.language | |
Control | 0..0 |
LOINC Code | |
4. Patient.extension:ethnicity | |
Slice Name | ethnicity |
Control | 0..0 |
LOINC Code | |
6. Patient.extension:nzCitizen | |
Slice Name | nzCitizen |
Control | 0..0 |
LOINC Code | |
8. Patient.extension:dhb | |
Slice Name | dhb |
Control | 0..0 |
LOINC Code | |
10. Patient.extension:domicile-code | |
Slice Name | domicile-code |
Control | 0..0 |
LOINC Code | |
12. Patient.extension:pho | |
Slice Name | pho |
Control | 0..0 |
LOINC Code | |
14. Patient.extension:sex-at-birth | |
Slice Name | sex-at-birth |
Control | 0..0 |
LOINC Code | |
16. Patient.extension:iwi | |
Slice Name | iwi |
Control | 0..0 |
LOINC Code | |
18. Patient.identifier | |
Note | This is a business identifier, not a resource identifier (see discussion) |
Control | 1..1 |
LOINC Code | |
20. Patient.identifier.system | |
Fixed Value | https://standards.digital.health.nz/ns/nhi-id |
22. Patient.identifier:NHI | |
Slice Name | NHI |
Note | This is a business identifier, not a resource identifier (see discussion) |
Control | 0..1 |
LOINC Code | |
24. Patient.active | |
Control | 0..0 |
LOINC Code | |
26. Patient.telecom | |
Control | 0..0 |
LOINC Code | |
28. Patient.gender | |
Control | 0..0 |
LOINC Code | |
30. Patient.deceased[x] | |
Control | 0..0 |
LOINC Code | |
32. Patient.address | |
Control | 0..0 |
LOINC Code | |
34. Patient.maritalStatus | |
Control | 0..0 |
LOINC Code | |
36. Patient.multipleBirth[x] | |
Control | 0..0 |
LOINC Code | |
38. Patient.photo | |
Control | 0..0 |
LOINC Code | |
40. Patient.contact | |
Control | 0..0 |
LOINC Code | |
42. Patient.generalPractitioner | |
Control | 0..0 |
LOINC Code | |
44. Patient.managingOrganization | |
Control | 0..0 |
LOINC Code | |
46. Patient.link | |
Control | 0..0 |
LOINC Code |
Guidance on how to interpret the contents of this table can be found here
0. Patient | |||||
Definition | Demographics and other administrative information about an individual or animal receiving care or other health-related services. | ||||
Short | Information about an individual or animal receiving health care services | ||||
Control | 0..* | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | SubjectOfCare Client Resident | ||||
Invariants | dom-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()) nz-pat-1: only a single official NHI ( Patient.identifier.where(system='https://standards.digital.health.nz/ns/nhi-id' and use='official').count() < 2 ) | ||||
2. Patient.implicitRules | |||||
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. | ||||
Short | A 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. | ||||
Control | 0..1 | ||||
Type | uri | ||||
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
4. Patient.language | |||||
Definition | The base language in which the resource is written. | ||||
Short | Language 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). | ||||
Control | 0..01 | ||||
Binding | The codes SHOULD be taken from CommonLanguageshttp://hl7.org/fhir/ValueSet/languages (preferred to http://hl7.org/fhir/ValueSet/languages )A human language.
