Guide d'implémentation Fr Core
2.0.0-ballot - trial-use France flag

This page is part of the Guide d'implémentation Fr Core (v2.0.0-ballot: Release) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Resource Profile: FRCorePatientProfile - Detailed Descriptions

Draft as of 2024-02-20

Definitions for the fr-core-patient resource profile.

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

0. Patient
2. Patient.meta
4. Patient.meta.profile
SlicingThis element introduces a set of slices on Patient.meta.profile. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ $this
6. Patient.meta.profile:fr-canonical
Slice Namefr-canonical
Control0..1
Pattern Valuehttps://hl7.fr/ig/fhir/core/StructureDefinition/fr-core-patient
8. Patient.extension
LOINC Code
SlicingThis element introduces a set of slices on Patient.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
10. Patient.extension:nationality
Slice Namenationality
Control0..1
TypeExtension(FR Core Nationality Extension) (Complex Extension)
12. Patient.extension:identityReliability
Slice NameidentityReliability
Control0..*
TypeExtension(FR Core Patient Ident Reliability Extension) (Complex Extension)
14. Patient.extension:deathPlace
Slice NamedeathPlace
Control0..1
TypeExtension(FR Core Patient Death Place Extension) (Extension Type: string)
16. Patient.extension:birthdateUpdateIndicator
Slice NamebirthdateUpdateIndicator
Control0..1
TypeExtension(FR Core Patient Birthdate Update Indicator Extension) (Extension Type: boolean)
18. Patient.extension:birthPlace
Slice NamebirthPlace
Control0..1
TypeExtension(Birth Place) (Extension Type: Address)
20. Patient.extension:birthPlace.value[x]
TypeAddress(FR Core Address Profile)
[x] NoteSee Choice of Data Types for further information about how to use [x]
22. Patient.identifier
ShortAn identifier for this patient | Identifiant patient. Pour modéliser un patient avec une INS validée, il est nécessaire de respecter la conformité au profil FrCorePatientINS. Les identifiants NIR et NIA ne sont définis uniquement dans le cas du FRCorePatientINS.
NoteThis is a business identifier, not a resource identifier (see discussion)
LOINC Code
SlicingThis element introduces a set of slices on Patient.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ type
24. Patient.identifier.type
BindingUnless not suitable, these codes SHALL be taken from FR Core ValueSet Patient identifier type
(extensible to https://hl7.fr/ig/fhir/core/ValueSet/fr-core-vs-patient-identifier-type
26. Patient.identifier:INS-C
Slice NameINS-C
Definition

Computed National Health Identifier | Identifiant National de Santé Calculé à partir des éléments de la carte vitale

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
28. Patient.identifier:INS-C.use
Pattern Valuesecondary
30. Patient.identifier:INS-C.type
Definition

Computed National Health Identifier | Identifiant National de Santé Calculé à partir des éléments de la carte vitale

Control1..?
Pattern Value{
  "coding" : [{
    "system" : "https://hl7.fr/ig/fhir/core/CodeSystem/fr-core-cs-v2-0203",
    "code" : "INS-C",
    "display" : "Identifiant National de Santé Calculé"
  }]
}
32. Patient.identifier:INS-C.system
Pattern Valueurn:oid:1.2.250.1.213.1.4.2
34. Patient.identifier:INS-C.value
Control1..?
36. Patient.identifier:NDP
Slice NameNDP
ShortFrench pharmaceutical Record Identifier | Numéro de Dossier Pharmaceutique français. Celui-ci est unique.
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..1
38. Patient.identifier:NDP.use
Pattern Valuesecondary
40. Patient.identifier:NDP.type
Control1..?
BindingUnless not suitable, these codes SHALL be taken from FR Core ValueSet Patient identifier type
(extensible to https://hl7.fr/ig/fhir/core/ValueSet/fr-core-vs-patient-identifier-type
Pattern Value{
  "coding" : [{
    "system" : "https://hl7.fr/ig/fhir/core/CodeSystem/fr-core-cs-v2-0203",
    "code" : "NDP",
    "display" : "Identifiant du patient au Dossier Pharmaceutique"
  }]
}
42. Patient.identifier:NDP.system
Control1..?
Pattern Valueurn:oid:1.2.250.1.176.1.2
44. Patient.identifier:NDP.value
Control1..?
46. Patient.identifier:PI
Slice NamePI
Definition

Hospital assigned patient identifier | IPP

ShortHospital assigned patient identifier | IPP
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..1
48. Patient.identifier:PI.use
Pattern Valueusual
50. Patient.identifier:PI.type
Control1..?
Pattern Value{
  "coding" : [{
    "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
    "code" : "PI",
    "display" : "Patient internal identifier"
  }]
}
52. Patient.identifier:PI.system
Control1..?
54. Patient.identifier:PI.value
Control1..?
56. Patient.identifier:RRI
Slice NameRRI
Definition

Regional Registry ID | Identifiant régional

ShortRegional Registry ID | Identifiant régional
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
58. Patient.identifier:RRI.use
Pattern Valuesecondary
60. Patient.identifier:RRI.type
Control1..?
Pattern Value{
  "coding" : [{
    "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
    "code" : "RRI",
    "display" : "Regional registry ID"
  }]
}
62. Patient.identifier:RRI.system
Control1..?
64. Patient.identifier:RRI.value
Control1..?
66. Patient.name
TypeHumanName(FR Core Human Name Profile)
LOINC Code
SlicingThis element introduces a set of slices on Patient.name. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ use
68. Patient.name:usualName
Slice NameusualName
Definition

A human's name with the ability to identify parts and usage | Le nom utilisé (usual) n’est transmis que s’il est défini (par exemple nom marital du conjoint).

