diff --git a/.github/workflows/broken-link-check.yml b/.github/workflows/broken-link-check.yml index ac9f1d68..36daa93f 100644 --- a/.github/workflows/broken-link-check.yml +++ b/.github/workflows/broken-link-check.yml @@ -3,7 +3,7 @@ name: "Broken Link Check" on: push: schedule: - - cron: 0 0 * * * # run daily at midnight + - cron: @weekly jobs: check: diff --git a/.lycheeignore b/.lycheeignore index 5a75d03e..e428fd0e 100644 --- a/.lycheeignore +++ b/.lycheeignore @@ -1,7 +1,7 @@ -.*\.ndjson +*.ndjson file://* https://dpc.cms.gov/checksum https://dpc.cms.gov/file_length -https://dpc.cms.gov/api/v1/CapabilityStatement/* -https://dpc.cms.gov/api/v1/StructureDefinition/* -http://hl7.org/fhir/StructureDefinition/* +https://dpc.cms.gov/api/v1/* +http://*.org/StructureDefinition/* +https://pacs.hospital.org/* diff --git a/ig/qa.html b/ig/qa.html index 6d35a3b2..a5900e94 100644 --- a/ig/qa.html +++ b/ig/qa.html @@ -352,9 +352,9 @@

n/a

/Users/pat/Documents/develop/cms/dpc-static-site/implementation_guide/source/DPCCapabilities.json

- - - + + + @@ -362,7 +362,7 @@

/Users/pat/Documents/dev

- + @@ -375,9 +375,9 @@

/Users/pat/Documents/dev

/Users/pat/Documents/develop/cms/dpc-static-site/implementation_guide/source/resources/implementationguide/cms-dpc-ig.xml

PathSeverityMessage
PathSeverityMessage
CapabilityStatement/dpc-capabilities: CapabilityStatement.instantiates[0] (l12/c4)errorURL value "http://hl7.org/fhir/uv/bulkdata/CapabilityStatement/bulk-data" does not resolve
CapabilityStatement/dpc-capabilities: CapabilityStatement.rest[0].security.extension[0] (l30/c12)errorThe extension http://fhir-registry.smarthealthit.org/StructureDefinition/oauth-uris is unknown, and not allowed here
CapabilityStatement/dpc-capabilities: CapabilityStatement.rest[0].security.service[0].coding[0] (l43/c16)informationCode System URI "http://terminology.hl7.org/CodeSystem/restful-security-service" is unknown so the code cannot be validatedCapabilityStatement/dpc-capabilities: CapabilityStatement.rest[0].security.service[0].coding[0] (l43/c16)informationCode System URI "https://www.hl7.org/fhir/codesystem-restful-security-service" is unknown so the code cannot be validated
CapabilityStatement/dpc-capabilities: CapabilityStatement.rest[0].resource[4].profile (l168/c12)errorUnable to resolve resource "https://dpc.cms.gov/api/v1/StructureDefinition"
- - - + + + @@ -410,9 +410,9 @@

/Users/pat/Documents/develop/c

/Users/pat/Documents/develop/cms/dpc-static-site/implementation_guide/source/resources/operationdefinition/dpc-group-add.json

PathSeverityMessage
PathSeverityMessage
ImplementationGuide/cms-dpc-ig: ImplementationGuide.package[0].resource[0].source.ofType(Reference)errorUnable to resolve resource "Patient/dpc-sample-patient"
- - - + + + @@ -421,9 +421,9 @@

/Users/pat/Docume

/Users/pat/Documents/develop/cms/dpc-static-site/implementation_guide/source/resources/operationdefinition/dpc-group-remove.json

PathSeverityMessage
PathSeverityMessage
OperationDefinition (l6/c49)errorUnrecognised property '@title'
- - - + + + @@ -432,9 +432,9 @@

/Users/pat/Doc

/Users/pat/Documents/develop/cms/dpc-static-site/implementation_guide/source/resources/operationdefinition/dpc-patient-submit.json

PathSeverityMessage
PathSeverityMessage
OperationDefinition (l6/c48)errorUnrecognised property '@title'
- - - + + + @@ -443,9 +443,9 @@

/Users/pat/D

/Users/pat/Documents/develop/cms/dpc-static-site/implementation_guide/source/resources/operationdefinition/dpc-patient-validate.json

PathSeverityMessage
PathSeverityMessage
OperationDefinition (l6/c52)errorUnrecognised property '@title'
- - - + + + @@ -454,9 +454,9 @@

/Users/pat

/Users/pat/Documents/develop/cms/dpc-static-site/implementation_guide/source/resources/operationdefinition/dpc-practitioner-submit.json

PathSeverityMessage
PathSeverityMessage
OperationDefinition (l6/c44)errorUnrecognised property '@title'
- - - + + + @@ -465,9 +465,9 @@

/Users/

/Users/pat/Documents/develop/cms/dpc-static-site/implementation_guide/source/resources/operationdefinition/dpc-practitioner-validate.json

PathSeverityMessage
PathSeverityMessage
OperationDefinition (l6/c57)errorUnrecognised property '@title'
- - - + + + @@ -476,28 +476,28 @@

/User

/Users/pat/Documents/develop/cms/dpc-static-site/implementation_guide/source/resources/patient/DPC-sample-patient.json

