ZD Patient

Resources conforming to this profile are requested by ZorgDomein when SSO has succeeded and patient details are fetched from the source system. Patient resources are requested by FHIR read request (i.e. a direct call on the patient id like https://[FHIRServerUrl]/Patient/[PatientID]).

Resources conforming to the ZD Patient profile are sent by ZorgDomein as part of a Bundle that is sent to deliver a FHIR document to the information system of the referrer or care provider.

The canonical URL for this profile is:

http://zorgdomein.nl/fhir/StructureDefinition/zd-patient

This profile builds on Patient.

diffhybridsnap

Patient	S	0..*	Patient	Element Id Patient Short description Information about an individual receiving health care services Alternate names SubjectOfCare Client Resident Definition Demographics and other administrative information about an individual or animal receiving care or other health-related services. Data Type Patient Constraints dom-2:If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-1:If the resource is contained in another resource, it SHALL NOT contain any narrative `contained.text.empty()` dom-4:If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-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()` Mappings rim:Entity. Role, or Act rim:Patient[classCode=PAT] cda:ClinicalDocument.recordTarget.patientRole w5:administrative.individual
extension		0..*	Extension	Element Id Patient.extension Short description Additional Content defined by implementations Alternate names extensions, user content 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. 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. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
pharmacy		0..1	Extension(Reference(nl-core-organization))	Element Id Patient.extension:pharmacy Short description Reference to patient's primary pharmacy Alternate names extensions, user content Definition Reference to patient's primary pharmacy 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. Data Type Extension(Reference(nl-core-organization)) Extension URL http://fhir.nl/fhir/StructureDefinition/nl-core-preferred-pharmacy Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id Patient.extension:pharmacy.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value http://fhir.nl/fhir/StructureDefinition/nl-core-preferred-pharmacy Mappings rim:n/a rim:N/A
valueReference		1..1	Reference(nl-core-organization)	There are no (further) constraints on this element Element Id Patient.extension:pharmacy.valueReference:valueReference Short description Value of extension Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). Comments A stream of bytes, base64 encoded Data Type Reference(nl-core-organization) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A
identifier	Σ	0..*	Identifier	Element Id Patient.identifier Short description An identifier for this patient Definition An identifier for this patient. Requirements Patients are almost always assigned specific numerical identifiers. Data Type Identifier Sliced: Unordered, Open, by system(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:CX / EI (occasionally, more often EI maps to a resource id or a URL) rim:II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd:Identifier v2:PID-3 rim:id cda:.id w5:id
BSN	S Σ	0..1	Identifier	Element Id Patient.identifier:BSN Short description BSN Definition An identifier for this patient. Requirements Patients are almost always assigned specific numerical identifiers. Data Type Identifier Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:CX / EI (occasionally, more often EI maps to a resource id or a URL) rim:II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd:Identifier v2:PID-3 rim:id cda:.id w5:id
use	Σ ?!	1..1	codeBindingFixed Value	Element Id Patient.identifier:BSN.use Short description usual \| official \| temp \| secondary (If known) Definition The purpose of this identifier. 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. Data Type code Binding IdentifierUse (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value official Mappings rim:n/a v2:N/A rim:Role.code or implied by context
type	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element Id Patient.identifier:BSN.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. 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. Data Type CodeableConcept Binding Identifier Type Codes (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:CX.5 rim:Role.code or implied by context
system	Σ	1..1	uriFixed Value	Element Id Patient.identifier:BSN.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value http://fhir.nl/fhir/NamingSystem/bsn Mappings rim:n/a v2:CX.4 / EI-2-4 rim:II.root or Role.id.root servd:./IdentifierType
value	Σ	1..1	string	Element Id Patient.identifier:BSN.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Examples General 123456 General 447363669 Mappings rim:n/a v2:CX.1 / EI.1 rim:II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd:./Value
period	Σ	0..1	Period	There are no (further) constraints on this element Element Id Patient.identifier:BSN.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Comments This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval\|Duration. Data Type Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.empty() or end.empty() or (start <= end)` Mappings rim:n/a v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2:CX.7 + CX.8 rim:Role.effectiveTime or implied by context servd:./StartDate and ./EndDate
assigner	Σ	0..1	Reference(Organization)	There are no (further) constraints on this element Element Id Patient.identifier:BSN.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. 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. Data Type Reference(Organization) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2:CX.4 / (CX.4,CX.9,CX.10) rim:II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd:./IdentifierIssuingAuthority
active	Σ ?!	0..1	boolean	There are no (further) constraints on this element Element Id Patient.active Short description Whether this patient's record is in active use Definition Whether this patient record is in active use. 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. Data Type boolean Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Default value true Mappings rim:n/a rim:statusCode cda:n/a w5:status
name	S Σ	0..*	nl-core-humanname	Element Id Patient.name Short description Name of a human - parts and usage Alternate names Naamgegevens Definition A human's name with the ability to identify parts and usage. Requirements Need to be able to track the patient by multiple names. Examples are your official name and a partner name. Comments Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts may or may not be imbued with some implicit meaning; various cultures associate different importance with the name parts and the degree to which systems must care about name parts around the world varies widely. A Dutch HumanName is a proper FHIR HumanName. Systems that do not understand any of the extensions, will be able to render and work with a Dutch name. Dutch names make certain name parts seaprately communicable. These parts are required for use in true Dutch systems when dealing with Dutch names, but may not have value for international systems when information gets sent abroad. To have true compatibility an implementer SHOULD use the core HumanName parts as intended. To have names work for Dutch context, the implementer SHOULD in addition use the extension elements. The extension elements cover birth name (NL: eigennaam / geslachtsnaam) and partner/spouse name. Both may have a prefix (NL: voorvoegsel). When a person marries, he or she may keep their own name, assume the partner name, append the partner name to their own name, or the other way around. For this reason, there are extensions for marking each part for what it is. Example: miss Irma Jongeneel marries mister de Haas and assumes the name Irma Jongeneel-de Haas family = "Jongeneel-de Haas" given = "Irma" humanname-own-name = "Jongeneel" humanname-partner-prefix = "de " humanname-partner-name = "Haas" Data Type nl-core-humanname Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` nl-core-humanname-1:if you specify a prefix for an own name then an own name is also expected `name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-prefix').empty().not() implies name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-name').empty().not()` nl-core-humanname-2:if you specify a voorvoegsel for a partner name then a partner name is also expected `name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix').empty().not() implies name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-name').empty().not()` Examples Structured HumanName (preferred above unstructured) { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/humanname-assembly-order", "valueCode": "NL4" } ], "use": "official", "family": "Jongeneel-de Haas", "_family": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/humanname-own-name", "valueString": "Jongeneel" }, { "url": "http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix", "valueString": "de" }, { "url": "http://hl7.org/fhir/StructureDefinition/humanname-partner-name", "valueString": "Haas" } ] }, "given": [ "Irma", "I." ], "_given": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier", "valueCode": "CL" } ] }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier", "valueCode": "IN" } ] } ] } Unstructured HumanName { "use": "official", "text": "Irma Jongeneel-de Haas" } Mappings rim:n/a v2:XPN rim:EN (actually, PN) servd:ProviderName v2:PID-5, PID-9 rim:name cda:.patient.name hcim-nameinformation-v2.0.1-2015EN:NL-CM:0.1.6 hcim-nameinformation-v3.0-2016EN:NL-CM:0.1.6 hcim-nameinformation-v1.0.1-2017EN:NL-CM:20.4.1 BRP:02 zib-patient:NL-CM:0.1.6