ShortName of a human | Nom utilisé
Control0..*
70. Patient.name:usualName.use
Control1..?
Pattern Valueusual
72. Patient.name:officialName
Slice NameofficialName
Definition

A human's name with the ability to identify parts and usage | Le nom de naissance (official) est obligatoire dans le cas où l’on véhicule l’INS et que l’identité est qualifiée (celui-ci ne doit pas être altéré).

ShortName of a human | Nom de naissance
Control0..*
74. Patient.name:officialName.extension:birth-list-given-name
Slice Namebirth-list-given-name
Control0..1
TypeExtension(FR Core Patient Birth List Given name Extension) (Extension Type: string)
76. Patient.name:officialName.use
Control1..?
Pattern Valueofficial
78. Patient.name:officialName.family
Control1..?
80. Patient.name:officialName.given
Control1..1
82. Patient.telecom
TypeContactPoint(FR Core Contact Point Profile)
LOINC Code
84. Patient.gender
Definition

French patient's gender checked with the INSi teleservice | Genre du patient. Dans le cas d'une identité récupérée par le téléservice INSi, les valeurs sont M ou F

LOINC Code
86. Patient.birthDate
Definition

The date of birth for the french patient checked with the INSitelservice | Date de naissance du patient. Dans le cas d'une identité récupérée du téléservice INSi, la date de naissance est modifiée selon les règles du RNIV dans le cas de dates exceptionnelles.

ShortThe date of birth for the french patient checked with the INSitelservice | Date de naissance du patient. Dans le cas d'une identité récupérée du téléservice INSi, la date de naissance est modifiée selon les règles du RNIV dans le cas de dates exceptionnelles.
LOINC Code
88. Patient.address
TypeAddress(FR Core Address Profile)
LOINC Code
90. Patient.maritalStatus
BindingUnless not suitable, these codes SHALL be taken from FR Core ValueSet Patient gender INS ValueSet
(extensible to https://hl7.fr/ig/fhir/core/ValueSet/fr-core-vs-marital-status
LOINC Code
92. Patient.contact
94. Patient.contact.extension
LOINC Code
SlicingThis element introduces a set of slices on Patient.contact.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
96. Patient.contact.extension:contactIdentifier
Slice NamecontactIdentifier
Control0..1
TypeExtension(FR Core Patient Contact Identifier Extension) (Extension Type: Identifier)
98. Patient.contact.extension:comment
Slice Namecomment
Control0..1
TypeExtension(FR Core Comment Extension) (Extension Type: string)
100. Patient.contact.relationship
Control1..1
LOINC Code
SlicingThis element introduces a set of slices on Patient.contact.relationship. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ coding.system
102. Patient.contact.relationship:RolePerson
Slice NameRolePerson
ShortThe nature of the relationship. Rôle de la personne. Ex : personne de confiance, aidant ...
Control0..1
BindingUnless not suitable, these codes SHALL be taken from FR Core ValueSet Related person role
(extensible to https://hl7.fr/ig/fhir/core/ValueSet/fr-core-vs-related-person-role
104. Patient.contact.relationship:RelatedPerson
Slice NameRelatedPerson
ShortThe nature of the relationship. Relation de la personne. Ex : Mère, époux, enfant ...
Control0..1
BindingUnless not suitable, these codes SHALL be taken from FR Core ValueSet Related person role
(extensible to https://hl7.fr/ig/fhir/core/ValueSet/fr-core-vs-related-person
106. Patient.contact.name
TypeHumanName(FR Core Human Name Profile)
LOINC Code
108. Patient.contact.telecom
TypeContactPoint(FR Core Contact Point Profile)
LOINC Code
110. Patient.generalPractitioner
TypeReference(FR Core Practitioner Profile, FR Core Organization Profile, PractitionerRole)
LOINC Code
112. Patient.managingOrganization
TypeReference(FR Core Organization Profile)
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.

ShortInformation 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.implicitRules
Definition

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

ShortA set of rules under which this content was created
Comments

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

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

An Extension


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

ShortExtensionAdditional content defined by implementations
Comments

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

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.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
6. Patient.extension:nationality
Slice Namenationality
Definition

The nationality of the patient.