| ||||
Type | code | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
6. Patient.extension:ethnicity | |||||
Slice Name | ethnicity | ||||
Definition | The ethnic group or groups that a person identifies with or feels they belong to. Ethnicity is a measure of cultural affiliation as opposed to race, ancestry, nationality or citizen. Ethnicity is self-perceived and a person can belong to more than one group. The Stats New Zealand standard can be found here. | ||||
Short | NZ Ethnicity | ||||
Control | 0..0 This element is affected by the following invariants: ele-1 | ||||
Type | Extension(NZ Ethnicity) (Extension Type: CodeableConcept) | ||||
Is Modifier | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() )ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) | ||||
LOINC Code | |||||
8. Patient.extension:nzCitizen | |||||
Slice Name | nzCitizen | ||||
Definition | New Zealand citizenship | ||||
Short | NZ Citizenship | ||||
Control | 0..0 This element is affected by the following invariants: ele-1 | ||||
Type | Extension(NZ Citizenship) (Complex Extension) | ||||
Is Modifier | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
LOINC Code | |||||
10. Patient.extension:dhb | |||||
Slice Name | dhb | ||||
Definition | District Health Board relating to a NZ Healthcare Service, Location (Facility) or Patient (primary, physical home address). | ||||
Short | District Health Board linked to a NZ Healthcare Service, Location or Patient | ||||
Control | 0..0 This element is affected by the following invariants: ele-1 | ||||
Type | Extension(District Health Board linked to a NZ Healthcare Service, Location or Patient) (Extension Type: CodeableConcept) | ||||
Is Modifier | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() )ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) | ||||
LOINC Code | |||||
12. Patient.extension:domicile-code | |||||
Slice Name | domicile-code | ||||
Definition | NZ Domicile Code. Derived from a patient's primary physical, home address. | ||||
Short | NZ Domicile Code | ||||
Control | 0..0 This element is affected by the following invariants: ele-1 | ||||
Type | Extension(NZ Domicile Code) (Extension Type: CodeableConcept) | ||||
Is Modifier | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() )ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) | ||||
LOINC Code | |||||
14. Patient.extension:pho | |||||
Slice Name | pho | ||||
Definition | Primary Healthcare Organisation associated with a General Practice linked to a NZ Healthcare Service, Location (Facility) or Patient (GP). | ||||
Short | Primary Healthcare Organisation | ||||
Control | 0..0 This element is affected by the following invariants: ele-1 | ||||
Type | Extension(Primary Healthcare Organisation) (Extension Type: CodeableConcept) | ||||
Is Modifier | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() )ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) | ||||
LOINC Code | |||||
16. Patient.extension:sex-at-birth | |||||
Slice Name | sex-at-birth | ||||
Definition | A person’s sex at the time of their birth (considered to be immutable). | ||||
Short | Sex At Birth | ||||
Control | 0..0 This element is affected by the following invariants: ele-1 | ||||
Type | Extension(Sex At Birth) (Extension Type: CodeableConcept) | ||||
Is Modifier | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() )ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) | ||||
LOINC Code | |||||
18. Patient.extension:iwi | |||||
Slice Name | iwi | ||||
Definition | Persons Iwi affiliation | ||||
Short | Extension | ||||
Control | 0..0 This element is affected by the following invariants: ele-1 | ||||
Type | Extension(Nz_iwi) (Extension Type: CodeableConcept) | ||||
Is Modifier | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() )ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) | ||||
LOINC Code | |||||
20. Patient.modifierExtension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | ||||
Short | Extensions 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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them | ||||
Summary | false | ||||
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 Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) | ||||
22. Patient.identifier | |||||
Definition | An identifier for this patient. | ||||
Short | An identifier for this patient | ||||
Note | This is a business identifier, not a resource identifier (see discussion) | ||||
Control | 10..1* | ||||
Type | Identifier | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Patients are almost always assigned specific numerical identifiers. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
Slicing | This element introduces a set of slices on Patient.identifier . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
24. Patient.identifier.use | |||||
Definition | The purpose of this identifier. | ||||
Short | usual | official | temp | secondary | old (If known) | ||||
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. | ||||
Control | 0..1 | ||||
Binding | The 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 . | ||||
Type | code | ||||
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
26. Patient.identifier.system | |||||
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique. | ||||
Short | The namespace for the identifier value | ||||
Comments | Identifier.system is always case sensitive. | ||||
Control | 0..1 | ||||
Type | uri | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
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 Value | https://standards.digital.health.nz/ns/nhi-id | ||||
Example | <br/><b>General</b>:http://www.acme.com/identifiers/patient | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
28. Patient.identifier:NHI | |||||
Slice Name | NHI | ||||
Definition | An identifier for this patient. | ||||
Short | An identifier for this patient | ||||
Note | This is a business identifier, not a resource identifier (see discussion) | ||||