telecom	S Σ	0..*	ContactPoint	There are no (further) constraints on this element Element Id Patient.telecom Short description A contact detail for the individual Definition A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted. 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). Data Type ContactPoint Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` cpt-2:A system is required if a value is provided. `value.empty() or system.exists()` Mappings rim:n/a v2:XTN rim:TEL servd:ContactPoint v2:PID-13, PID-14, PID-40 rim:telecom cda:.telecom
system	Σ	1..1	codeBinding	There are no (further) constraints on this element Element Id Patient.telecom.system Short description phone \| fax \| email \| pager \| url \| sms \| other Definition Telecommunications form for contact point - what communications system is required to make use of the contact. Comments Note that FHIR strings may not exceed 1MB in size Data Type code Binding ContactPointSystem (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:XTN.3 rim:./scheme servd:./ContactPointType
value	Σ	1..1	string	There are no (further) constraints on this element Element Id Patient.telecom.value Short description The actual contact point details Definition The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address). Requirements Need to support legacy numbers that are not in a tightly controlled format. Comments Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value. Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:XTN.1 (or XTN.12) rim:./url servd:./Value
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element Id Patient.telecom.use Short description home \| work \| temp \| old \| mobile - purpose of this contact point Definition Identifies the purpose for the contact point. Requirements Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose. Comments This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one. Applications can assume that a contact is current unless it explicitly says that it is temporary or old. Data Type code Binding ContactPointUse (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:XTN.2 - but often indicated by field rim:unique(./use) servd:./ContactPointPurpose
rank	Σ	0..1	positiveInt	There are no (further) constraints on this element Element Id Patient.telecom.rank Short description Specify preferred order of use (1 = highest) Definition Specifies a preferred order in which to use a set of contacts. Contacts are ranked with lower values coming before higher values. Comments Note that rank does not necessarily follow the order in which the contacts are represented in the instance. Data Type positiveInt Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:n/a
period	Σ	0..1	Period	There are no (further) constraints on this element Element Id Patient.telecom.period Short description Time period when the contact point was/is in use Definition Time period when the contact point was/is in use. Comments This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval\|Duration. Data Type Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.empty() or end.empty() or (start <= end)` Mappings rim:n/a v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2:N/A rim:./usablePeriod[type="IVL<TS>"] servd:./StartDate and ./EndDate
gender	S Σ	0..1	codeBinding	There are no (further) constraints on this element Element Id Patient.gender Short description male \| female \| other \| unknown Definition Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes. 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. Data Type code Binding AdministrativeGender (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:PID-8 rim:player[classCode=PSN\|ANM and determinerCode=INSTANCE]/administrativeGender cda:.patient.administrativeGenderCode
birthDate	S Σ	0..1	date	Element Id Patient.birthDate Short description The date of birth for the individual Definition The date of birth for the individual. 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). Data Type date Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` zd-date-1:BirthDate must be at least today. `($this as dateTime).toString().length() >= 8` Mappings rim:n/a v2:PID-7 rim:player[classCode=PSN\|ANM and determinerCode=INSTANCE]/birthTime cda:.patient.birthTime loinc:21112-8
deceased[x]	Σ ?!	0..1		There are no (further) constraints on this element Element Id Patient.deceased[x] Short description Indicates if the individual is deceased or not Definition Indicates if the individual is deceased or not. 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. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:PID-30 (bool) and PID-29 (datetime) rim:player[classCode=PSN\|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN\|ANM and determinerCode=INSTANCE]/deceasedTime cda:n/a
deceasedBoolean			boolean	There are no (further) constraints on this element Data Type boolean
deceasedDateTime			dateTime	There are no (further) constraints on this element Data Type dateTime
address	S Σ	0..*	nl-core-address	Element Id Patient.address Short description Addresses for the individual Alternate names AdresInformatie Definition This datatype defines a common basis for expressing all addresses around the world, but adds extensions to express Dutch addresses specifically, according to the HCIM AddressInformation (v1.0, 2017). A Dutch Address still is a proper FHIR Address, which means that systems that cannot interpret the extensions will still be able to render and work with this datatype. To have true compatibility an implementer SHOULD use the core Address parts as intended. To have addresses work for Dutch context, the implementer SHOULD in addition use the extension elements. Separate address parts The first addition is that Dutch addresses make certain address parts separately communicable. These parts are required for use in true Dutch systems when dealing with Dutch addresses, but may not have value for international systems when information gets sent abroad. Custom address types The second addition is that the HCIM defines its own ValueSet for address types, which can only be partially expressed using the FHIR Address datatype and requires a mapping to multiple elements. The table below explains how the HCIM concepts are mapped to the various FHIR elements (see the ConceptMaps http://nictiz.nl/fhir/ConceptMap/AdresSoortCodelijst-to-AddressUse and http://nictiz.nl/fhir/ConceptMap/AdresSoortCodelijst-to-AddressType as well). The HCIM code itself should also be included using the AddressType extension. `\| HCIM \| .ext:AddressType \| .ext:official \| .use \| .type \| \|-----------------------------------\|------------------\|---------------\|------\|----------\| \| Postal Address/Postadres \| PST \| \| \| postal \| \| Primary Home/Officieel adres \| HP \| true \| home \| \| \| Visit Address/Woon-/verblijfadres \| PHYS \| \| home \| physical \| \| Temporary Address/Tijdelijk adres \| TMP \| \| temp \| \| \| Work Place/Werkadres \| WP \| \| work \| \| \| Vacation Home/Vakantie adres \| HV \| \| temp \| \|` If Address.type is "both" then this is to be understood as a dual purpose address (postal and physical). Systems that support importing it like this are encouraged to do so, otherwise they may need to import this as two separate addresses. NOTE: FHIR core defines the AD-use extension to further specify the postal address type. However, the ValueSet used in that extension doesn't completely match the HCIM ValueSet. Therefore, a custom extension has been made. This doesn't preclude the use of the AD-use extension. Requirements May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification. Comments Note: address is for postal addresses, not physical locations. Data Type nl-core-address Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` nl-streetname-if-official-and-other-line-parts:Address.streetName in an official address SHALL have a value if one of houseNumber\|buildingNumberSuffix\|additionalLocator has a value (extension.where(url = 'http://fhir.nl/fhir/StructureDefinition/nl-core-address-official').where(value = true)).empty() or (line.extension.where(url = 