ShortNationality
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(FR Core Nationality Extension) (Complex Extension)
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
LOINC Code
8. Patient.extension:identityReliability
Slice NameidentityReliability
Definition

Reliabilility of the patient's identity | Précision sur le degré de fiabilité de l'identité du patient (si provisoire, validé... avec la justification : quelle type de pièce d'identité ?) avec la méthode de collection

ShortReliabilility of the identity | Fiabilité de l'identité
Control0..*
This element is affected by the following invariants: ele-1
TypeExtension(FR Core Patient Ident Reliability Extension) (Complex Extension)
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
LOINC Code
10. Patient.extension:deathPlace
Slice NamedeathPlace
Definition

Carries the death place of the patient |Précise le lieu de décès du patient (hôpital, sur la voie publique, au domicile, etc.).

ShortFR Core Patient Death Place Extension
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(FR Core Patient Death Place Extension) (Extension Type: string)
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
LOINC Code
12. Patient.extension:birthdateUpdateIndicator
Slice NamebirthdateUpdateIndicator
Definition

An Extension

ShortFR Core Patient Birthdate Update Indicator Extension
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(FR Core Patient Birthdate Update Indicator Extension) (Extension Type: boolean)
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
LOINC Code
14. Patient.extension:birthPlace
Slice NamebirthPlace
Definition

The registered place of birth of the patient. A sytem may use the address.text if they don't store the birthPlace address in discrete elements.

ShortPlace of Birth for patient
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(Birth Place) (Extension Type: Address)
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
LOINC Code
16. Patient.extension:birthPlace.extension
Definition

An Extension


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

ShortExtensionAdditional content defined by implementations
Comments

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

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

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

Shortidentifies the meaning of the extension
Comments

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

Control1..1
Typeuri
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
Fixed Valuehttp://hl7.org/fhir/StructureDefinition/patient-birthPlace
20. Patient.extension:birthPlace.value[x]
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.


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

ShortAn address expressed using postal conventions (as opposed to GPS or other location definition formats)Value of extension
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).

Control10..1
This element is affected by the following invariants: ele-1
TypeAddress(FR Core Address Profile), date, Meta, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] NoteSee Choice of Data Types for further information about how to use [x]
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. Patient.modifierExtension
Definition

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

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

ShortExtensions that cannot be ignored
Comments

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

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

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

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

An identifier for this patient.

ShortAn identifier for this patient | Identifiant patient. Pour modéliser un patient avec une INS validée, il est nécessaire de respecter la conformité au profil FrCorePatientINS. Les identifiants NIR et NIA ne sont définis uniquement dans le cas du FRCorePatientINS.
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Is Modifierfalse
Summarytrue
Requirements

Patients are almost always assigned specific numerical identifiers.

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

The purpose of this identifier.

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

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

Control0..1
BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
(required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
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.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 FR Core ValueSet Patient identifier typehttp://hl7.org/fhir/ValueSet/identifier-type
(extensible to https://hl7.fr/ig/fhir/core/ValueSet/fr-core-vs-patient-identifier-type
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()))
30. Patient.identifier:INS-C
Slice NameINS-C
Definition

Computed National Health Identifier | Identifiant National de Santé Calculé à partir des éléments de la carte vitale


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
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()))
32. Patient.identifier:INS-C.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
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.

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

Computed National Health Identifier | Identifiant National de Santé Calculé à partir des éléments de la carte vitale


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
(extensible to http://hl7.org/fhir/ValueSet/identifier-type
TypeCodeableConcept
Is Modifierfalse
Summarytrue
Requirements

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

Pattern Value{
  "coding" : [{
    "system" : "https://hl7.fr/ig/fhir/core/CodeSystem/fr-core-cs-v2-0203",
    "code" : "INS-C",
    "display" : "Identifiant National de Santé Calculé"
  }]
}
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. Patient.identifier:INS-C.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.

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

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Pattern Valueurn:oid:1.2.250.1.213.1.4.2
Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. Patient.identifier:INS-C.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
Summarytrue
Example<br/><b>General</b>:123456
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. Patient.identifier:NDP
Slice NameNDP
Definition

An identifier for this patient.

ShortFrench pharmaceutical Record Identifier | Numéro de Dossier Pharmaceutique français. Celui-ci est unique.An identifier for this patient
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..1*
TypeIdentifier
Is Modifierfalse
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:NDP.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
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.

Pattern Valuesecondary
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
44. Patient.identifier:NDP.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 FR Core ValueSet Patient identifier typehttp://hl7.org/fhir/ValueSet/identifier-type
(extensible to https://hl7.fr/ig/fhir/core/ValueSet/fr-core-vs-patient-identifier-type
TypeCodeableConcept
Is Modifierfalse
Summarytrue
Requirements

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

Pattern Value{
  "coding" : [{
    "system" : "https://hl7.fr/ig/fhir/core/CodeSystem/fr-core-cs-v2-0203",
    "code" : "NDP",
    "display" : "Identifiant du patient au Dossier Pharmaceutique"
  }]
}
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
46. Patient.identifier:NDP.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
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Pattern Valueurn:oid:1.2.250.1.176.1.2
Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
48. Patient.identifier:NDP.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
Summarytrue
Example<br/><b>General</b>:123456
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
50. Patient.identifier:PI
Slice NamePI
Definition

Hospital assigned patient identifier | IPP


An identifier for this patient.