PathSeverityMessage
PathSeverityMessage
OperationDefinition (l6/c49)errorUnrecognised property '@title'
- - - + + + - +
PathSeverityMessage
PathSeverityMessage
Patient/728b270d-d7de-4143-82fe-d3ccd92cebe4: Patient.identifier[1].system (l14/c50)errorURL value "http://hl7.org/fhir/sid/us-mbi" does not resolvePatient/728b270d-d7de-4143-82fe-d3ccd92cebe4: Patient.identifier[1].system (l14/c50)errorURL value "http://terminology.hl7.org/NamingSystem/cmsMBI" does not resolve

/Users/pat/Documents/develop/cms/dpc-static-site/implementation_guide/source/resources/practitioner/DPC-sample-practitioner.json

- - - + + +
✓
✓

/Users/pat/Documents/develop/cms/dpc-static-site/implementation_guide/source/validations/DPCAddress.json

- - - + + + @@ -506,9 +506,9 @@

/Users/pat/Documents/

/Users/pat/Documents/develop/cms/dpc-static-site/implementation_guide/source/validations/DPCAttestation.json

PathSeverityMessage
PathSeverityMessage
StructureDefinition.where(url = 'https://dpc.cms.gov/api/v1/StructureDefinition/dpc-profile-address')warningThe Implementation Guide contains no examples for this data type profile
- - - + + + @@ -523,9 +523,9 @@

/Users/pat/Docume

/Users/pat/Documents/develop/cms/dpc-static-site/implementation_guide/source/validations/DPCAttributionRoster.json

PathSeverityMessage
PathSeverityMessage
DPC Attribution Attestation.Provenance.targeterrorElement Provenance.target: derived min (0) cannot be less than base min (1)
- - - + + + @@ -534,9 +534,9 @@

/Users/pat

/Users/pat/Documents/develop/cms/dpc-static-site/implementation_guide/source/validations/DPCEndpoint.json

PathSeverityMessage
PathSeverityMessage
StructureDefinition.where(url = 'https://dpc.cms.gov/api/v1/StructureDefinition/dpc-profile-attribution-roster')warningThe Implementation Guide contains no examples for this profile
- - - + + + @@ -545,9 +545,9 @@

/Users/pat/Documents

/Users/pat/Documents/develop/cms/dpc-static-site/implementation_guide/source/validations/DPCOrganization.json

PathSeverityMessage
PathSeverityMessage
StructureDefinition.where(url = 'https://dpc.cms.gov/api/v1/StructureDefinition/dpc-profile-endpoint')warningThe Implementation Guide contains no examples for this profile
- - - + + + @@ -559,9 +559,9 @@

/Users/pat/Docum

/Users/pat/Documents/develop/cms/dpc-static-site/implementation_guide/source/validations/DPCPatient.json

PathSeverityMessage
PathSeverityMessage
Identifier.systemerrorThe fixed value has type 'code' which is not valid (valid type: [uri])
- - - + + + @@ -576,9 +576,9 @@

/Users/pat/Documents/

/Users/pat/Documents/develop/cms/dpc-static-site/implementation_guide/source/validations/DPCPractitioner.json

PathSeverityMessage
PathSeverityMessage
StructureDefinition.differential.element[9].max (l82/c18)errorError parsing JSON: the primitive value must be a string
- - - + + + @@ -586,10 +586,10 @@

/Users/pat/Docum

PathSeverityMessage
PathSeverityMessage
Identifier.systemerrorThe fixed value has type 'code' which is not valid (valid type: [uri])
StructureDefinition.where(url = 'https://dpc.cms.gov/api/v1/StructureDefinition/dpc-profile-practitioner')warningThe Implementation Guide contains no examples for this profile
- -

Suppressed Messages (Warnings, hints, broken links)

-

No suppressed messsages

-

Errors sorted by type

+ +

Suppressed Messages (Warnings, hints, broken links)

+

No suppressed messsages

+

Errors sorted by type

Extension_EXT_Unknown_NotHere

@@ -641,7 +641,7 @@

Reference_REF_CantResolve

Terminology_TX_System_NotKnown

- +
/Users/pat/Documents/develop/cms/dpc-static-site/implementation_guide/source/DPCCapabilities.jsonCode System URI "http://terminology.hl7.org/CodeSystem/restful-security-service" is unknown so the code cannot be validated/Users/pat/Documents/develop/cms/dpc-static-site/implementation_guide/source/DPCCapabilities.jsonCode System URI "https://www.hl7.org/fhir/codesystem-restful-security-service" is unknown so the code cannot be validated
@@ -652,7 +652,7 @@

Type_Specific_Checks_DT_URL_Resolve

/Users/pat/Documents/develop/cms/dpc-static-site/implementation_guide/source/DPCCapabilities.jsonURL value "http://hl7.org/fhir/uv/bulkdata/CapabilityStatement/bulk-data" does not resolve - /Users/pat/Documents/develop/cms/dpc-static-site/implementation_guide/source/resources/patient/DPC-sample-patient.jsonURL value "http://hl7.org/fhir/sid/us-mbi" does not resolve + /Users/pat/Documents/develop/cms/dpc-static-site/implementation_guide/source/resources/patient/DPC-sample-patient.jsonURL value "http://terminology.hl7.org/NamingSystem/cmsMBI" does not resolve diff --git a/ig/security.html b/ig/security.html index 3d6777d4..32f46057 100644 --- a/ig/security.html +++ b/ig/security.html @@ -48,9 +48,9 @@
- + Implementation Guide CI Build - +
--> @@ -82,7 +82,7 @@
- @@ -224,7 +224,7 @@

Security

The DPC application makes use of the SMART Backend Services Authorization Spec, which is outlined here.

-

The DPC specific implementation is detailed on the Project website.