'http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName').empty().not() and (line.extension.where(url='http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber').empty().not() or line.extension.where(url='http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-buildingNumberSuffix').empty().not() or line.extension.where(url='http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator').empty().not())) Examples Example of a Vacation Home address { "extension": [ { "url": "http://nictiz.nl/fhir/StructureDefinition/zib-AddressInformation-AddressType", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/v3/AddressUse", "code": "HV", "display": "Vakantie adres" } ] } } ], "use": "temp", "line": [ "Binnenkant 12A Hoog" ], "_line": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName", "valueString": "Binnenkant" }, { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber", "valueString": "12" }, { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-buildingNumberSuffix", "valueString": "A" }, { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-unitID", "valueString": "Hoog" } ] } ], "city": "Amsterdam", "state": "NH", "postalCode": "1000AA", "country": "NLD" } Example of a Primary Home address { "extension": [ { "url": "http://nictiz.nl/fhir/StructureDefinition/zib-AddressInformation-AddressType", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/v3/AddressUse", "code": "HP", "display": "Officieel adres" } ] } }, { "url": "http://fhir.nl/fhir/StructureDefinition/nl-core-address-official", "valueBoolean": true } ], "use": "home", "line": [ "Binnenkant to 10" ], "_line": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName", "valueString": "Binnenkant" }, { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator", "valueString": "to" }, { "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber", "valueString": "10" } ] } ], "city": "Amsterdam", "state": "NH", "postalCode": "1001AA", "country": "NLD" } Mappings rim:n/a v2:XAD rim:AD servd:Address v2:PID-11 rim:addr cda:.addr hcim-address-v2.0.1-2015EN:NL-CM:0.1.4 hcim-addressinformation-v3.0-2016EN:NL-CM:0.1.4 hcim-addressinformation-v1.0-2017EN:NL-CM:20.5.1
extension		0..*	Extension	There are no (further) constraints on this element Element Id Patient.address.extension Short description Additional Content defined by implementations Alternate names extensions, user content 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. 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. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
AddressType		0..1	Extension(CodeableConcept)	There are no (further) constraints on this element Element Id Patient.address.extension:AddressType Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. 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. Data Type Extension(CodeableConcept) Extension URL http://nictiz.nl/fhir/StructureDefinition/zib-AddressInformation-AddressType Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id Patient.address.extension:AddressType.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value http://nictiz.nl/fhir/StructureDefinition/zib-AddressInformation-AddressType Mappings rim:n/a rim:N/A
valueCodeableConcept		0..1	CodeableConceptBinding	There are no (further) constraints on this element Element Id Patient.address.extension:AddressType.value[x]:valueCodeableConcept Short description AddressType Alternate names AdresSoort Definition The type of address in question, such as a home address or mailing address. Comments This extension can be used to include the HCIM AddressType code. See the documentation on the root level for mapping these codes to the various elements of this datatype. NOTE: FHIR core defines the AD-use extension to further specify the postal address type. However, the ValueSet used in that extension doesn't completely match the HCIM ValueSet. Therefore, a custom extension has been made. This doesn't preclude the use of the AD-use extension. Data Type CodeableConcept Binding AdresSoortCodelijst (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A hcim-address-v2.0.1-2015EN:NL-CM:0.1.11 hcim-addressinformation-v3.0-2016EN:NL-CM:0.1.11 hcim-addressinformation-v1.0-2017EN:NL-CM:20.5.8
official		0..1	Extension(boolean)	There are no (further) constraints on this element Element Id Patient.address.extension:official Short description Mark an address as an 'officially registered' address. Alternate names extensions, user content, Markeer een adres als een 'officieel geregistreerd adres. Definition Mark an address as an 'officially registered' address. In Dutch context that means it is registered in the Basisregistratie persoonsgegevens (BRP) 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. Data Type Extension(boolean) Extension URL http://fhir.nl/fhir/StructureDefinition/nl-core-address-official Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A hcim-address-v2.0.1-2015EN:NL-CM:0.1.11 hcim-addressinformation-v3.0-2016EN:NL-CM:0.1.11 hcim-addressinformation-v1.0-2017EN:NL-CM:20.5.8
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id Patient.address.extension:official.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value http://fhir.nl/fhir/StructureDefinition/nl-core-address-official Mappings rim:n/a rim:N/A
valueBoolean		1..1	boolean	There are no (further) constraints on this element Element Id Patient.address.extension:official.valueBoolean:valueBoolean Short description true if part of an official registry. false if it is not Alternate names true als deze deel is van een officieel register. false indien dat niet het geval is Definition When the value is true, this address is marked to be part of an official registry (Dutch realm: BRP). When the value is false, this address is explicitly marked as not part of an official registry. Comments A stream of bytes, base64 encoded Data Type boolean Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A rim:AD/@use[.='OR']
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element Id Patient.address.use Short description home \| work \| temp \| old - purpose of this address Definition Purpose of this address Requirements Allows an appropriate address to be chosen from a list of many. Comments This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one. Applications can assume that an address is current unless it explicitly says that it is temporary or old. Data Type code Binding AddressUse (required) Permitted Values AdresSoortCodelijst-to-AddressUse Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Examples General home Mappings rim:n/a v2:XAD.7 rim:unique(./use) servd:./AddressPurpose hcim-address-v2.0.1-2015EN:NL-CM:0.1.11 hcim-address-v3.0-2016EN:NL-CM:0.1.11 hcim-addressinformation-v1.0-2017EN:NL-CM:20.5.8
type	Σ	0..1	codeBinding	There are no (further) constraints on this element Element Id Patient.address.type Short description postal \| physical \| both Definition Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both. Comments Note that FHIR strings may not exceed 1MB in size Data Type code Binding AddressType (required) Permitted Values AdresSoortCodelijst-to-AddressType Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Examples General both Mappings rim:n/a v2:XAD.18 rim:unique(./use) vcard:address type parameter hcim-address-v2.0.1-2015EN:NL-CM:0.1.11 hcim-address-v3.0-2016EN:NL-CM:0.1.11 hcim-addressinformation-v1.0-2017EN:NL-CM:20.5.8
text	Σ	0..1	string	There are no (further) constraints on this element Element Id Patient.address.text Short description Text representation of the address Definition A full text representation of the address. Requirements A renderable, unencoded form. Comments Can provide both a text representation and parts. Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Examples General 137 Nowhere Street, Erewhon 9132 Mappings rim:n/a v2:XAD.1 + XAD.2 + XAD.3 + XAD.4 + XAD.5 + XAD.6 rim:./formatted vcard:address label parameter
line	Σ	0..*	string	There are no (further) constraints on this element Element Id Patient.address.line Short description Street name, number, direction & P.O. Box etc. Definition This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information. Requirements home \| work \| temp \| old - purpose of this address. Comments Note that FHIR strings may not exceed 1MB in size Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Examples General 137 Nowhere Street Mappings rim:n/a v2:XAD.1 + XAD.2 (note: XAD.1 and XAD.2 have different meanings for a company address than for a person address) rim:AD.part[parttype = AL] vcard:street servd:./StreetAddress (newline delimitted)
extension		0..*	Extension	There are no (further) constraints on this element Element Id Patient.address.line.extension Short description Additional Content defined by implementations Alternate names extensions, user content 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. 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. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