ShortHospital assigned patient identifier | IPPAn identifier for this patient
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..1*
TypeIdentifier
Is Modifierfalse
Summarytrue
Requirements

Patients are almost always assigned specific numerical identifiers.

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

Pattern Valueusual
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
54. Patient.identifier:PI.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
(extensible to http://hl7.org/fhir/ValueSet/identifier-type
TypeCodeableConcept
Is Modifierfalse
Summarytrue
Requirements

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

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

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
58. Patient.identifier:PI.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
Summarytrue
Example<br/><b>General</b>:123456
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
60. Patient.identifier:RRI
Slice NameRRI
Definition

Regional Registry ID | Identifiant régional


An identifier for this patient.

ShortRegional Registry ID | Identifiant régionalAn identifier for this patient
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Is Modifierfalse
Summarytrue
Requirements

Patients are almost always assigned specific numerical identifiers.

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

Pattern Valuesecondary
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
64. Patient.identifier:RRI.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
(extensible to http://hl7.org/fhir/ValueSet/identifier-type
TypeCodeableConcept
Is Modifierfalse
Summarytrue
Requirements

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

Pattern Value{
  "coding" : [{
    "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
    "code" : "RRI",
    "display" : "Regional registry ID"
  }]
}
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
66. Patient.identifier:RRI.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
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
68. Patient.identifier:RRI.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
Summarytrue
Example<br/><b>General</b>:123456
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
70. 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()))
72. 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(FR Core Human Name Profile)
Is Modifierfalse
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()))
SlicingThis element introduces a set of slices on Patient.name. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ use
74. Patient.name:usualName
Slice NameusualName
Definition

A human's name with the ability to identify parts and usage | Le nom utilisé (usual) n’est transmis que s’il est défini (par exemple nom marital du conjoint).


A name associated with the individual.

ShortName of a human | Nom utiliséA 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
Is Modifierfalse
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()))
76. Patient.name:usualName.use
Definition

Identifies the purpose for this name.

Shortusual | official | temp | nickname | anonymous | old | maiden
Comments

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

Control10..1
BindingThe codes SHALL be taken from NameUsehttp://hl7.org/fhir/ValueSet/name-use|4.0.1
(required to http://hl7.org/fhir/ValueSet/name-use|4.0.1
Typecode
Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

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

Pattern Valueusual
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
78. Patient.name:officialName
Slice NameofficialName
Definition

A human's name with the ability to identify parts and usage | Le nom de naissance (official) est obligatoire dans le cas où l’on véhicule l’INS et que l’identité est qualifiée (celui-ci ne doit pas être altéré).


A name associated with the individual.

ShortName of a human | Nom de naissanceA 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
Is Modifierfalse
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()))
80. Patient.name:officialName.extension:birth-list-given-name
Slice Namebirth-list-given-name
Definition

Prénoms de l'acte de naissance

ShortDans le cas d’une identité créée ou modifiée par un appel au téléservice INSi, il s’agit de la liste des prénoms retournée par le téléservice. Ce composant contient tous les prénoms du patient, y compris le premier, que l'on retrouve également dans le champ name.given. Il s'agit de la liste des prénoms du patient, qu'elle soit issue d'une saisie locale ou du retour à l'appel au téléservice INSi. Conformément aux spécifications INS, cette liste est constituée des prénoms, séparés par des espaces.
Control0..1
TypeExtension(FR Core Patient Birth List Given name Extension) (Extension Type: string)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
LOINC Code
82. Patient.name:officialName.use
Definition

Identifies the purpose for this name.

Shortusual | official | temp | nickname | anonymous | old | maiden
Comments

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

Control10..1
BindingThe codes SHALL be taken from NameUsehttp://hl7.org/fhir/ValueSet/name-use|4.0.1
(required to http://hl7.org/fhir/ValueSet/name-use|4.0.1
Typecode
Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

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

Pattern Valueofficial
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
84. Patient.name:officialName.family
Definition

The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.

ShortFamily name (often called 'Surname')
Comments

Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).

Control10..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Alternate Namessurname
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
86. Patient.name:officialName.given
Definition

Given name.

ShortGiven names (not always 'first'). Includes middle names
Comments

If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first.

Control10..1*
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Alternate Namesfirst name, middle name
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
88. 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.

ShortDetails 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).

Control0..*
This element is affected by the following invariants: ele-1
TypeContactPoint(FR Core Contact Point Profile)
Is Modifierfalse
Requirements

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

Invariantscpt-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()))
90. Patient.gender
Definition

French patient's gender checked with the INSi teleservice | Genre du patient. Dans le cas d'une identité récupérée par le téléservice INSi, les valeurs sont M ou F


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
Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
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()))
92. Patient.birthDate
Definition

The date of birth for the french patient checked with the INSitelservice | Date de naissance du patient. Dans le cas d'une identité récupérée du téléservice INSi, la date de naissance est modifiée selon les règles du RNIV dans le cas de dates exceptionnelles.