Control | 0..1* | ||||
Type | Identifier | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Patients are almost always assigned specific numerical identifiers. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
30. Patient.identifier:NHI.use | |||||
Definition | The purpose of this identifier. | ||||
Short | usual | official | temp | secondary | old (If known) | ||||
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. | ||||
Control | 0..1 | ||||
Binding | The codes SHALL be taken from Valid use values for NHIhttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1 (required to https://nzhts.digital.health.nz/fhir/ValueSet/nhi-use-code ) | ||||
Type | code | ||||
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
32. Patient.identifier:NHI.system | |||||
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique. | ||||
Short | The namespace for the identifier value | ||||
Comments | Identifier.system is always case sensitive. | ||||
Control | 10..1 | ||||
Type | uri | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
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 Value | https://standards.digital.health.nz/ns/nhi-id | ||||
Example | <br/><b>General</b>:http://www.acme.com/identifiers/patient | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
34. 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. | ||||
Short | Whether 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. | ||||
Control | 0..01 | ||||
Type | boolean | ||||
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Need to be able to mark a patient record as not to be used because it was created in error. | ||||
Meaning if Missing | This resource is generally assumed to be active if no value is provided for the active element | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
36. Patient.telecom | |||||
Definition | Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc. A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted. | ||||
Short | Details of a Technology mediated contact point (phone, fax, email, etc.)A 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). | ||||
Control | 0..0* This element is affected by the following invariants: ele-1 | ||||
Type | ContactPoint(Common NZ ContactPoint datatype) | ||||
Is Modifier | false | ||||
Requirements | People have (primary) ways to contact them in some way such as phone, email. | ||||
Invariants | cpt-2: A system is required if a value is provided. (value.empty() or system.exists() )ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
38. Patient.gender | |||||
Definition | Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes. | ||||
Short | male | female | other | unknown | ||||
Comments | The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex. | ||||
Control | 0..01 | ||||
Binding | The 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. | ||||
Type | code | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Needed for identification of the individual, in combination with (at least) name and birth date. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
40. Patient.deceased[x] | |||||
Definition | Indicates if the individual is deceased or not. | ||||
Short | Indicates 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. | ||||
Control | 0..01 | ||||
Type | Choice of: boolean, dateTime | ||||
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
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. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
42. Patient.address | |||||
Definition | An address expressed using postal conventions (as opposed to GPS or other location definition formats). This data type may be used to convey addresses for use in delivering mail as well as for visiting locations which might not be valid for mail delivery. There are a variety of postal address formats defined around the world. An address for the individual. | ||||
Short | An address expressed using postal conventions (as opposed to GPS or other location definition formats)An address for the individual | ||||
Comments | Note: address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource). Patient may have multiple addresses with different uses or applicable periods. | ||||
Control | 0..0* This element is affected by the following invariants: ele-1 | ||||
Type | Address(Common NZ Address datatype) | ||||
Is Modifier | false | ||||
Requirements | May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
44. Patient.maritalStatus | |||||
Definition | This field contains a patient's most recent marital (civil) status. | ||||
Short | Marital (civil) status of a patient | ||||
Control | 0..01 | ||||
Binding | Unless not suitable, these codes SHALL be taken from Marital Status Codeshttp://hl7.org/fhir/ValueSet/marital-status (extensible to http://hl7.org/fhir/ValueSet/marital-status )The domestic partnership status of a person. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Summary | false | ||||
Requirements | Most, if not all systems capture it. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
46. Patient.multipleBirth[x] | |||||
Definition | Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer). | ||||
Short | Whether 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). | ||||
Control | 0..01 | ||||
Type | Choice of: boolean, integer | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | false | ||||
Requirements | For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
48. Patient.photo | |||||
Definition | Image of the patient. | ||||
Short | Image of the patient | ||||
Comments | Guidelines:
| ||||
Control | 0..0* | ||||
Type | Attachment | ||||
Is Modifier | false | ||||
Summary | false | ||||
Requirements | Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
50. Patient.contact | |||||
Definition | A contact party (e.g. guardian, partner, friend) for the patient. | ||||
Short | A 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. | ||||
Control | 0..0* | ||||
Type | BackboneElement | ||||