streetName		0..1	Extension(string)	There are no (further) constraints on this element Element Id Patient.address.line.extension:streetName Short description streetName Alternate names extensions, user content Definition Street name. If the address is a P.O. Box then the Dutch word "Postbus" shall be communicated. If the address is an answer number (mailing address where the receiver pays postage) then the Dutch word "Antwoordnummer" shall be communicated. Requirements Basisregistratie Persoonsgegevens 11.10 Straatnaam 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. Data Type Extension(string) Extension URL http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A rim:ADXP[partType=STR] hcim-address-v2.0.1-2015EN:NL-CM:0.1.12 hcim-addressinformation-v3.0-2016EN:NL-CM:0.1.12 hcim-addressinformation-v1.0-2017EN:NL-CM:20.5.2 BRP:11.10
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id Patient.address.line.extension:streetName.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName Mappings rim:n/a rim:N/A
valueString		0..1	string	There are no (further) constraints on this element Element Id Patient.address.line.extension:streetName.valueString:valueString Short description Value of extension Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). Comments A stream of bytes, base64 encoded Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A
houseNumber		0..1	Extension(string)	There are no (further) constraints on this element Element Id Patient.address.line.extension:houseNumber Short description houseNumber Alternate names extensions, user content Definition The element houseNumber shall contain the house number. The house number may contains non-numeric parts that further determine the address, e.g. "23a", but only if the source system cannot discretely communicate those. House letter shall, if possible, be communicated through the element buildingNumberSuffix. Information such as "to" (house boats that do not have their own house number, but are across (tegenover) a house with a house number or "3 hoog achter" are not part of this attribute. This type of information is conveyed elsewhere in the Address datatype. Requirements Basisregistratie Persoonsgegevens 11.20 Huisnummer 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. Data Type Extension(string) Extension URL http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A rim:ADXP[partType=BNR] hcim-address-v2.0.1-2015EN:NL-CM:0.1.13 hcim-addressinformation-v3.0-2016EN:NL-CM:0.1.13 hcim-addressinformation-v1.0-2017EN:NL-CM:20.5.12 BRP:11.20
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id Patient.address.line.extension:houseNumber.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber Mappings rim:n/a rim:N/A
valueString		0..1	string	There are no (further) constraints on this element Element Id Patient.address.line.extension:houseNumber.valueString:valueString Short description Value of extension Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). Comments A stream of bytes, base64 encoded Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A
buildingNumbersuffix		0..*	Extension(string)	There are no (further) constraints on this element Element Id Patient.address.line.extension:buildingNumbersuffix Short description buildingNumberSuffix Alternate names extensions, user content Definition HouseNumberLetter A letter following the house number as assigned by the municipal authorities. HouseNumberAddition The letters or signs needed to locate the mailbox, in addition to the house number and letter. Requirements Basisregistratie Persoonsgegevens 11.30 Huisletter 11.40 Huisnummertoevoeging 12.10 Locatieomschrijving Comments Export If a house letter as well as a house number addition is known: house letter first, followed by a space and finally the house letter suffix. If only a house letter is known send just that. No trailing space is required. If only a house letter suffix is known, communicate that with a leading space. Import If the value of buildingNumberSuffix contains no space, then the whole value is considered to be the house letter If the value of buildingNumberSuffix contains a space, then everything before the first space is considered to be the house letter, and the everything trailing the first space is considered to be the house number suffix Data Type Extension(string) Extension URL http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-buildingNumberSuffix Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A rim:ADXP[partType=BNS] hcim-address-v2.0.1-2015EN:NL-CM:0.1.40 hcim-address-v2.0.1-2015EN:NL-CM:0.1.41 hcim-addressinformation-v3.0-2016EN:NL-CM:0.1.40 hcim-addressinformation-v3.0-2016EN:NL-CM:0.1.41 hcim-addressinformation-v1.0-2017EN:NL-CM:20.5.11 hcim-addressinformation-v1.0-2017EN:NL-CM:20.5.10 BRP:11.30 BRP:11.40
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id Patient.address.line.extension:buildingNumbersuffix.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-buildingNumberSuffix Mappings rim:n/a rim:N/A
valueString		0..1	string	There are no (further) constraints on this element Element Id Patient.address.line.extension:buildingNumbersuffix.value[x]:valueString Short description Value of extension Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). Comments A stream of bytes, base64 encoded Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A
unitID		0..1	Extension(string)	There are no (further) constraints on this element Element Id Patient.address.line.extension:unitID Short description unitID Alternate names extensions, user content Definition Extra information such as the building name, building number, entrance, route number. 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. Data Type Extension(string) Extension URL http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-unitID Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A rim:ADXP[partType=UNID] hcim-address-v2.0.1-2015EN:NL-CM:0.1.28 hcim-addressinformation-v3.0-2016EN:NL-CM:0.1.28 hcim-addressinformation-v1.0-2017EN:NL-CM:20.5.7
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id Patient.address.line.extension:unitID.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-unitID Mappings rim:n/a rim:N/A
valueString		0..1	string	There are no (further) constraints on this element Element Id Patient.address.line.extension:unitID.value[x]:valueString Short description Value of extension Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). Comments A stream of bytes, base64 encoded Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A
additionalLocator		0..1	Extension(string)	There are no (further) constraints on this element Element Id Patient.address.line.extension:additionalLocator Short description additionalLocator Alternate names extensions, user content Definition HouseNumberIndication - The indication used for addresses that do not consist of the usual street name and house number. Requirements Basisregistratie Persoonsgegevens 11.50 Aanduiding bij huisnummer 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. Data Type Extension(string) Extension URL http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A rim:ADXP[partType=ADL] hcim-address-v2.0.1-2015EN:NL-CM:0.1.42 hcim-addressinformation-v3.0-2016EN:NL-CM:0.1.42 hcim-addressinformation-v1.0-2017EN:NL-CM:20.5.9 BRP:11.50
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id Patient.address.line.extension:additionalLocator.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator Mappings rim:n/a rim:N/A
valueString		0..1	string	There are no (further) constraints on this element Element Id Patient.address.line.extension:additionalLocator.valueString:valueString Short description Value of extension Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). Comments A stream of bytes, base64 encoded Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A
buildingNumberSuffix		0..*	Extension	There are no (further) constraints on this element Element Id Patient.address.line.extension:buildingNumberSuffix Short description Additional Content defined by implementations Alternate names extensions, user content 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. 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. Data Type Extension Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id Patient.address.line.extension:buildingNumberSuffix.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value buildingNumberSuffix Mappings rim:n/a rim:N/A
valueString		0..1		There are no (further) constraints on this element Element Id Patient.address.line.extension:buildingNumberSuffix.valueString:valueString Short description Value of extension Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). Comments A stream of bytes, base64 encoded Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A
valueBase64Binary			base64Binary	There are no (further) constraints on this element Data Type base64Binary
valueBoolean			boolean	There are no (further) constraints on this element Data Type boolean
valueCode			code	There are no (further) constraints on this element Data Type code