+

The DPC specific implementation is detailed on the Project website.

@@ -258,7 +258,7 @@

Security

Data @ the Point of Care Implementation Guide Version: ®© FHIR Version: 3.0.2 (IG Publisher v3.0.2-11200) generated on Wed, Apr 21, 2021 11:33-0400. | CC0 - +

@@ -282,10 +282,10 @@

Security

- + - \ No newline at end of file + diff --git a/implementation_guide/generated_output/qa/StructureDefinition-dpc-profile-organization-html.html b/implementation_guide/generated_output/qa/StructureDefinition-dpc-profile-organization-html.html index fe0b487f..a1bc99e4 100644 --- a/implementation_guide/generated_output/qa/StructureDefinition-dpc-profile-organization-html.html +++ b/implementation_guide/generated_output/qa/StructureDefinition-dpc-profile-organization-html.html @@ -7,7 +7,7 @@
- +
NameFlagsCard.TypeDescription & Constraintsdoco
.. Organization 0..*OrganizationA grouping of people or organizations with a common purpose
... identifier 0..*(Slice Definition)Identifies this organization across multiple systems
Slice: Unordered, Open by value:system
.... identifier:organization-npi 1..1IdentifierIdentifies this organization across multiple systems
..... system 1..1uriThe namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
..... system 1..1uriThe namespace for the identifier value
Fixed Value: http://terminology.hl7.org/NamingSystem/npi
... address 1..1DPC AddressAn address expressed using postal conventions (as opposed to GPS or other location definition formats)
... endpoint 1..*Reference(DPC Endpoint)Technical endpoints providing access to services operated for the organization

doco Documentation for this format
diff --git a/implementation_guide/generated_output/qa/StructureDefinition-dpc-profile-patient-dict.html b/implementation_guide/generated_output/qa/StructureDefinition-dpc-profile-patient-dict.html index 789f4f12..ce500f1a 100644 --- a/implementation_guide/generated_output/qa/StructureDefinition-dpc-profile-patient-dict.html +++ b/implementation_guide/generated_output/qa/StructureDefinition-dpc-profile-patient-dict.html @@ -6,587 +6,587 @@ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - + - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - diff --git a/implementation_guide/generated_output/qa/StructureDefinition-dpc-profile-practitioner-dict-active.html b/implementation_guide/generated_output/qa/StructureDefinition-dpc-profile-practitioner-dict-active.html index b0e2f59a..526891af 100644 --- a/implementation_guide/generated_output/qa/StructureDefinition-dpc-profile-practitioner-dict-active.html +++ b/implementation_guide/generated_output/qa/StructureDefinition-dpc-profile-practitioner-dict-active.html @@ -6,361 +6,361 @@
1. Patient
Definition

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

+
Definition

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

Control0..*
Alternate NamesSubjectOfCare Client Resident
InvariantsDefined on this element
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (: contained.text.empty())
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (: contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (: contained.where(('#'+id in %resource.descendants().reference).not()).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())
2. Patient.id
Definition

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

+
Definition

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

Control0..1
Typeid
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.

+
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.

3. Patient.meta
Definition

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

+
Definition

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

Control0..1
TypeMeta
4. Patient.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

+
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.

Control0..1
Typeuri
Is Modifiertrue
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.

-

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

+
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.

+

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

5. Patient.language
Definition

The base language in which the resource is written.

+
Definition

The base language in which the resource is written.

Control0..1
BindingA human language.
The codes SHALL be taken from Common Languages; other codes may be used where these codes are not suitable
Max Binding: All Languages
Typecode
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).

+
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).

6. Patient.text
Definition

A human-readable narrative that contains a summary of the resource, and may 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.

+
Definition

A human-readable narrative that contains a summary of the resource, and may 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.

Control0..1 This element is affected by the following invariants: dom-1
TypeNarrative
Alternate Namesnarrative, html, xhtml, display
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 in formation is added later.

+
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 in formation is added later.

7. 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.

+
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.

Control0..*
TypeResource
Alternate Namesinline resources, anonymous resources, contained 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.

+
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.

8. Patient.extension
Definition

May be used to represent additional information that is not part of the basic definition of the resource. In order 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.

+
Definition

May be used to represent additional information that is not part of the basic definition of the resource. In order 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

+
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.

9. 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. Usually modifier elements provide negation or qualification. In order 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.

+
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. Usually modifier elements provide negation or qualification. In order 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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content
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.

+
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.

10. Patient.identifier
Definition

Must have MBI

+
Definition

Must have MBI

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Requirements

Patients are almost always assigned specific numerical identifiers.

+
Requirements

Patients are almost always assigned specific numerical identifiers.

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 @ system
11. Patient.identifier:patient-mbi
SliceNamepatient-mbi
Definition

An identifier for this patient.

+
Definition

An identifier for this patient.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control1..1
TypeIdentifier
Requirements

Patients are almost always assigned specific numerical identifiers.

+
Requirements

Patients are almost always assigned specific numerical identifiers.

12. Patient.identifier:patient-mbi.id
Definition

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

+
Definition

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

Control0..1
Typestring
13. Patient.identifier:patient-mbi.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

+
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

+
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.

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
14. Patient.identifier:patient-mbi.use
Definition

The purpose of this identifier.

+
Definition

The purpose of this identifier.