The date of birth for the individual.

ShortThe date of birth for the french patient checked with the INSitelservice | Date de naissance du patient. Dans le cas d'une identité récupérée du téléservice INSi, la date de naissance est modifiée selon les règles du RNIV dans le cas de dates exceptionnelles.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).

Control0..1
Typedate
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
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
94. 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] NoteSee Choice of Data Types for further information about how to use [x]
Is Modifiertrue because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
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()))
96. 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.

ShortAn 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.

Control0..*
This element is affected by the following invariants: ele-1
TypeAddress(FR Core Address Profile)
Is Modifierfalse
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()))
98. Patient.maritalStatus
Definition

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

ShortMarital (civil) status of a patient
Control0..1
BindingUnless not suitable, these codes SHALL be taken from FR Core ValueSet Patient gender INS ValueSethttp://hl7.org/fhir/ValueSet/marital-status
(extensible to https://hl7.fr/ig/fhir/core/ValueSet/fr-core-vs-marital-status
TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Requirements

Most, if not all systems capture it.

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

Patient's nominated care provider.

ShortPatient's nominated primary care provider
Comments

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

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

Control0..*
TypeReference(FR Core Practitioner Profile, FR Core Organization Profile, PractitionerRole, Organization, Practitioner)
Is Modifierfalse
Summaryfalse
Alternate NamescareProvider
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
102. 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(FR Core Organization Profile, 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()))
104. 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()))
106. 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())
108. 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()))
110. 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
Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

0. Patient
Definition

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

ShortInformation about an individual or animal receiving health care services
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 logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

ShortLogical id of this artifact
Comments

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

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

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

ShortMetadata about the resource
Control0..1
TypeMeta
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. Patient.meta.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
8. Patient.meta.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.meta.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
10. Patient.meta.versionId
Definition

The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

ShortVersion specific identifier
Comments

The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

Control0..1
Typeid
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()))
12. Patient.meta.lastUpdated
Definition

When the resource last changed - e.g. when the version changed.

ShortWhen the resource version last changed
Comments

This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

Control0..1
Typeinstant
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()))
14. Patient.meta.source
Definition

A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

ShortIdentifies where the resource comes from
Comments

In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

Control0..1
Typeuri
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()))
16. Patient.meta.profile
Definition

A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

ShortProfiles this resource claims to conform to
Comments

It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

Control0..*
Typecanonical(StructureDefinition)
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()))
SlicingThis element introduces a set of slices on Patient.meta.profile. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ $this
18. Patient.meta.profile:fr-canonical
Slice Namefr-canonical
Definition

A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

ShortProfiles this resource claims to conform to
Comments

It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

Control0..1
Typecanonical(StructureDefinition)
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Pattern Valuehttps://hl7.fr/ig/fhir/core/StructureDefinition/fr-core-patient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. Patient.meta.security
Definition

Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

ShortSecurity Labels applied to this resource
Comments

The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

Control0..*
BindingUnless not suitable, these codes SHALL be taken from All Security Labels
(extensible to http://hl7.org/fhir/ValueSet/security-labels
TypeCoding
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. Patient.meta.tag
Definition

Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

ShortTags applied to this resource
Comments

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

Control0..*
BindingFor example codes, see CommonTags
(example to http://hl7.org/fhir/ValueSet/common-tags
TypeCoding
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. Patient.implicitRules
Definition

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

ShortA set of rules under which this content was created
Comments

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

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. 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
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()))
28. 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()))
30. Patient.contained
Definition

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

ShortContained, inline Resources
Comments

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

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

An Extension

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

The nationality of the patient.

ShortNationality
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(FR Core Nationality Extension) (Complex Extension)
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
36. Patient.extension:identityReliability
Slice NameidentityReliability
Definition

Reliabilility of the patient's identity | Précision sur le degré de fiabilité de l'identité du patient (si provisoire, validé... avec la justification : quelle type de pièce d'identité ?) avec la méthode de collection

ShortReliabilility of the identity | Fiabilité de l'identité
Control0..*
This element is affected by the following invariants: ele-1
TypeExtension(FR Core Patient Ident Reliability Extension) (Complex Extension)
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
38. Patient.extension:deathPlace
Slice NamedeathPlace
Definition

Carries the death place of the patient |Précise le lieu de décès du patient (hôpital, sur la voie publique, au domicile, etc.).

ShortFR Core Patient Death Place Extension
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(FR Core Patient Death Place Extension) (Extension Type: string)
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
40. Patient.extension:birthdateUpdateIndicator
Slice NamebirthdateUpdateIndicator
Definition

An Extension

ShortFR Core Patient Birthdate Update Indicator Extension
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(FR Core Patient Birthdate Update Indicator Extension) (Extension Type: boolean)
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
42. Patient.extension:birthPlace
Slice NamebirthPlace
Definition

The registered place of birth of the patient. A sytem may use the address.text if they don't store the birthPlace address in discrete elements.