valueDate			date	There are no (further) constraints on this element Data Type date
valueDateTime			dateTime	There are no (further) constraints on this element Data Type dateTime
valueDecimal			decimal	There are no (further) constraints on this element Data Type decimal
valueId			id	There are no (further) constraints on this element Data Type id
valueInstant			instant	There are no (further) constraints on this element Data Type instant
valueInteger			integer	There are no (further) constraints on this element Data Type integer
valueMarkdown			markdown	There are no (further) constraints on this element Data Type markdown
valueOid			oid	There are no (further) constraints on this element Data Type oid
valuePositiveInt			positiveInt	There are no (further) constraints on this element Data Type positiveInt
valueString			string	There are no (further) constraints on this element Data Type string
valueTime			time	There are no (further) constraints on this element Data Type time
valueUnsignedInt			unsignedInt	There are no (further) constraints on this element Data Type unsignedInt
valueUri			uri	There are no (further) constraints on this element Data Type uri
valueAddress			Address	There are no (further) constraints on this element Data Type Address
valueAge			Age	There are no (further) constraints on this element Data Type Age
valueAnnotation			Annotation	There are no (further) constraints on this element Data Type Annotation
valueAttachment			Attachment	There are no (further) constraints on this element Data Type Attachment
valueCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data Type CodeableConcept
valueCoding			Coding	There are no (further) constraints on this element Data Type Coding
valueContactPoint			ContactPoint	There are no (further) constraints on this element Data Type ContactPoint
valueCount			Count	There are no (further) constraints on this element Data Type Count
valueDistance			Distance	There are no (further) constraints on this element Data Type Distance
valueDuration			Duration	There are no (further) constraints on this element Data Type Duration
valueHumanName			HumanName	There are no (further) constraints on this element Data Type HumanName
valueIdentifier			Identifier	There are no (further) constraints on this element Data Type Identifier
valueMoney			Money	There are no (further) constraints on this element Data Type Money
valuePeriod			Period	There are no (further) constraints on this element Data Type Period
valueQuantity			Quantity	There are no (further) constraints on this element Data Type Quantity
valueRange			Range	There are no (further) constraints on this element Data Type Range
valueRatio			Ratio	There are no (further) constraints on this element Data Type Ratio
valueSampledData			SampledData	There are no (further) constraints on this element Data Type SampledData
valueSignature			Signature	There are no (further) constraints on this element Data Type Signature
valueTiming			Timing	There are no (further) constraints on this element Data Type Timing
valueMeta			Meta	There are no (further) constraints on this element Data Type Meta
valueReference			Reference()	There are no (further) constraints on this element Data Type Reference()
unitID		0..*	Extension	There are no (further) constraints on this element Element Id Patient.address.line.extension:unitID Short description Additional Content defined by implementations Alternate names extensions, user content 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. 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. Data Type Extension Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id Patient.address.line.extension:unitID.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value unitID Mappings rim:n/a rim:N/A
valueString		0..1		There are no (further) constraints on this element Element Id Patient.address.line.extension:unitID.valueString:valueString Short description Value of extension Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). Comments A stream of bytes, base64 encoded Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A
valueBase64Binary			base64Binary	There are no (further) constraints on this element Data Type base64Binary
valueBoolean			boolean	There are no (further) constraints on this element Data Type boolean
valueCode			code	There are no (further) constraints on this element Data Type code
valueDate			date	There are no (further) constraints on this element Data Type date
valueDateTime			dateTime	There are no (further) constraints on this element Data Type dateTime
valueDecimal			decimal	There are no (further) constraints on this element Data Type decimal
valueId			id	There are no (further) constraints on this element Data Type id
valueInstant			instant	There are no (further) constraints on this element Data Type instant
valueInteger			integer	There are no (further) constraints on this element Data Type integer
valueMarkdown			markdown	There are no (further) constraints on this element Data Type markdown
valueOid			oid	There are no (further) constraints on this element Data Type oid
valuePositiveInt			positiveInt	There are no (further) constraints on this element Data Type positiveInt
valueString			string	There are no (further) constraints on this element Data Type string
valueTime			time	There are no (further) constraints on this element Data Type time
valueUnsignedInt			unsignedInt	There are no (further) constraints on this element Data Type unsignedInt
valueUri			uri	There are no (further) constraints on this element Data Type uri
valueAddress			Address	There are no (further) constraints on this element Data Type Address
valueAge			Age	There are no (further) constraints on this element Data Type Age
valueAnnotation			Annotation	There are no (further) constraints on this element Data Type Annotation
valueAttachment			Attachment	There are no (further) constraints on this element Data Type Attachment
valueCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data Type CodeableConcept
valueCoding			Coding	There are no (further) constraints on this element Data Type Coding
valueContactPoint			ContactPoint	There are no (further) constraints on this element Data Type ContactPoint
valueCount			Count	There are no (further) constraints on this element Data Type Count
valueDistance			Distance	There are no (further) constraints on this element Data Type Distance
valueDuration			Duration	There are no (further) constraints on this element Data Type Duration
valueHumanName			HumanName	There are no (further) constraints on this element Data Type HumanName
valueIdentifier			Identifier	There are no (further) constraints on this element Data Type Identifier
valueMoney			Money	There are no (further) constraints on this element Data Type Money
valuePeriod			Period	There are no (further) constraints on this element Data Type Period
valueQuantity			Quantity	There are no (further) constraints on this element Data Type Quantity
valueRange			Range	There are no (further) constraints on this element Data Type Range
valueRatio			Ratio	There are no (further) constraints on this element Data Type Ratio
valueSampledData			SampledData	There are no (further) constraints on this element Data Type SampledData
valueSignature			Signature	There are no (further) constraints on this element Data Type Signature
valueTiming			Timing	There are no (further) constraints on this element Data Type Timing
valueMeta			Meta	There are no (further) constraints on this element Data Type Meta
valueReference			Reference()	There are no (further) constraints on this element Data Type Reference()
city	Σ	0..1	string	There are no (further) constraints on this element Element Id Patient.address.city Short description Name of city, town etc. Alternate names Municpality, Municipality, woonplaats Definition The name of the city, town, village or other community or delivery center. Requirements Basisregistratie Persoonsgegevens 11.70 Woonplaatsnaam Comments Note that FHIR strings may not exceed 1MB in size Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Examples General Erewhon Example city Den Haag Mappings rim:n/a v2:XAD.3 rim:AD.part[parttype = CTY] vcard:locality servd:./Jurisdiction hcim-address-v2.0.1-2015EN:NL-CM:0.1.14 hcim-addressinformation-v3.0-2016EN:NL-CM:0.1.14 hcim-addressinformation-v1.0-2017EN:NL-CM:20.5.3 BRP:11.70
district	Σ	0..1	string	There are no (further) constraints on this element Element Id Patient.address.district Short description District name (aka county) Alternate names County, Gemeente Definition The name of the administrative area (county). Requirements Basisregistratie Persoonsgegevens 09.10 Gemeente van inschrijving Comments District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead. In a Dutch address this element is used for the population of a "gemeente" Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Examples General Madison Example district Wateringen Mappings rim:n/a v2:XAD.9 rim:AD.part[parttype = CNT \| CPA] hcim-address-v2.0.1-2015EN:NL-CM:0.1.16 hcim-addressinformation-v3.0-2016EN:NL-CM:0.1.16 hcim-addressinformation-v1.0-2017EN:NL-CM:20.5.4 BRP:09.10