Control0..1
BindingIdentifies the purpose for this identifier, if known .
The codes SHALL be taken from IdentifierUse
Typecode
Is Modifiertrue
Requirements

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

+
Requirements

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

Comments

This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

+
Comments

This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

15. Patient.identifier:patient-mbi.type
Definition

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

+
Definition

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

Control0..1
BindingA coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
The codes SHALL be taken from Identifier Type Codes; other codes may be used where these codes are not suitable
TypeCodeableConcept
Requirements

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

+
Requirements

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

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.

+
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.

16. Patient.identifier:patient-mbi.system
Definition

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

+
Definition

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

Control1..1
Typeuri
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.

+
Requirements

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

Fixed Valuehttp://hl7.org/fhir/sid/us-mbi
Fixed Valuehttp://terminology.hl7.org/NamingSystem/cmsMBI
Example
General:http://www.acme.com/identifiers/patient
17. Patient.identifier:patient-mbi.value
Definition

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

+
Definition

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

Control0..1
Typestring
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.

+
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.

Example
General:123456
18. Patient.identifier:patient-mbi.period
Definition

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

+
Definition

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

Control0..1
TypePeriod
19. Patient.identifier:patient-mbi.assigner
Definition

Organization that issued/manages the identifier.

+
Definition

Organization that issued/manages the identifier.

Control0..1
TypeReference(Organization)
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.

+
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.

20. Patient.active
Definition

Whether this patient record is in active use.

+
Definition

Whether this patient record is in active use.

Control0..1
Typeboolean
Is Modifiertrue
Requirements

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

+
Requirements

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

Comments

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

-

This element is labeled as a modifier because when the patient record is marked as not active it is not expected to be used/referenced without being changed back to active.

+
Comments

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

+

This element is labeled as a modifier because when the patient record is marked as not active it is not expected to be used/referenced without being changed back to active.

Default Valuetrue
21. Patient.name
Definition

Patient name

+
Definition

Patient name

Control1..*
TypeHumanName
Requirements

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

+
Requirements

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

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.

+
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.

22. Patient.name.id
Definition

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

+
Definition

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

Control0..1
Typestring
23. Patient.name.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

+
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

+
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.

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
24. Patient.name.use
Definition

Identifies the purpose for this name.

+
Definition

Identifies the purpose for this name.

Control0..1
BindingThe use of a human name
The codes SHALL be taken from NameUse
Typecode
Is Modifiertrue
Requirements

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

+
Requirements

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

Comments

This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one. Applications can assume that a name is current unless it explicitly says that it is temporary or old.

+
Comments

This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one. Applications can assume that a name is current unless it explicitly says that it is temporary or old.

25. Patient.name.text
Definition

A full text representation of the name.

+
Definition

A full text representation of the name.

Control0..1
Typestring
Requirements

A renderable, unencoded form.

+
Requirements

A renderable, unencoded form.

Comments

Can provide both a text representation and structured parts.

+
Comments

Can provide both a text representation and structured parts.

26. Patient.name.family
Definition

Patient family name

+
Definition

Patient family name

Control1..1
Typestring
Alternate Namessurname
Comments

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

+
Comments

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

27. Patient.name.given
Definition

Patient given name

+
Definition

Patient given name

Control1..*
Typestring
Alternate Namesfirst name, middle name
Comments

If only initials are recorded, they may be used in place of the full name. Not called "first name" since given names do not always come first.

+
Comments

If only initials are recorded, they may be used in place of the full name. Not called "first name" since given names do not always come first.

28. Patient.name.prefix
Definition

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

+
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.

Control0..*
Typestring
29. Patient.name.suffix
Definition

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

+
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.

Control0..*
Typestring
30. Patient.name.period
Definition

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

+
Definition

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

Control0..1
TypePeriod
Requirements

Allows names to be placed in historical context.

+
Requirements

Allows names to be placed in historical context.

31. Patient.telecom
Definition

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

+
Definition

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

Control0..*
TypeContactPoint
Requirements

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

+
Requirements

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

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 may 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).

+
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 may 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).

32. Patient.gender
Definition

Gender

+
Definition

Gender

Control1..1
BindingThe gender of a person used for administrative purposes.
The codes SHALL be taken from AdministrativeGender
Typecode
Requirements

Needed for identification of the individual, in combination with (at least) name and birth date. Gender of individual drives many clinical processes.

+
Requirements

Needed for identification of the individual, in combination with (at least) name and birth date. Gender of individual drives many clinical processes.

Comments

The gender may 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 M and F, though the vast majority of systems and contexts only support M and F. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific gender aspect of interest (anatomical, chromosonal, 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, chromosonal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overrideable error, not a "hard" error.

+
Comments

The gender may 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 M and F, though the vast majority of systems and contexts only support M and F. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific gender aspect of interest (anatomical, chromosonal, 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, chromosonal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overrideable error, not a "hard" error.

33. Patient.birthDate
Definition

Birth date

+
Definition

Birth date

Control1..1
Typedate
Requirements

Age of the individual drives many clinical processes.

+
Requirements

Age of the individual drives many clinical processes.

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 maternaty/infant care systems).

+
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 maternaty/infant care systems).

LOINC Code21112-8
34. Patient.deceased[x]
Definition

Indicates if the individual is deceased or not.

+
Definition

Indicates if the individual is deceased or not.

Control0..1
TypeChoice of: boolean, dateTime
[x] NoteSee Choice of Data Types for further information about how to use [x]
Is Modifiertrue
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.

+
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.

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.

-

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.

+
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.

+

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.

35. Patient.address
Definition

Addresses for the individual.

+
Definition

Addresses for the individual.