ShortPlace of Birth for patient
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(Birth Place) (Extension Type: Address)
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
44. Patient.extension:birthPlace.id
Definition

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

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

An Extension

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

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

Shortidentifies the meaning of the extension
Comments

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

Control1..1
Typeuri
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
Fixed Valuehttp://hl7.org/fhir/StructureDefinition/patient-birthPlace
50. Patient.extension:birthPlace.value[x]
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.

ShortAn 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).

Control1..1
This element is affected by the following invariants: ele-1
TypeAddress(FR Core Address Profile)
[x] NoteSee Choice of Data Types for further information about how to use [x]
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
52. Patient.modifierExtension
Definition

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

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

ShortExtensions that cannot be ignored
Comments

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

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

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

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

An identifier for this patient.

ShortAn identifier for this patient | Identifiant patient. Pour modéliser un patient avec une INS validée, il est nécessaire de respecter la conformité au profil FrCorePatientINS. Les identifiants NIR et NIA ne sont définis uniquement dans le cas du FRCorePatientINS.
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Is Modifierfalse
Summarytrue
Requirements

Patients are almost always assigned specific numerical identifiers.

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

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

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

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

ShortAdditional content defined by implementations
Comments

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

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

The purpose of this identifier.

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

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

Control0..1
BindingThe codes SHALL be taken from IdentifierUse
(required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
Typecode
Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

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

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
62. Patient.identifier.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 FR Core ValueSet Patient identifier type
(extensible to https://hl7.fr/ig/fhir/core/ValueSet/fr-core-vs-patient-identifier-type
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()))
64. Patient.identifier.system
Definition

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

ShortThe namespace for the identifier value
Comments

Identifier.system is always case sensitive.

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

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
66. Patient.identifier.value
Definition

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

ShortThe value that is unique
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.

Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Example<br/><b>General</b>:123456
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
68. Patient.identifier.period
Definition

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

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

Organization that issued/manages the identifier.

ShortOrganization that issued id (may be just text)
Comments

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

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

Computed National Health Identifier | Identifiant National de Santé Calculé à partir des éléments de la carte vitale

ShortAn identifier for this patient
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Is Modifierfalse
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()))
74. Patient.identifier:INS-C.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
76. Patient.identifier:INS-C.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 are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
78. Patient.identifier:INS-C.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
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.

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

Computed National Health Identifier | Identifiant National de Santé Calculé à partir des éléments de la carte vitale

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
TypeCodeableConcept
Is Modifierfalse
Summarytrue
Requirements

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

Pattern Value{
  "coding" : [{
    "system" : "https://hl7.fr/ig/fhir/core/CodeSystem/fr-core-cs-v2-0203",
    "code" : "INS-C",
    "display" : "Identifiant National de Santé Calculé"
  }]
}
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
82. Patient.identifier:INS-C.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.

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

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Pattern Valueurn:oid:1.2.250.1.213.1.4.2
Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
84. Patient.identifier:INS-C.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
Summarytrue
Example<br/><b>General</b>:123456
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
86. Patient.identifier:INS-C.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()))
88. Patient.identifier:INS-C.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()))
90. Patient.identifier:NDP
Slice NameNDP
Definition

An identifier for this patient.

ShortFrench pharmaceutical Record Identifier | Numéro de Dossier Pharmaceutique français. Celui-ci est unique.
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..1
TypeIdentifier
Is Modifierfalse
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()))
92. Patient.identifier:NDP.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
94. Patient.identifier:NDP.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 are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
96. Patient.identifier:NDP.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
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.

Pattern Valuesecondary
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
98. Patient.identifier:NDP.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 FR Core ValueSet Patient identifier type
(extensible to https://hl7.fr/ig/fhir/core/ValueSet/fr-core-vs-patient-identifier-type
TypeCodeableConcept
Is Modifierfalse
Summarytrue
Requirements

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

Pattern Value{
  "coding" : [{
    "system" : "https://hl7.fr/ig/fhir/core/CodeSystem/fr-core-cs-v2-0203",
    "code" : "NDP",
    "display" : "Identifiant du patient au Dossier Pharmaceutique"
  }]
}
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
100. Patient.identifier:NDP.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
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Pattern Valueurn:oid:1.2.250.1.176.1.2
Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
102. Patient.identifier:NDP.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
Summarytrue
Example<br/><b>General</b>:123456
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
104. Patient.identifier:NDP.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()))
106. Patient.identifier:NDP.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()))
108. Patient.identifier:PI
Slice NamePI
Definition

Hospital assigned patient identifier | IPP

ShortHospital assigned patient identifier | IPP
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..1
TypeIdentifier
Is Modifierfalse
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()))
110. Patient.identifier:PI.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
112. Patient.identifier:PI.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 are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
114. Patient.identifier:PI.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
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.