state	Σ	0..1	string	There are no (further) constraints on this element Element Id Patient.address.state Short description Sub-unit of country (abbreviations ok). Alternate names Province, Territory, Provincie Definition Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (i.e. US 2 letter state codes). For Dutch addresses this element should contain the "provincie" code Requirements Some (Dutch) cities have the same name in multiple provinces. Dutch examples include Bergen (Noord-Holland / Limburg) and Geesteren (Gelderland / Overijssel). Comments Note that FHIR strings may not exceed 1MB in size Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Examples Example province ZH Mappings rim:n/a v2:XAD.4 rim:AD.part[parttype = STA] vcard:region servd:./Region
postalCode	Σ	0..1	string	There are no (further) constraints on this element Element Id Patient.address.postalCode Short description Postal code for area Alternate names Zip, Postcode Definition A postal code designating a region defined by the postal service. Comments Dutch postal codes have pattern '\d{4}[A-Z]{2}' so they do not have spaces. Systems can easily render postal codes with a space if necessary. Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` nl-postal-code-pattern:Dutch postal code pattern 'nnnnAA' `(country in 'nl' \| 'nld' \| 'nederland').not() or matches('^\\d{4}[A-Z]{2}$')` Examples General 9132 Example postcode 9132AG Mappings rim:n/a v2:XAD.5 rim:AD.part[parttype = ZIP] vcard:code servd:./PostalIdentificationCode hcim-address-v2.0.1-2015EN:NL-CM:0.1.15 hcim-addressinformation-v3.0-2016EN:NL-CM:0.1.15 hcim-addressinformation-v1.0-2017EN:NL-CM:20.5.6 BRP:11.60
country	Σ	0..1	string	There are no (further) constraints on this element Element Id Patient.address.country Short description Country (can be ISO 3166 3 letter code) Alternate names land Definition A country (code) for the address. Comments The FHIR datatype does not properly support coding the country using a CodeableConcept or Coding datatype. If the sender supports coded countries, it SHALL send the coded value using the code-specification extension under Address.country. Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Examples Example country NLD Mappings rim:n/a v2:XAD.6 rim:AD.part[parttype = CNT] vcard:country servd:./Country hcim-address-v2.0.1-2015EN:NL-CM:0.1.17 hcim-addressinformation-v3.0-2016EN:NL-CM:0.1.17 hcim-addressinformation-v1.0-2017EN:NL-CM:20.5.5
extension		0..*	Extension	There are no (further) constraints on this element Element Id Patient.address.country.extension Short description Additional Content defined by implementations Alternate names extensions, user content 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. 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. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
countryCode		0..1	Extension(CodeableConcept)	There are no (further) constraints on this element Element Id Patient.address.country.extension:countryCode Short description CountryGBACode \| CountryISOCode Alternate names extensions, user content, Bevat de specifieke code conform de zib, bij een FHIR-element die een verplichte koppeling heeft met een bepaalde FHIR waardelijst of een FHIR element die niet gecodeerd is gedefinieerd, terwijl de zib dit wel doet. Definition Defines a more specific coded value for a code or string. Especially useful for FHIR's required ValueSets. These extensions are primarily used on codes bound to a required value set, where you would like to use a more specific code than the codes in the bounded value set. 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. Data Type Extension(CodeableConcept) Extension URL http://nictiz.nl/fhir/StructureDefinition/code-specification Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	uriFixed Value	There are no (further) constraints on this element Element Id Patient.address.country.extension:countryCode.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed Value http://nictiz.nl/fhir/StructureDefinition/code-specification Mappings rim:n/a rim:N/A
valueCodeableConcept		1..1	CodeableConcept	There are no (further) constraints on this element Element Id Patient.address.country.extension:countryCode.value[x]:valueCodeableConcept Short description CountryGBACode \| CountryISOCode Alternate names LandGBACodelijst, LandISOCodelijst Definition Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list). Comments A stream of bytes, base64 encoded Data Type CodeableConcept Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:N/A
coding	Σ	1..*	Coding	There are no (further) constraints on this element Element Id Patient.address.country.extension:countryCode.value[x]:valueCodeableConcept.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data Type Coding Sliced: Unordered, Open, by $this(Pattern) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim:CV orim:fhir:Coding rdfs:subClassOf dt:CDCoding v2:CE.1-8, CE.10-22 rim:union(., ./translation) orim:fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
countryGBACodelist	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element Id Patient.address.country.extension:countryCode.value[x]:valueCodeableConcept.coding:countryGBACodelist Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data Type Coding Binding LandGBACodelijst (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Pattern { "system": "urn:oid:2.16.840.1.113883.2.4.4.16.34" } Mappings rim:n/a v2:CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim:CV orim:fhir:Coding rdfs:subClassOf dt:CDCoding v2:CE.1-8, CE.10-22 rim:union(., ./translation) orim:fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
countryISOCodelist	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element Id Patient.address.country.extension:countryCode.value[x]:valueCodeableConcept.coding:countryISOCodelist Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data Type Coding Binding LandISOCodelijst (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Pattern { "system": "urn:iso:std:iso:3166" } Mappings rim:n/a v2:CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim:CV orim:fhir:Coding rdfs:subClassOf dt:CDCoding v2:CE.1-8, CE.10-22 rim:union(., ./translation) orim:fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
text	Σ	0..1	string	There are no (further) constraints on this element Element Id Patient.address.country.extension:countryCode.value[x]:valueCodeableConcept.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:CE.9. But note many systems use CE.2 for this rim:./originalText[mediaType/code="text/plain"]/data orim:fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
period	Σ	0..1	Period	There are no (further) constraints on this element Element Id Patient.address.period Short description Time period when address was/is in use Definition Time period when address was/is in use. Requirements Allows addresses to be placed in historical context. Comments This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval\|Duration. Data Type Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.empty() or end.empty() or (start <= end)` Examples General { "start": "2010-03-23", "end": "2010-07-01" } Mappings rim:n/a v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2:XAD.12 / XAD.13 + XAD.14 rim:./usablePeriod[type="IVL<TS>"] servd:./StartDate and ./EndDate
maritalStatus		0..1	CodeableConceptBinding	There are no (further) constraints on this element Element Id Patient.maritalStatus Short description Marital (civil) status of a patient Definition This field contains a patient's most recent marital (civil) status. Requirements Most, if not all systems capture it. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data Type CodeableConcept Binding Marital Status Codes (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:PID-16 rim:player[classCode=PSN]/maritalStatusCode cda:.patient.maritalStatusCode
multipleBirth[x]		0..1		There are no (further) constraints on this element Element Id Patient.multipleBirth[x] Short description Whether patient is part of a multiple birth Definition Indicates whether the patient is part of a multiple (bool) or indicates the actual birth order (integer). 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). Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:PID-24 (bool), PID-25 (integer) rim:player[classCode=PSN\|ANM and determinerCode=INSTANCE]/multipleBirthInd, player[classCode=PSN\|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber cda:n/a
multipleBirthBoolean			boolean	There are no (further) constraints on this element Data Type boolean
multipleBirthInteger			integer	There are no (further) constraints on this element Data Type integer