Is Modifier | false | ||||
Summary | false | ||||
Requirements | Need to track people you can contact about the patient. | ||||
Invariants | ele-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()) | ||||
53. Patient.generalPractitioner | |||||
Definition | Patient's nominated care provider. | ||||
Short | Patient's nominated primary care provider | ||||
Comments | This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues. Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type. | ||||
Control | 0..0* | ||||
Type | Reference(Organization, Practitioner, PractitionerRole) | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | careProvider | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
55. Patient.managingOrganization | |||||
Definition | Organization that is the custodian of the patient record. | ||||
Short | Organization 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). | ||||
Control | 0..01 | ||||
Type | Reference(Organization) | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Need to know who recognizes this patient record, manages and updates it. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
57. Patient.link | |||||
Definition | Link to another patient resource that concerns the same actual patient. | ||||
Short | Link to another patient resource that concerns the same actual person | ||||
Comments | There is no assumption that linked patient records have mutual links. | ||||
Control | 0..0* | ||||
Type | BackboneElement | ||||
Is Modifier | true 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' | ||||
Summary | true | ||||
Requirements | There are multiple use cases:
| ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
Guidance on how to interpret the contents of this table can be found here
0. Patient | |||||
Definition | Demographics and other administrative information about an individual or animal receiving care or other health-related services. | ||||
Short | Information about an individual or animal receiving health care services | ||||
Control | 0..* | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | SubjectOfCare Client Resident | ||||
Invariants | dom-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() )nz-pat-1: only a single official NHI ( Patient.identifier.where(system='https://standards.digital.health.nz/ns/nhi-id' and use='official').count() < 2 ) | ||||
2. Patient.id | |||||
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. | ||||
Short | Logical id of this artifact | ||||
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation. | ||||
Control | 0..1 | ||||
Type | id | ||||
Is Modifier | false | ||||
Summary | true | ||||
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. | ||||
Short | Metadata about the resource | ||||
Control | 0..1 | ||||
Type | Meta | ||||
Is Modifier | false | ||||
Summary | true | ||||
Invariants | ele-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. | ||||
Short | A 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. | ||||
Control | 0..1 | ||||
Type | uri | ||||
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Invariants | ele-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. | ||||
Short | Language 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). | ||||
Control | 0..0 | ||||
Binding | The codes SHOULD be taken from CommonLanguages (preferred to http://hl7.org/fhir/ValueSet/languages )A human language.
| ||||
Type | code | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | false | ||||
Invariants | ele-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. | ||||
Short | Text 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. | ||||
Control | 0..1 | ||||
Type | Narrative | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | narrative, html, xhtml, display | ||||
Invariants | ele-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. | ||||
Short | Contained, 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. | ||||
Control | 0..* | ||||
Type | Resource | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | inline resources, anonymous resources, contained resources | ||||
14. Patient.extension | |||||
Definition | An Extension | ||||
Short | Extension | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
Slicing | This element introduces a set of slices on Patient.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
16. Patient.extension:ethnicity | |||||
Slice Name | ethnicity | ||||
Definition | The ethnic group or groups that a person identifies with or feels they belong to. Ethnicity is a measure of cultural affiliation as opposed to race, ancestry, nationality or citizen. Ethnicity is self-perceived and a person can belong to more than one group. The Stats New Zealand standard can be found here. | ||||
Short | NZ Ethnicity | ||||
Control | 0..0 This element is affected by the following invariants: ele-1 | ||||
Type | Extension(NZ Ethnicity) (Extension Type: CodeableConcept) | ||||
Is Modifier | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
18. Patient.extension:nzCitizen | |||||
Slice Name | nzCitizen | ||||
Definition | New Zealand citizenship | ||||
Short | NZ Citizenship | ||||
Control | 0..0 This element is affected by the following invariants: ele-1 | ||||
Type | Extension(NZ Citizenship) (Complex Extension) | ||||
Is Modifier | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
20. Patient.extension:dhb | |||||
Slice Name | dhb | ||||
Definition | District Health Board relating to a NZ Healthcare Service, Location (Facility) or Patient (primary, physical home address). | ||||
Short | District Health Board linked to a NZ Healthcare Service, Location or Patient | ||||
Control | 0..0 This element is affected by the following invariants: ele-1 | ||||
Type | Extension(District Health Board linked to a NZ Healthcare Service, Location or Patient) (Extension Type: CodeableConcept) | ||||
Is Modifier | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
22. Patient.extension:domicile-code | |||||
Slice Name | domicile-code | ||||