Control0..*
TypeAddress
Requirements

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

+
Requirements

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

Comments

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

+
Comments

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

36. Patient.maritalStatus
Definition

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

+
Definition

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

Control0..1
BindingThe domestic partnership status of a person.
The codes SHALL be taken from Marital Status Codes; other codes may be used where these codes are not suitable
TypeCodeableConcept
Requirements

Most, if not all systems capture it.

+
Requirements

Most, if not all systems capture it.

37. Patient.multipleBirth[x]
Definition

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

+
Definition

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

Control0..1
TypeChoice of: boolean, integer
[x] NoteSee Choice of Data Types for further information about how to use [x]
Requirements

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

+
Requirements

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

Comments

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

+
Comments

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

38. Patient.photo
Definition

Image of the patient.

+
Definition

Image of the patient.

Control0..*
TypeAttachment
Requirements

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

+
Requirements

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

39. Patient.contact
Definition

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

+
Definition

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

Control0..*
TypeBackboneElement
Requirements

Need to track people you can contact about the patient.

+
Requirements

Need to track people you can contact about 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.

+
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (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())
40. 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.

+
Definition

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

Control0..1
Typestring
41. Patient.contact.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

+
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

+
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.

42. 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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

+
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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
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.

+
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.

43. Patient.contact.relationship
Definition

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

+
Definition

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

Control0..*
BindingThe nature of the relationship between a patient and a contact person for that patient.
The codes SHALL be taken from v2 Contact Role; other codes may be used where these codes are not suitable
TypeCodeableConcept
Requirements

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

+
Requirements

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

44. Patient.contact.name
Definition

A name associated with the contact person.

+
Definition

A name associated with the contact person.

Control0..1
TypeHumanName
Requirements

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

+
Requirements

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

45. Patient.contact.telecom
Definition

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

+
Definition

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

Control0..*
TypeContactPoint
Requirements

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

+
Requirements

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

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.

+
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.

46. Patient.contact.address
Definition

Address for the contact person.

+
Definition

Address for the contact person.

Control0..1
TypeAddress
Requirements

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

+
Requirements

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

47. Patient.contact.gender
Definition

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

+
Definition

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

Control0..1
BindingThe gender of a person used for administrative purposes.
The codes SHALL be taken from AdministrativeGender
Typecode
Requirements

Needed to address the person correctly.

+
Requirements

Needed to address the person correctly.

48. Patient.contact.organization
Definition

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

+
Definition

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

Control0..1 This element is affected by the following invariants: pat-1
TypeReference(Organization)
Requirements

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

+
Requirements

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

49. Patient.contact.period
Definition

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

+
Definition

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

Control0..1
TypePeriod
50. Patient.animal
Definition

This patient is known to be an animal.

+
Definition

This patient is known to be an animal.

Control0..1
TypeBackboneElement
Is Modifiertrue
Requirements

Many clinical systems are extended to care for animal patients as well as human.

+
Requirements

Many clinical systems are extended to care for animal patients as well as human.

Comments

The animal element is labeled "Is Modifier" since patients may be non-human. Systems SHALL either handle patient details appropriately (e.g. inform users patient is not human) or reject declared animal records. The absense of the animal element does not imply that the patient is a human. If a system requires such a positive assertion that the patient is human, an extension will be required. (Do not use a species of homo-sapiens in animal species, as this would incorrectly infer that the patient is an animal).

+
Comments

The animal element is labeled "Is Modifier" since patients may be non-human. Systems SHALL either handle patient details appropriately (e.g. inform users patient is not human) or reject declared animal records. The absense of the animal element does not imply that the patient is a human. If a system requires such a positive assertion that the patient is human, an extension will be required. (Do not use a species of homo-sapiens in animal species, as this would incorrectly infer that the patient is an animal).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
51. Patient.animal.id
Definition

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

+
Definition

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

Control0..1
Typestring
52. Patient.animal.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

+
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

+
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.

53. Patient.animal.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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

+
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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
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.

+
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.

54. Patient.animal.species
Definition

Identifies the high level taxonomic categorization of the kind of animal.

+
Definition

Identifies the high level taxonomic categorization of the kind of animal.

Control1..1
BindingThe species of an animal.
For example codes, see AnimalSpecies
TypeCodeableConcept
Requirements

Need to know what kind of animal.

+
Requirements

Need to know what kind of animal.

Comments

If the patient is non-human, at least a species SHALL be specified. Species SHALL be a widely recognised taxonomic classification. It may or may not be Linnaean taxonomy and may or may not be at the level of species. If the level is finer than species--such as a breed code--the code system used SHALL allow inference of the species. (The common example is that the word "Hereford" does not allow inference of the species Bos taurus, because there is a Hereford pig breed, but the SNOMED CT code for "Hereford Cattle Breed" does.).

+
Comments

If the patient is non-human, at least a species SHALL be specified. Species SHALL be a widely recognised taxonomic classification. It may or may not be Linnaean taxonomy and may or may not be at the level of species. If the level is finer than species--such as a breed code--the code system used SHALL allow inference of the species. (The common example is that the word "Hereford" does not allow inference of the species Bos taurus, because there is a Hereford pig breed, but the SNOMED CT code for "Hereford Cattle Breed" does.).

55. Patient.animal.breed
Definition

Identifies the detailed categorization of the kind of animal.

+
Definition

Identifies the detailed categorization of the kind of animal.

Control0..1
BindingThe breed of an animal.
For example codes, see AnimalBreeds
TypeCodeableConcept
Requirements

May need to know the specific kind within the species.

+
Requirements

May need to know the specific kind within the species.