photo		0..*	Attachment	There are no (further) constraints on this element Element Id Patient.photo Short description Image of the patient Definition Image of the patient. Requirements Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too. Comments When providing a summary view (for example with Observation.value[x]) Attachment should be represented with a brief display text such as "Attachment". Data Type Attachment Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` att-1:It the Attachment has data, it SHALL have a contentType `data.empty() or contentType.exists()` Mappings rim:n/a v2:ED/RP rim:ED v2:OBX-5 - needs a profile rim:player[classCode=PSN\|ANM and determinerCode=INSTANCE]/desc cda:n/a
contact		0..*	BackboneElement	There are no (further) constraints on this element Element Id Patient.contact Short description A contact party (e.g. guardian, partner, friend) for the patient Definition A contact party (e.g. guardian, partner, friend) for 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. Data Type BackboneElement Constraints 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()` Mappings rim:n/a rim:player[classCode=PSN\|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON] cda:n/a
relationship		0..*	CodeableConceptBinding	There are no (further) constraints on this element Element Id Patient.contact.relationship Short description The kind of relationship Definition The nature of the relationship between the patient and the contact person. Requirements Used to determine which contact person is the most relevant to approach, depending on circumstances. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data Type CodeableConcept Binding v2 Contact Role (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:NK1-7, NK1-3 rim:code cda:n/a
name		0..1	HumanName	There are no (further) constraints on this element Element Id Patient.contact.name Short description A name associated with the contact person Definition A name associated with the 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. Comments Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts may or may not be imbued with some implicit meaning; various cultures associate different importance with the name parts and the degree to which systems must care about name parts around the world varies widely. Data Type HumanName Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:XPN rim:EN (actually, PN) servd:ProviderName v2:NK1-2 rim:name cda:n/a
telecom		0..*	ContactPoint	There are no (further) constraints on this element Element Id Patient.contact.telecom Short description A contact detail for the person Definition A contact detail for the person, e.g. a telephone number or an email address. 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. Data Type ContactPoint Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` cpt-2:A system is required if a value is provided. `value.empty() or system.exists()` Mappings rim:n/a v2:XTN rim:TEL servd:ContactPoint v2:NK1-5, NK1-6, NK1-40 rim:telecom cda:n/a
address		0..1	Address	There are no (further) constraints on this element Element Id Patient.contact.address Short description Address for the contact person Definition Address for the contact person. Requirements Need to keep track where the contact person can be contacted per postal mail or visited. Comments Note: address is for postal addresses, not physical locations. Data Type Address Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:XAD rim:AD servd:Address v2:NK1-4 rim:addr cda:n/a
gender		0..1	codeBinding	There are no (further) constraints on this element Element Id Patient.contact.gender Short description male \| female \| other \| unknown Definition Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes. Requirements Needed to address the person correctly. Comments Note that FHIR strings may not exceed 1MB in size Data Type code Binding AdministrativeGender (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:NK1-15 rim:player[classCode=PSN\|ANM and determinerCode=INSTANCE]/administrativeGender cda:n/a
organization		0..1	Reference(Organization)	There are no (further) constraints on this element Element Id Patient.contact.organization Short description Organization that is associated with the contact Definition Organization on behalf of which the contact is acting or for which the contact is working. Requirements For guardians or business related contacts, the organization is relevant. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Organization) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2:NK1-13, NK1-30, NK1-31, NK1-32, NK1-41 rim:scoper cda:n/a
period		0..1	Period	There are no (further) constraints on this element Element Id Patient.contact.period Short description 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. Comments This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval\|Duration. Data Type Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.empty() or end.empty() or (start <= end)` Mappings rim:n/a v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] rim:effectiveTime cda:n/a
animal	Σ ?!	0..0	BackboneElement	There are no (further) constraints on this element Element Id Patient.animal Short description This patient is known to be an animal (non-human) Definition This patient is known to be an animal. 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). Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:player[classCode=ANM] cda:n/a
communication		0..*	BackboneElement	There are no (further) constraints on this element Element Id Patient.communication Short description A list of 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. 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. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:LanguageCommunication cda:patient.languageCommunication
language		1..1	CodeableConceptBinding	There are no (further) constraints on this element Element Id Patient.communication.language Short description The language which can be used to communicate with the patient about his or her health 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. 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. Data Type CodeableConcept Binding Common Languages (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:PID-15, LAN-2 rim:player[classCode=PSN\|ANM and determinerCode=INSTANCE]/languageCommunication/code cda:.languageCode
preferred		0..1	boolean	There are no (further) constraints on this element Element Id Patient.communication.preferred Short description Language preference indicator Definition Indicates whether or not the patient prefers this language (over other languages he masters up a certain level). 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. Data Type boolean Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a v2:PID-15 rim:preferenceInd cda:.preferenceInd
generalPractitioner		0..*	Reference(Organization \| Practitioner)	There are no (further) constraints on this element Element Id Patient.generalPractitioner Short description Patient's nominated primary care provider Alternate names careProvider Definition Patient's nominated care provider. Comments This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/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. Data Type Reference(Organization \| Practitioner) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2:PD1-4 rim:subjectOf.CareEvent.performer.AssignedEntity cda:n/a
managingOrganization	Σ	0..1	Reference(Organization)	There are no (further) constraints on this element Element Id Patient.managingOrganization Short description Organization that is the custodian of the patient record Definition Organization that is the custodian of the patient record. 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). Data Type Reference(Organization) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim:scoper cda:.providerOrganization
link	Σ ?!	0..*	BackboneElement	There are no (further) constraints on this element Element Id Patient.link Short description Link to another patient resource that concerns the same actual person Definition Link to another patient resource that concerns the same actual patient. 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'. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:outboundLink cda:n/a
other	Σ	1..1	Reference(Patient \| RelatedPerson)	There are no (further) constraints on this element Element Id Patient.link.other Short description The other patient or related person resource that the link refers to Definition The other patient resource that the link refers to. Comments Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual. Data Type Reference(Patient \| RelatedPerson) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2:PID-3, MRG-1 rim:id cda:n/a
type	Σ	1..1	codeBinding	There are no (further) constraints on this element Element Id Patient.link.type Short description replaced-by \| replaces \| refer \| seealso - type of link Definition The type of link between this patient resource and another patient resource. Comments Note that FHIR strings may not exceed 1MB in size Data Type code Binding LinkType (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim:n/a rim:typeCode cda:n/a