Pattern Valueusual
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
116. Patient.identifier:PI.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
TypeCodeableConcept
Is Modifierfalse
Summarytrue
Requirements

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

Pattern Value{
  "coding" : [{
    "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
    "code" : "PI",
    "display" : "Patient internal identifier"
  }]
}
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
118. Patient.identifier:PI.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
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
120. Patient.identifier:PI.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
Summarytrue
Example<br/><b>General</b>:123456
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
122. Patient.identifier:PI.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()))
124. Patient.identifier:PI.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()))
126. Patient.identifier:RRI
Slice NameRRI
Definition

Regional Registry ID | Identifiant régional

ShortRegional Registry ID | Identifiant régional
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Is Modifierfalse
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()))
128. Patient.identifier:RRI.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
130. Patient.identifier:RRI.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 are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
132. Patient.identifier:RRI.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
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.

Pattern Valuesecondary
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
134. Patient.identifier:RRI.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
TypeCodeableConcept
Is Modifierfalse
Summarytrue
Requirements

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

Pattern Value{
  "coding" : [{
    "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
    "code" : "RRI",
    "display" : "Regional registry ID"
  }]
}
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
136. Patient.identifier:RRI.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
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
138. Patient.identifier:RRI.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
Summarytrue
Example<br/><b>General</b>:123456
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
140. Patient.identifier:RRI.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()))
142. Patient.identifier:RRI.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()))
144. 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()))
146. 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(FR Core Human Name Profile)
Is Modifierfalse
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()))
SlicingThis element introduces a set of slices on Patient.name. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ use
148. Patient.name:usualName
Slice NameusualName
Definition

A human's name with the ability to identify parts and usage | Le nom utilisé (usual) n’est transmis que s’il est défini (par exemple nom marital du conjoint).

ShortName of a human | Nom utilisé
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
Is Modifierfalse
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()))
150. Patient.name:usualName.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
152. Patient.name:usualName.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.name.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
154. Patient.name:usualName.use
Definition

Identifies the purpose for this name.

Shortusual | official | temp | nickname | anonymous | old | maiden
Comments

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

Control1..1
BindingThe codes SHALL be taken from NameUse
(required to http://hl7.org/fhir/ValueSet/name-use|4.0.1
Typecode
Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

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

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

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

ShortText representation of the full name
Comments

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

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

A renderable, unencoded form.

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

The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.

ShortFamily name (often called 'Surname')
Comments

Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).

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

Given name.

ShortGiven names (not always 'first'). Includes middle names
Comments

If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first.

Control0..*
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Alternate Namesfirst name, middle name
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
162. Patient.name:usualName.prefix
Definition

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

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

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

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

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

ShortTime period when name was/is in use
Control0..1
TypePeriod
Is Modifierfalse
Summarytrue
Requirements

Allows names to be placed in historical context.

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

A human's name with the ability to identify parts and usage | Le nom de naissance (official) est obligatoire dans le cas où l’on véhicule l’INS et que l’identité est qualifiée (celui-ci ne doit pas être altéré).

ShortName of a human | Nom de naissance
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
Is Modifierfalse
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()))
170. Patient.name:officialName.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
172. Patient.name:officialName.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.name.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
174. Patient.name:officialName.extension:birth-list-given-name
Slice Namebirth-list-given-name
Definition

Prénoms de l'acte de naissance

ShortDans le cas d’une identité créée ou modifiée par un appel au téléservice INSi, il s’agit de la liste des prénoms retournée par le téléservice. Ce composant contient tous les prénoms du patient, y compris le premier, que l'on retrouve également dans le champ name.given. Il s'agit de la liste des prénoms du patient, qu'elle soit issue d'une saisie locale ou du retour à l'appel au téléservice INSi. Conformément aux spécifications INS, cette liste est constituée des prénoms, séparés par des espaces.
Control0..1
TypeExtension(FR Core Patient Birth List Given name Extension) (Extension Type: string)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
176. Patient.name:officialName.use
Definition

Identifies the purpose for this name.

Shortusual | official | temp | nickname | anonymous | old | maiden
Comments

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

Control1..1
BindingThe codes SHALL be taken from NameUse
(required to http://hl7.org/fhir/ValueSet/name-use|4.0.1
Typecode
Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

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

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

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

ShortText representation of the full name
Comments

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

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

A renderable, unencoded form.

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

The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.

ShortFamily name (often called 'Surname')
Comments

Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).

Control1..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Alternate Namessurname
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
182. Patient.name:officialName.given
Definition

Given name.

ShortGiven names (not always 'first'). Includes middle names
Comments

If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first.

Control1..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Alternate Namesfirst name, middle name
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
184. Patient.name:officialName.prefix
Definition

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

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

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

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

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

ShortTime period when name was/is in use
Control0..1
TypePeriod
Is Modifierfalse
Summarytrue
Requirements

Allows names to be placed in historical context.

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

Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc.

ShortDetails 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).