Comments

Breed MAY be used to provide further taxonomic or non-taxonomic classification. It may involve local or proprietary designation--such as commercial strain--and/or additional information such as production type.

+
Comments

Breed MAY be used to provide further taxonomic or non-taxonomic classification. It may involve local or proprietary designation--such as commercial strain--and/or additional information such as production type.

56. Patient.animal.genderStatus
Definition

Indicates the current state of the animal's reproductive organs.

+
Definition

Indicates the current state of the animal's reproductive organs.

Control0..1
BindingThe state of the animal's reproductive organs.
For example codes, see GenderStatus
TypeCodeableConcept
Requirements

Gender status can affect housing and animal behavior.

+
Requirements

Gender status can affect housing and animal behavior.

57. Patient.communication
Definition

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

+
Definition

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

Control0..*
TypeBackboneElement
Requirements

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

+
Requirements

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

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.

+
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
58. 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.

+
Definition

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

Control0..1
Typestring
59. Patient.communication.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

+
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

+
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.

60. 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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

+
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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
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.

+
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.

61. 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.

+
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.

Control1..1
BindingA human language.
The codes SHALL be taken from Common Languages; other codes may be used where these codes are not suitable
Max Binding: All Languages
TypeCodeableConcept
Requirements

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

+
Requirements

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

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.

+
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.

62. Patient.communication.preferred
Definition

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

+
Definition

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

Control0..1
Typeboolean
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.

+
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.

Comments

This language is specifically identified for communicating healthcare information.

+
Comments

This language is specifically identified for communicating healthcare information.

63. Patient.generalPractitioner
Definition

Patient's nominated care provider.

+
Definition

Patient's nominated care provider.

Control0..*
TypeReference(Organization | Practitioner)
Alternate NamescareProvider
Comments

This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disablity 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.

+
Comments

This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disablity 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.

64. Patient.managingOrganization
Definition

Organization which is responsible for the patient

+
Definition

Organization which is responsible for the patient

Control0..1
TypeReference(DPC Organization)
Requirements

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

+
Requirements

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

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).

+
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).

65. Patient.link
Definition

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

+
Definition

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

Control0..*
TypeBackboneElement
Is Modifiertrue
Requirements

There are multiple usecases:

-
    -
  • Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and * Distribution of patient information across multiple servers.
    • -
+
Requirements

There are multiple usecases:

+
    +
  • Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and * Distribution of patient information across multiple servers.
    • +
Comments

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

-

This element is labelled as a modifier because it may 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'.

+
Comments

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

+

This element is labelled as a modifier because it may 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'.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
66. 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.

+
Definition

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

Control0..1
Typestring
67. Patient.link.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

+
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

+
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.

68. 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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

+
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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
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.

+
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.

69. Patient.link.other
Definition

The other patient resource that the link refers to.

+
Definition

The other patient resource that the link refers to.

Control1..1
TypeReference(Patient | RelatedPerson)
Comments

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

+
Comments

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

70. Patient.link.type
Definition

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

+
Definition

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

Control1..1
BindingThe type of link between this patient resource and another patient resource.
The codes SHALL be taken from LinkType
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - + - - - - - - - - - - - + - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
1. Practitioner
Definition

A person who is directly or indirectly involved in the provisioning of healthcare.

+
Definition

A person who is directly or indirectly involved in the provisioning of healthcare.

Control0..*
Comments

Note that a cab driver no longer fits the bill. You probably would be interested in the organization rather than the individual?

+
Comments

Note that a cab driver no longer fits the bill. You probably would be interested in the organization rather than the individual?

InvariantsDefined on this element
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (: contained.text.empty())
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (: contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (: contained.where(('#'+id in %resource.descendants().reference).not()).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())
2. Practitioner.id
Definition

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

+
Definition

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

Control0..1
Typeid
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.

+
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.

3. Practitioner.meta
Definition

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

+
Definition

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

Control0..1
TypeMeta
4. Practitioner.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.

+
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.

Control0..1
Typeuri
Is Modifiertrue
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.

-

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

+
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.

+

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

5. Practitioner.language
Definition

The base language in which the resource is written.

+
Definition

The base language in which the resource is written.

Control0..1
BindingA human language.
The codes SHALL be taken from Common Languages; other codes may be used where these codes are not suitable
Max Binding: All Languages
Typecode
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).

+
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).

6. Practitioner.text
Definition

A human-readable narrative that contains a summary of the resource, and may 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.

+
Definition

A human-readable narrative that contains a summary of the resource, and may 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.

Control0..1 This element is affected by the following invariants: dom-1
TypeNarrative
Alternate Namesnarrative, html, xhtml, display
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 in formation is added later.

+
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 in formation is added later.

7. Practitioner.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.

+
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.

Control0..*
TypeResource
Alternate Namesinline resources, anonymous resources, contained 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.

+
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.

8. Practitioner.extension
Definition

May be used to represent additional information that is not part of the basic definition of the resource. In order 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.

+
Definition

May be used to represent additional information that is not part of the basic definition of the resource. In order 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

+
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.

9. Practitioner.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. Usually modifier elements provide negation or qualification. In order 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.

+
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. Usually modifier elements provide negation or qualification. In order 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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content
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.

+
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.

10. Practitioner.identifier
Definition

Practitioner must have NPI identifier

+
Definition

Practitioner must have NPI identifier

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Requirements

Often, specific identities are assigned for the agent.

+
Requirements

Often, specific identities are assigned for the agent.