See the profile on simplifier.net for additional details.

Resource example

Below you find an example of a Patient resource that conforms to the ZD Patient profile.

{
  "resourceType": "Patient",
  "id": "zd-patient-1",
  "meta": {
    "profile": [
      "http://zorgdomein.nl/fhir/StructureDefinition/zd-patient"
    ]
  },
  "identifier": [
    {
      "use": "official",
      "system": "http://fhir.nl/fhir/NamingSystem/bsn",
      "value": "695752947"
    }
  ],
  "name": [
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/humanname-assembly-order",
          "valueCode": "NL4"
        }
      ],
      "use": "official",
      "family": "Aelbrinck-de Jager",
      "_family": {
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/humanname-own-name",
            "valueString": "Aelbrinck"
          },
          {
            "url": "http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix",
            "valueString": "de"
          },
          {
            "url": "http://hl7.org/fhir/StructureDefinition/humanname-partner-name",
            "valueString": "Jager"
          }
        ]
      },
      "given": [
        "Kristel",
        "K."
      ],
      "_given": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier",
              "valueCode": "CL"
            }
          ]
        },
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier",
              "valueCode": "IN"
            }
          ]
        }
      ]
    }
  ],
  "telecom": [
    {
      "system": "phone",
      "value": "0650896532",
      "use": "mobile"
    },
    {
      "system": "email",
      "value": "k.aelbrinck@home.nl",
      "use": "home"
    }
  ],
  "gender": "female",
  "birthDate": "1979-02-02",
  "address": [
    {
      "extension": [
        {
          "url": "http://fhir.nl/fhir/StructureDefinition/nl-core-address-official",
          "valueBoolean": true
        }
      ],
      "type": "physical",
      "line": [
        "Zuiderhaven 1a 2hg"
      ],
      "_line": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName",
              "valueString": "Zuiderhaven"
            },
            {
              "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber",
              "valueString": "1"
            },
            {
              "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-buildingNumberSuffix",
              "valueString": "a"
            },
            {
              "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator",
              "valueString": "2hg"
            }
          ]
        }
      ],
      "city": "Amsterdam",
      "postalCode": "1060HT",
      "country": "NL"
    }
  ]
}

<Patient xmlns='http://hl7.org/fhir'>
  <id value='zd-patient-1'/>
  <meta>
    <profile value='http://zorgdomein.nl/fhir/StructureDefinition/zd-patient'/>
  </meta>
  <identifier>
    <use value='official'/>
    <system value='http://fhir.nl/fhir/NamingSystem/bsn'/>
    <value value='695752947'/>
  </identifier>
  <name>
    <extension url='http://hl7.org/fhir/StructureDefinition/humanname-assembly-order'>
      <valueCode value='NL4'/>
    </extension>
    <use value='official'/>
    <family value='Aelbrinck-de Jager'>
      <extension url='http://hl7.org/fhir/StructureDefinition/humanname-own-name'>
        <valueString value='Aelbrinck'/>
      </extension>
      <extension url='http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix'>
        <valueString value='de'/>
      </extension>
      <extension url='http://hl7.org/fhir/StructureDefinition/humanname-partner-name'>
        <valueString value='Jager'/>
      </extension>
    </family>
    <given value='Kristel'>
      <extension url='http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier'>
        <valueCode value='CL'/>
      </extension>
    </given>
    <given value='K.'>
      <extension url='http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier'>
        <valueCode value='IN'/>
      </extension>
    </given>
  </name>
  <telecom>
    <system value='phone'/>
    <value value='0650896532'/>
    <use value='mobile'/>
  </telecom>
  <telecom>
    <system value='email'/>
    <value value='k.aelbrinck@home.nl'/>
    <use value='home'/>
  </telecom>
  <gender value='female'/>
  <birthDate value='1979-02-02'/>
  <address>
    <extension url='http://fhir.nl/fhir/StructureDefinition/nl-core-address-official'>
      <valueBoolean value='true'/>
    </extension>
    <type value='physical'/>
    <line value='Zuiderhaven 1a 2hg'>
      <extension url='http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName'>
        <valueString value='Zuiderhaven'/>
      </extension>
      <extension url='http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber'>
        <valueString value='1'/>
      </extension>
      <extension url='http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-buildingNumberSuffix'>
        <valueString value='a'/>
      </extension>
      <extension url='http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator'>
        <valueString value='2hg'/>
      </extension>
    </line>
    <city value='Amsterdam'/>
    <postalCode value='1060HT'/>
    <country value='NL'/>
  </address>
</Patient>

ZD Patient

Resource example

Questions or comments?

Thank you!