Control0..*
This element is affected by the following invariants: ele-1
TypeContactPoint(FR Core Contact Point Profile)
Is Modifierfalse
Requirements

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

Invariantscpt-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()))
192. Patient.gender
Definition

French patient's gender checked with the INSi teleservice | Genre du patient. Dans le cas d'une identité récupérée par le téléservice INSi, les valeurs sont M ou F

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
Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
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()))
194. Patient.birthDate
Definition

The date of birth for the french patient checked with the INSitelservice | Date de naissance du patient. Dans le cas d'une identité récupérée du téléservice INSi, la date de naissance est modifiée selon les règles du RNIV dans le cas de dates exceptionnelles.

ShortThe date of birth for the french patient checked with the INSitelservice | Date de naissance du patient. Dans le cas d'une identité récupérée du téléservice INSi, la date de naissance est modifiée selon les règles du RNIV dans le cas de dates exceptionnelles.
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
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
196. 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] NoteSee Choice of Data Types for further information about how to use [x]
Is Modifiertrue because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
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()))
198. 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.

ShortAn 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).

Control0..*
This element is affected by the following invariants: ele-1
TypeAddress(FR Core Address Profile)
Is Modifierfalse
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()))
200. Patient.maritalStatus
Definition

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

ShortMarital (civil) status of a patient
Control0..1
BindingUnless not suitable, these codes SHALL be taken from FR Core ValueSet Patient gender INS ValueSet
(extensible to https://hl7.fr/ig/fhir/core/ValueSet/fr-core-vs-marital-status
TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Requirements

Most, if not all systems capture it.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
202. 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] NoteSee Choice of Data Types for further information about how to use [x]
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
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()))
204. Patient.photo
Definition

Image of the patient.

ShortImage of the patient
Comments

Guidelines:

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

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

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
206. 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())
208. 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
210. Patient.contact.extension
Definition

An Extension

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

This extension carries the contact identifier in the patient resource | Ajout d'un identifiant de contact dans la ressource Patient

ShortContact identifier in the patient resource | Identifiant de contact dans la ressource Patient
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(FR Core Patient Contact Identifier Extension) (Extension Type: Identifier)
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
214. Patient.contact.extension:comment
Slice Namecomment
Definition

add a comment on a dataElement of a resource | Ajout d'un commentaire sur un dataElement d'une ressource

ShortComment on a dataElement | Commentaire sur un dataElement
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(FR Core Comment Extension) (Extension Type: string)
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
216. 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())
218. Patient.contact.relationship
Definition

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

ShortThe kind of relationship
Control1..1
BindingUnless not suitable, these codes SHALL be taken from PatientContactRelationship
(extensible to http://hl7.org/fhir/ValueSet/patient-contactrelationship
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()))
SlicingThis element introduces a set of slices on Patient.contact.relationship. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ coding.system
220. Patient.contact.relationship:RolePerson
Slice NameRolePerson
Definition

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

ShortThe nature of the relationship. Rôle de la personne. Ex : personne de confiance, aidant ...
Control0..1
BindingUnless not suitable, these codes SHALL be taken from FR Core ValueSet Related person role
(extensible to https://hl7.fr/ig/fhir/core/ValueSet/fr-core-vs-related-person-role
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()))
222. Patient.contact.relationship:RelatedPerson
Slice NameRelatedPerson
Definition

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

ShortThe nature of the relationship. Relation de la personne. Ex : Mère, époux, enfant ...
Control0..1
BindingUnless not suitable, these codes SHALL be taken from FR Core ValueSet Related person role
(extensible to https://hl7.fr/ig/fhir/core/ValueSet/fr-core-vs-related-person
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()))
224. Patient.contact.name
Definition

A human's name with the ability to identify parts and usage.

ShortName of a human - parts and usage
Comments

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

Control0..1
This element is affected by the following invariants: ele-1
TypeHumanName(FR Core Human Name Profile)
Is Modifierfalse
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()))
226. Patient.contact.telecom
Definition

Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc.

ShortDetails of a Technology mediated contact point (phone, fax, email, etc.)
Comments

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

Control0..*
This element is affected by the following invariants: ele-1
TypeContactPoint(FR Core Contact Point Profile)
Is Modifierfalse
Requirements

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

Invariantscpt-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()))
228. 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()))
230. 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
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()))
232. 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()))
234. 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()))
236. 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
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()))
238. 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
240. 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())
242. 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())
244. 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
TypeCodeableConcept
Is Modifierfalse
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()))
246. Patient.communication.preferred
Definition

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

ShortLanguage preference indicator
Comments

This language is specifically identified for communicating healthcare information.

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

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

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

Patient's nominated care provider.

ShortPatient's nominated primary care provider
Comments

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

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

Control0..*
TypeReference(FR Core Practitioner Profile, FR Core Organization Profile, PractitionerRole)
Is Modifierfalse
Summaryfalse
Alternate NamescareProvider
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
250. 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(FR Core Organization Profile)
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()))
252. 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()))
254. 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
256. 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())
258. 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())
260. 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()))
262. 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
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()))