SlicingThis element introduces a set of slices on Practitioner.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ system
11. Practitioner.identifier:practitioner-npi
SliceNamepractitioner-npi
Definition

An identifier that applies to this person in this role.

+
Definition

An identifier that applies to this person in this role.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control1..1
TypeIdentifier
Requirements

Often, specific identities are assigned for the agent.

+
Requirements

Often, specific identities are assigned for the agent.

12. Practitioner.identifier:practitioner-npi.id
Definition

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

+
Definition

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

Control0..1
Typestring
13. Practitioner.identifier:practitioner-npi.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

+
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

+
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.

SlicingThis element introduces a set of slices on Practitioner.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
14. Practitioner.identifier:practitioner-npi.use
Definition

The purpose of this identifier.

+
Definition

The purpose of this identifier.

Control0..1
BindingIdentifies the purpose for this identifier, if known .
The codes SHALL be taken from IdentifierUse
Typecode
Is Modifiertrue
Requirements

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

+
Requirements

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

Comments

This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

+
Comments

This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

15. Practitioner.identifier:practitioner-npi.type
Definition

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

+
Definition

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

Control0..1
BindingA coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
The codes SHALL be taken from Identifier Type Codes; other codes may be used where these codes are not suitable
TypeCodeableConcept
Requirements

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

+
Requirements

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

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.

+
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.

16. Practitioner.identifier:practitioner-npi.system
Definition

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

+
Definition

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

Control1..1
Typeuri
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.

+
Requirements

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

Fixed Valuehttp://hl7.org/fhir/sid/us-npi
Fixed Valuehttp://terminology.hl7.org/NamingSystem/npi
Example
General:http://www.acme.com/identifiers/patient
17. Practitioner.identifier:practitioner-npi.value
Definition

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

+
Definition

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

Control0..1
Typestring
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.

+
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.

Example
General:123456
18. Practitioner.identifier:practitioner-npi.period
Definition

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

+
Definition

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

Control0..1
TypePeriod
19. Practitioner.identifier:practitioner-npi.assigner
Definition

Organization that issued/manages the identifier.

+
Definition

Organization that issued/manages the identifier.

Control0..1
TypeReference(Organization)
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.

+
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.

20. Practitioner.active
Definition

Whether this practitioner's record is in active use.

+
Definition

Whether this practitioner's record is in active use.

Control0..1
Typeboolean
Requirements

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

+
Requirements

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

Comments

Default is true.

-

If the practitioner is not in use by one organization, then it should mark the period on the PractitonerRole with an end date (even if they are active) as they may be active in another role.

+
Comments

Default is true.

+

If the practitioner is not in use by one organization, then it should mark the period on the PractitonerRole with an end date (even if they are active) as they may be active in another role.

Default Valuetrue
21. Practitioner.name
Definition

Practitioner must have a provided name

+
Definition

Practitioner must have a provided name

Control1..*
TypeHumanName
Requirements

The name(s) that a Practitioner is known by. Where there are multiple, the name that the practitioner is usually known as should be used in the display.

-
Comments

The selection of the use property should ensure that there is a single usual name specified, and others use the nickname (alias), old, or other values as appropriate.

-

In general select the value to be used in the ResourceReference.display based on this:

-
    -
  1. There is more than 1 name
    2. -
  2. Use = usual
    3. -
  3. Period is current to the date of the usage
    4. -
  4. Use = official
    5. -
  5. Other order as decided by internal business rules.
    6. -
+
Requirements

The name(s) that a Practitioner is known by. Where there are multiple, the name that the practitioner is usually known as should be used in the display.

+
Comments

The selection of the use property should ensure that there is a single usual name specified, and others use the nickname (alias), old, or other values as appropriate.

+

In general select the value to be used in the ResourceReference.display based on this:

+
    +
  1. There is more than 1 name
    2. +
  2. Use = usual
    3. +
  3. Period is current to the date of the usage
    4. +
  4. Use = official
    5. +
  5. Other order as decided by internal business rules.
    6. +
22. Practitioner.name.id
Definition

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

+
Definition

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

Control0..1
Typestring
23. Practitioner.name.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

+
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

+
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.

SlicingThis element introduces a set of slices on Practitioner.name.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
24. Practitioner.name.use
Definition

Identifies the purpose for this name.

+
Definition

Identifies the purpose for this name.

Control0..1
BindingThe use of a human name
The codes SHALL be taken from NameUse
Typecode
Is Modifiertrue
Requirements

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

+
Requirements

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

Comments

This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one. Applications can assume that a name is current unless it explicitly says that it is temporary or old.

+
Comments

This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one. Applications can assume that a name is current unless it explicitly says that it is temporary or old.

25. Practitioner.name.text
Definition

A full text representation of the name.

+
Definition

A full text representation of the name.

Control0..1
Typestring
Requirements

A renderable, unencoded form.

+
Requirements

A renderable, unencoded form.

Comments

Can provide both a text representation and structured parts.

+
Comments

Can provide both a text representation and structured parts.

26. Practitioner.name.family
Definition

Practitioner family name

+
Definition

Practitioner family name

Control1..1
Typestring
Alternate Namessurname
Comments

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

+
Comments

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

27. Practitioner.name.given
Definition

Practitioner given name

+
Definition

Practitioner given name

Control1..*
Typestring
Alternate Namesfirst name, middle name
Comments

If only initials are recorded, they may be used in place of the full name. Not called "first name" since given names do not always come first.

+
Comments

If only initials are recorded, they may be used in place of the full name. Not called "first name" since given names do not always come first.

28. Practitioner.name.prefix
Definition

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

+
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.

Control0..*
Typestring
29. Practitioner.name.suffix
Definition

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

+
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.

Control0..*
Typestring
30. Practitioner.name.period
Definition

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

+
Definition

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

Control0..1
TypePeriod
Requirements

Allows names to be placed in historical context.

+
Requirements

Allows names to be placed in historical context.

31. Practitioner.telecom
Definition

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

+
Definition

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

Control0..*
TypeContactPoint
Requirements

Need to know how to reach a practitioner independent to any roles the practitioner may have.

+
Requirements

Need to know how to reach a practitioner independent to any roles the practitioner may have.

Comments

Person 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

-

These typically will have home numbers, or mobile numbers that are not role specific.

+
Comments

Person 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

+

These typically will have home numbers, or mobile numbers that are not role specific.

32. Practitioner.address
Definition

Address(es) of the practitioner that are not role specific (typically home address). -Work addresses are not typically entered in this property as they are usually role dependent.

+
Definition

Address(es) of the practitioner that are not role specific (typically home address). +Work addresses are not typically entered in this property as they are usually role dependent.

Control0..*
TypeAddress
Requirements

The home/mailing address of the practitioner is often required for employee administration purposes, and also for some rostering services where the start point (practitioners home) can be used in calculations.

+
Requirements

The home/mailing address of the practitioner is often required for employee administration purposes, and also for some rostering services where the start point (practitioners home) can be used in calculations.

Comments

The PractitionerRole does not have an address value on it, as it is expected that the location property be used for this purpose (which has an address).

+
Comments

The PractitionerRole does not have an address value on it, as it is expected that the location property be used for this purpose (which has an address).

33. Practitioner.gender
Definition

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

+
Definition

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

Control0..1
BindingThe gender of a person used for administrative purposes.
The codes SHALL be taken from AdministrativeGender
Typecode
Requirements

Needed to address the person correctly.

+
Requirements

Needed to address the person correctly.

34. Practitioner.birthDate
Definition

The date of birth for the practitioner.

+
Definition

The date of birth for the practitioner.

Control0..1
Typedate
Requirements

Needed for identification.

+
Requirements

Needed for identification.

35. Practitioner.photo
Definition

Image of the person.

+
Definition

Image of the person.

Control0..*
TypeAttachment
Requirements

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

+
Requirements

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

36. Practitioner.qualification
Definition

Qualifications obtained by training and certification.

+
Definition

Qualifications obtained by training and certification.

Control0..*
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
37. Practitioner.qualification.id
Definition

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

+
Definition

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

Control0..1
Typestring
38. Practitioner.qualification.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

+
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

+
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.

39. Practitioner.qualification.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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

+
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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
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.

+
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.

40. Practitioner.qualification.identifier
Definition

An identifier that applies to this person's qualification in this role.

+
Definition

An identifier that applies to this person's qualification in this role.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Requirements

Often, specific identities are assigned for the qualification.

+
Requirements

Often, specific identities are assigned for the qualification.

41. Practitioner.qualification.code
Definition

Coded representation of the qualification.

+
Definition

Coded representation of the qualification.

Control1..1
BindingSpecific qualification the practitioner has to provide a service
For example codes, see v2 table 0360, Version 2.7
TypeCodeableConcept
42. Practitioner.qualification.period
Definition

Period during which the qualification is valid.

+
Definition

Period during which the qualification is valid.

Control0..1
TypePeriod
Requirements

Qualifications are often for a limited period of time, and can be revoked.

+
Requirements

Qualifications are often for a limited period of time, and can be revoked.

43. Practitioner.qualification.issuer
Definition

Organization that regulates and issues the qualification.

+
Definition

Organization that regulates and issues the qualification.

Control0..1
TypeReference(Organization)
44. Practitioner.communication
Definition

A language the practitioner is able to use in patient communication.

+
Definition

A language the practitioner is able to use in patient communication.

Control0..*
BindingA human language.
The codes SHALL be taken from Common Languages; other codes may be used where these codes are not suitable
Max Binding: All Languages
TypeCodeableConcept
Requirements

Knowing which language a practitioner speaks can help in facilitating communication with patients.

+
Requirements

Knowing which language a practitioner speaks can help in facilitating communication with patients.

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.

+
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.

diff --git a/implementation_guide/generated_output/qa/StructureDefinition-dpc-profile-practitioner-diff.html b/implementation_guide/generated_output/qa/StructureDefinition-dpc-profile-practitioner-diff.html index 383e4321..ae54db66 100644 --- a/implementation_guide/generated_output/qa/StructureDefinition-dpc-profile-practitioner-diff.html +++ b/implementation_guide/generated_output/qa/StructureDefinition-dpc-profile-practitioner-diff.html @@ -7,7 +7,7 @@ - +
NameFlagsCard.TypeDescription & Constraintsdoco
.. Practitioner 0..*PractitionerA person with a formal responsibility in the provisioning of healthcare or related services
... identifier 0..*(Slice Definition)A identifier for the person as this agent
Slice: Unordered, Open by value:system
.... identifier:practitioner-npi 1..1IdentifierA identifier for the person as this agent
..... system 1..1uriThe namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
..... system 1..1uriThe namespace for the identifier value
Fixed Value: http://terminology.hl7.org/NamingSystem/npi
... name 1..*HumanNameThe name(s) associated with the practitioner
.... family 1..1stringFamily name (often called 'Surname')
.... given 1..*stringGiven names (not always 'first'). Includes middle names