Definition | NZ Domicile Code. Derived from a patient's primary physical, home address. | ||||
Short | NZ Domicile Code | ||||
Control | 0..0 This element is affected by the following invariants: ele-1 | ||||
Type | Extension(NZ Domicile Code) (Extension Type: CodeableConcept) | ||||
Is Modifier | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
24. Patient.extension:pho | |||||
Slice Name | pho | ||||
Definition | Primary Healthcare Organisation associated with a General Practice linked to a NZ Healthcare Service, Location (Facility) or Patient (GP). | ||||
Short | Primary Healthcare Organisation | ||||
Control | 0..0 This element is affected by the following invariants: ele-1 | ||||
Type | Extension(Primary Healthcare Organisation) (Extension Type: CodeableConcept) | ||||
Is Modifier | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
26. Patient.extension:sex-at-birth | |||||
Slice Name | sex-at-birth | ||||
Definition | A person’s sex at the time of their birth (considered to be immutable). | ||||
Short | Sex At Birth | ||||
Control | 0..0 This element is affected by the following invariants: ele-1 | ||||
Type | Extension(Sex At Birth) (Extension Type: CodeableConcept) | ||||
Is Modifier | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
28. Patient.extension:iwi | |||||
Slice Name | iwi | ||||
Definition | Persons Iwi affiliation | ||||
Short | Extension | ||||
Control | 0..0 This element is affected by the following invariants: ele-1 | ||||
Type | Extension(Nz_iwi) (Extension Type: CodeableConcept) | ||||
Is Modifier | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
30. Patient.modifierExtension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | ||||
Short | Extensions 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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them | ||||
Summary | false | ||||
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 Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
32. Patient.identifier | |||||
Definition | An identifier for this patient. | ||||
Short | An identifier for this patient | ||||
Note | This is a business identifier, not a resource identifier (see discussion) | ||||
Control | 1..1 | ||||
Type | Identifier | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Patients are almost always assigned specific numerical identifiers. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
Slicing | This element introduces a set of slices on Patient.identifier . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
34. Patient.identifier.id | |||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
36. Patient.identifier.extension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | ||||
Short | Additional 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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
Slicing | This element introduces a set of slices on Patient.identifier.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
38. Patient.identifier.use | |||||
Definition | The purpose of this identifier. | ||||
Short | usual | official | temp | secondary | old (If known) | ||||
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. | ||||
Control | 0..1 | ||||
Binding | The 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 . | ||||
Type | code | ||||
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
40. Patient.identifier.type | |||||
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. | ||||
Short | Description 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. | ||||
Control | 0..1 | ||||
Binding | Unless not suitable, these codes SHALL be taken from Identifier Type Codes (extensible to http://hl7.org/fhir/ValueSet/identifier-type )A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Allows users to make use of identifiers when the identifier system is not known. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
42. Patient.identifier.system | |||||
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique. | ||||
Short | The namespace for the identifier value | ||||
Comments | Identifier.system is always case sensitive. | ||||
Control | 0..1 | ||||
Type | uri | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
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 Value | https://standards.digital.health.nz/ns/nhi-id | ||||
Example | <br/><b>General</b>:http://www.acme.com/identifiers/patient | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
44. Patient.identifier.value | |||||
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system. | ||||
Short | 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. | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Example | <br/><b>General</b>:123456 | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
46. Patient.identifier.period | |||||
Definition | Time period during which identifier is/was valid for use. | ||||
Short | Time period when id is/was valid for use | ||||
Control | 0..1 | ||||
Type | Period | ||||
Is Modifier | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
48. Patient.identifier.assigner | |||||
Definition | Organization that issued/manages the identifier. | ||||
Short | Organization 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. | ||||
Control | 0..1 | ||||
Type | Reference(Organization) | ||||
Is Modifier | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
50. Patient.identifier:NHI | |||||
Slice Name | NHI | ||||
Definition | An identifier for this patient. | ||||
Short | An identifier for this patient | ||||
Note | This is a business identifier, not a resource identifier (see discussion) | ||||
Control | 0..1 | ||||
Type | Identifier | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Patients are almost always assigned specific numerical identifiers. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
52. Patient.identifier:NHI.id | |||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
54. Patient.identifier:NHI.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. | ||||
Short | Additional 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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
Slicing | This element introduces a set of slices on Patient.identifier.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
56. Patient.identifier:NHI.use | |||||
Definition | The purpose of this identifier. | ||||
Short | usual | official | temp | secondary | old (If known) | ||||
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. | ||||
Control | 0..1 | ||||
Binding | The codes SHALL be taken from Valid use values for NHI (required to https://nzhts.digital.health.nz/fhir/ValueSet/nhi-use-code ) | ||||
Type | code | ||||
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
58. Patient.identifier:NHI.type | |||||
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. | ||||
Short | Description 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. | ||||
Control | 0..1 | ||||
Binding | Unless not suitable, these codes SHALL be taken from Identifier Type Codes (extensible to http://hl7.org/fhir/ValueSet/identifier-type )A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Allows users to make use of identifiers when the identifier system is not known. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
60. Patient.identifier:NHI.system | |||||
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique. | ||||
Short | The namespace for the identifier value | ||||
Comments | Identifier.system is always case sensitive. | ||||
Control | 1..1 | ||||
Type | uri | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
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 Value | https://standards.digital.health.nz/ns/nhi-id | ||||
Example | <br/><b>General</b>:http://www.acme.com/identifiers/patient | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
62. Patient.identifier:NHI.value | |||||
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system. | ||||
Short | 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. | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Example | <br/><b>General</b>:123456 | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
64. Patient.identifier:NHI.period | |||||
Definition | Time period during which identifier is/was valid for use. | ||||
Short | Time period when id is/was valid for use | ||||
Control | 0..1 | ||||
Type | Period | ||||
Is Modifier | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
66. Patient.identifier:NHI.assigner | |||||
Definition | Organization that issued/manages the identifier. | ||||
Short | Organization 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. | ||||
Control | 0..1 | ||||
Type | Reference(Organization) | ||||
Is Modifier | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
68. 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. | ||||
Short | Whether 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. | ||||
Control | 0..0 | ||||
Type | boolean | ||||
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Need to be able to mark a patient record as not to be used because it was created in error. | ||||
Meaning if Missing | This resource is generally assumed to be active if no value is provided for the active element | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
70. Patient.name | |||||
Definition | A name associated with the individual. | ||||
Short | A 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. | ||||
Control | 0..* | ||||
Type | HumanName | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Need to be able to track the patient by multiple names. Examples are your official name and a partner name. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
72. Patient.telecom | |||||
Definition | Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc. | ||||
Short | Details of a Technology mediated contact point (phone, fax, email, etc.) | ||||
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). | ||||
Control | 0..0 This element is affected by the following invariants: ele-1 | ||||
Type | ContactPoint(Common NZ ContactPoint datatype) | ||||
Is Modifier | false | ||||
Requirements | People have (primary) ways to contact them in some way such as phone, email. | ||||
Invariants | cpt-2: A system is required if a value is provided. (value.empty() or system.exists() )ele-1: All FHIR elements must have a @value or children ( hasValue() or (children().count() > id.count()) ) | ||||
74. Patient.gender | |||||
Definition | Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes. | ||||
Short | male | female | other | unknown | ||||
Comments | The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex. | ||||
Control | 0..0 | ||||
Binding | The 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. | ||||
Type | code | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Needed for identification of the individual, in combination with (at least) name and birth date. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
76. Patient.birthDate | |||||
Definition | The date of birth for the individual. | ||||
Short | The 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). | ||||
Control | 0..1 | ||||
Type | date | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Age of the individual drives many clinical processes. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
LOINC Code | 21112-8 | ||||
78. Patient.deceased[x] | |||||
Definition | Indicates if the individual is deceased or not. | ||||
Short | Indicates 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. | ||||
Control | 0..0 | ||||
Type | Choice of: boolean, dateTime | ||||
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
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. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
80. Patient.address | |||||
Definition | An address expressed using postal conventions (as opposed to GPS or other location definition formats). This data type may be used to convey addresses for use in delivering mail as well as for visiting locations which might not be valid for mail delivery. There are a variety of postal address formats defined around the world. | ||||
Short | An address expressed using postal conventions (as opposed to GPS or other location definition formats) | ||||
Comments | Note: address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource). | ||||
Control | 0..0 This element is affected by the following invariants: ele-1 | ||||
Type | Address(Common NZ Address datatype) | ||||
Is Modifier | false | ||||
Requirements | May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
82. Patient.maritalStatus | |||||
Definition | This field contains a patient's most recent marital (civil) status. | ||||
Short | Marital (civil) status of a patient | ||||
Control | 0..0 | ||||
Binding | Unless not suitable, these codes SHALL be taken from Marital Status Codes (extensible to http://hl7.org/fhir/ValueSet/marital-status )The domestic partnership status of a person. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Summary | false | ||||
Requirements | Most, if not all systems capture it. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
84. Patient.multipleBirth[x] | |||||
Definition | Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer). | ||||
Short | Whether 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). | ||||
Control | 0..0 | ||||
Type | Choice of: boolean, integer | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | false | ||||
Requirements | For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
86. Patient.photo | |||||
Definition | Image of the patient. | ||||
Short | Image of the patient | ||||
Comments | Guidelines:
| ||||
Control | 0..0 | ||||
Type | Attachment | ||||
Is Modifier | false | ||||
Summary | false | ||||
Requirements | Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too. | ||||
Invariants | ele-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. | ||||
Short | A 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. | ||||
Control | 0..0 | ||||
Type | BackboneElement | ||||
Is Modifier | false | ||||
Summary | false | ||||
Requirements | Need to track people you can contact about the patient. | ||||
Invariants | ele-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() ) | ||||
100. Patient.communication | |||||
Definition | A language which may be used to communicate with the patient about his or her health. | ||||
Short | A 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. | ||||
Control | 0..* | ||||
Type | BackboneElement | ||||
Is Modifier | false | ||||
Summary | false | ||||
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. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
102. 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. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
104. 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. | ||||
Short | Additional 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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
106. 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). | ||||
Short | Extensions 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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | ||||
Summary | true | ||||
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 Names | extensions, user content, modifiers | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
108. Patient.communication.language | |||||
Definition | The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English. | ||||
Short | The language which can be used to communicate with the patient about his or her health | ||||
Comments | The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type. | ||||
Control | 1..1 | ||||
Binding | The codes SHOULD be taken from CommonLanguages (preferred to http://hl7.org/fhir/ValueSet/languages )A human language.
| ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Summary | false | ||||
Requirements | Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
110. Patient.communication.preferred | |||||
Definition | Indicates whether or not the patient prefers this language (over other languages he masters up a certain level). | ||||
Short | Language preference indicator | ||||
Comments | This language is specifically identified for communicating healthcare information. | ||||
Control | 0..1 | ||||
Type | boolean | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | false | ||||
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. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
112. Patient.generalPractitioner | |||||
Definition | Patient's nominated care provider. | ||||
Short | Patient's nominated primary care provider | ||||
Comments | This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues. Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type. | ||||
Control | 0..0 | ||||
Type | Reference(Organization, Practitioner, PractitionerRole) | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | careProvider | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
114. Patient.managingOrganization | |||||
Definition | Organization that is the custodian of the patient record. | ||||
Short | Organization 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). | ||||
Control | 0..0 | ||||
Type | Reference(Organization) | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Need to know who recognizes this patient record, manages and updates it. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
116. Patient.link | |||||
Definition | Link to another patient resource that concerns the same actual patient. | ||||
Short | Link to another patient resource that concerns the same actual person | ||||
Comments | There is no assumption that linked patient records have mutual links. | ||||
Control | 0..0 | ||||
Type | BackboneElement | ||||
Is Modifier | true 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' | ||||
Summary | true | ||||
Requirements | There are multiple use cases:
| ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |