HRSA 2023 Uniform Data System (UDS) Patient Level Submission (PLS) (UDS+) FHIR IG
1.0.1 - STU1 Release 1 - Standard for Trial-Use
This page is part of the HRSA Uniform Data System (UDS) Patient Level Submission (PLS) (UDS+ or uds-plus) FHIR IG (v1.0.1: STU1) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions
Page standards status: Trial-use | Maturity Level: 2 |
Definitions for the de-identified-uds-plus-patient resource profile.
Guidance on how to interpret the contents of this table can be found here
0. Patient | |
Definition | The UDS+ profile is based on the **FHIR Patient resource and establishes the core elements, extensions, vocabularies and value sets for representing patients for UDS+ program. |
Short | De-Identified UDS Plus Patient |
LOINC Code | |
2. Patient.id | |
Definition | De-dentified patient identifier. |
Short | The de-identified patient identifier created by the health center to send data to HRSA. |
Must Support | true |
LOINC Code | |
4. Patient.text | |
Short | Cannot include any text in the resource as part of the de-identified data. |
Control | 0..0 |
Must Support | false |
LOINC Code | |
6. Patient.contained | |
Short | Cannot include any contained resources in the resource as part of the de-identified data. |
Control | 0..0 |
Must Support | false |
LOINC Code | |
8. Patient.extension:uds-plus-race | |
Slice Name | uds-plus-race |
Control | 1..1 |
Type | Extension(UDS Plus Race Extension) (Complex Extension) |
Must Support | true |
10. Patient.extension:uds-plus-ethnicty | |
Slice Name | uds-plus-ethnicty |
Control | 1..1 |
Type | Extension(UDS Plus Ethnicity Extension) (Complex Extension) |
Must Support | true |
12. Patient.extension:uds-plus-birthsex | |
Slice Name | uds-plus-birthsex |
Control | 1..1 |
Type | Extension(UDS Plus Birth Sex Extension) (Extension Type: code) |
Must Support | true |
14. Patient.extension:uds-plus-age-extension | |
Slice Name | uds-plus-age-extension |
Short | Age of the Patient computed using birthDate and the reporting period reference |
Control | 1..1 |
Type | Extension(UDS Plus Age Extension) (Extension Type: Quantity) |
Must Support | true |
16. Patient.extension:uds-plus-gender-identity-extension | |
Slice Name | uds-plus-gender-identity-extension |
Short | Gender Identity of the pateient |
Control | 0..1 |
Type | Extension(UDS Plus Gender Identity Extension) (Extension Type: CodeableConcept) |
Must Support | true |
18. Patient.extension:uds-plus-agriculture-worker-status | |
Slice Name | uds-plus-agriculture-worker-status |
Short | Agriculture Status of the patient |
Control | 0..1 |
Type | Extension(UDS Plus Agriculture Worker Status Extension) (Extension Type: code) |
Must Support | true |
20. Patient.extension:uds-plus-housing-status | |
Slice Name | uds-plus-housing-status |
Short | Housing Status of the patient |
Control | 0..1 |
Type | Extension(UDS Plus Housing Status Extension) (Extension Type: code) |
Must Support | true |
22. Patient.extension:uds-plus-veteran-status | |
Slice Name | uds-plus-veteran-status |
Short | Veteran Status of the patient |
Control | 0..1 |
Type | Extension(UDS Plus Veteran Status Extension) (Extension Type: boolean) |
Must Support | true |
24. Patient.identifier | |
Short | Cannot include any identifier in the resource as part of the de-identified data. |
Note | This is a business identifier, not a resource identifier (see discussion) |
Control | 0..0 |
Must Support | false |
LOINC Code | |
26. Patient.name | |
Short | Cannot include any name in the resource as part of the de-identified data. |
Control | 0..0 |
Must Support | false |
LOINC Code | |
28. Patient.telecom | |
Short | Cannot include any telecom information in the resource as part of the de-identified data. |
Control | 0..0 |
Must Support | false |
LOINC Code | |
30. Patient.birthDate | |
Short | Cannot include any date of birth information in the resource as part of the de-identified data. |
Control | 0..0 |
Must Support | false |
LOINC Code | |
32. Patient.deceasedBoolean | |
Short | Can only have deceased boolean. |
Control | 0..1 |
Must Support | true |
34. Patient.address | |
Short | Included only to support zip code |
Control | 1..1 |
Must Support | true |
LOINC Code | |
36. Patient.address.text | |
Short | Text cannot be included in the profile |
Control | 0..0 |
Must Support | false |
38. Patient.address.line | |
Short | Street names cannot be included in the profile |
Control | 0..0 |
Must Support | false |
40. Patient.address.postalCode | |
Short | ZipCode must be included in the profile |
Control | 1..1 |
Must Support | true |
42. Patient.address.postalCode.extension:dataAbsentReason | |
Slice Name | dataAbsentReason |
Short | Reason why the data is not present |
Control | 0..1 |
Type | Extension(Why value is missing) (Extension Type: code) |
Must Support | true |
44. Patient.address.postalCode.extension:dataAbsentReason.value[x] | |
Control | 1..? |
Type | code |
[x] Note | See Choice of Data Types for further information about how to use [x] |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | true |
46. Patient.maritalStatus | |
Short | Cannot include information not required for UDS+ |
Control | 0..0 |
Must Support | false |
LOINC Code | |
48. Patient.multipleBirth[x] | |
Short | Cannot include information not required for UDS+ |
Control | 0..0 |
Must Support | false |
LOINC Code | |
50. Patient.photo | |
Short | Cannot include information not required for UDS+ |
Control | 0..0 |
Must Support | false |
LOINC Code | |
52. Patient.contact | |
Short | Cannot include information not required for UDS+ |
Control | 0..0 |
Must Support | false |
LOINC Code | |
54. Patient.communication | |
56. Patient.communication.language | |
Short | Language must be included in the profile |
Control | 1..1 |
Binding | Unless not suitable, these codes SHALL be taken from Language codes with language and optionally a region modifier The set of languages that the patient uses |
Must Support | true |
LOINC Code | |
58. Patient.generalPractitioner | |
Short | Cannot include information not required for UDS+ |
Control | 0..0 |
Must Support | false |
LOINC Code | |
60. Patient.managingOrganization | |
Short | Cannot include information not required for UDS+ |
Control | 0..0 |
Must Support | false |
LOINC Code | |
62. Patient.link | |
Short | Cannot include information not required for UDS+ |
Control | 0..0 |
Must Support | false |
LOINC Code |
Guidance on how to interpret the contents of this table can be found here
0. Patient | |
Definition | The UDS+ profile is based on the **FHIR Patient resource and establishes the core elements, extensions, vocabularies and value sets for representing patients for UDS+ program. Demographics and other administrative information about an individual or animal receiving care or other health-related services. |
Short | De-Identified UDS Plus PatientInformation about an individual or animal receiving health care services |
Control | 0..* |
Is Modifier | false |
Summary | false |
Alternate Names | SubjectOfCare Client Resident |
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty()) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (text.`div`.exists()) |
2. Patient.id | |
Definition | De-dentified patient identifier. The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. |
Short | The de-identified patient identifier created by the health center to send data to HRSA.Logical id of this artifact |
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation. |
Control | 0..1 |
Type | idstring |
Is Modifier | false |
Must Support | true |
Summary | true |
4. Patient.implicitRules | |
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. |
Short | A set of rules under which this content was created |
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. |
Control | 0..1 |
Type | uri |
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
6. Patient.text | |
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. |
Short | Cannot include any text in the resource as part of the de-identified data.Text summary of the resource, for human interpretation |
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. |
Control | 0..01 |
Type | Narrative |
Is Modifier | false |
Must Support | false |
Summary | false |
Alternate Names | narrative, html, xhtml, display |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
8. Patient.contained | |
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. |
Short | Cannot include any contained resources in the resource as part of the de-identified data.Contained, inline Resources |
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. |
Control | 0..0* |
Type | Resource |
Is Modifier | false |
Must Support | false |
Summary | false |
Alternate Names | inline resources, anonymous resources, contained resources |
10. Patient.extension | |
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Short | ExtensionAdditional content defined by implementations |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Control | 40..* |
Type | Extension |
Is Modifier | false |
Summary | false |
Alternate Names | extensions, user content |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
Slicing | This element introduces a set of slices on Patient.extension . The slices are unordered and Open, and can be differentiated using the following discriminators: |
12. Patient.extension:uds-plus-race | |
Slice Name | uds-plus-race |
Definition | Indicates the race of the Patient |
Short | Indicates the race of the Patient. |
Control | 1..1 This element is affected by the following invariants: ele-1 |
Type | Extension(UDS Plus Race Extension) (Complex Extension) |
Is Modifier | false |
Must Support | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) |
LOINC Code | |
14. Patient.extension:uds-plus-ethnicty | |
Slice Name | uds-plus-ethnicty |
Definition | Indicates the ethnicity of the Patient |
Short | Indicates the ethnicity of the Patient. |
Control | 1..1 This element is affected by the following invariants: ele-1 |
Type | Extension(UDS Plus Ethnicity Extension) (Complex Extension) |
Is Modifier | false |
Must Support | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) |
LOINC Code | |
16. Patient.extension:uds-plus-birthsex | |
Slice Name | uds-plus-birthsex |
Definition | Indicates the birth sex of the Patient |
Short | Indicates the birth sex of the Patient. |
Control | 1..1 This element is affected by the following invariants: ele-1 |
Type | Extension(UDS Plus Birth Sex Extension) (Extension Type: code) |
Is Modifier | false |
Must Support | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() )ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
LOINC Code | |
18. Patient.extension:uds-plus-age-extension | |
Slice Name | uds-plus-age-extension |
Definition | Indicates the age of the Patient computed based on date of birth at a specific time |
Short | Age of the Patient computed using birthDate and the reporting period reference |
Control | 1..1 This element is affected by the following invariants: ele-1 |
Type | Extension(UDS Plus Age Extension) (Extension Type: Quantity) |
Is Modifier | false |
Must Support | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() )ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
LOINC Code | |
20. Patient.extension:uds-plus-gender-identity-extension | |
Slice Name | uds-plus-gender-identity-extension |
Definition | Indicates the gender identity of the Patient at a specific time |
Short | Gender Identity of the pateient |
Control | 0..1 This element is affected by the following invariants: ele-1 |
Type | Extension(UDS Plus Gender Identity Extension) (Extension Type: CodeableConcept) |
Is Modifier | false |
Must Support | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() )ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
LOINC Code | |
22. Patient.extension:uds-plus-agriculture-worker-status | |
Slice Name | uds-plus-agriculture-worker-status |
Definition | Indicates the agriculture worker status of the patient. |
Short | Agriculture Status of the patient |
Control | 0..1 This element is affected by the following invariants: ele-1 |
Type | Extension(UDS Plus Agriculture Worker Status Extension) (Extension Type: code) |
Is Modifier | false |
Must Support | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() )ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
LOINC Code | |
24. Patient.extension:uds-plus-housing-status | |
Slice Name | uds-plus-housing-status |
Definition | Indicates the housing status of the Patient at a specific time |
Short | Housing Status of the patient |
Control | 0..1 This element is affected by the following invariants: ele-1 |
Type | Extension(UDS Plus Housing Status Extension) (Extension Type: code) |
Is Modifier | false |
Must Support | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() )ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
LOINC Code | |
26. Patient.extension:uds-plus-veteran-status | |
Slice Name | uds-plus-veteran-status |
Definition | Indicates the Veteran status of the Patient, populate with true when the patient is a veteran |
Short | Veteran Status of the patient |
Control | 0..1 This element is affected by the following invariants: ele-1 |
Type | Extension(UDS Plus Veteran Status Extension) (Extension Type: boolean) |
Is Modifier | false |
Must Support | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() )ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
LOINC Code | |
28. Patient.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Short | Extensions that cannot be ignored |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Control | 0..* |
Type | Extension |
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them |
Summary | false |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
Alternate Names | extensions, user content |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
30. Patient.identifier | |
Definition | An identifier for this patient. |
Short | Cannot include any identifier in the resource as part of the de-identified data.An identifier for this patient |
Note | This is a business identifier, not a resource identifier (see discussion) |
Control | 0..0* |
Type | Identifier |
Is Modifier | false |
Must Support | false |
Summary | true |
Requirements | Patients are almost always assigned specific numerical identifiers. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
32. Patient.active | |
Definition | Whether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules. It is often used to filter patient lists to exclude inactive patients Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death. |
Short | Whether this patient's record is in active use |
Comments | If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient. |
Control | 0..1 |
Type | boolean |
Is Modifier | true because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | Need to be able to mark a patient record as not to be used because it was created in error. |
Meaning if Missing | This resource is generally assumed to be active if no value is provided for the active element |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
34. Patient.name | |
Definition | A name associated with the individual. |
Short | Cannot include any name in the resource as part of the de-identified data.A name associated with the patient |
Comments | A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns. |
Control | 0..0* |
Type | HumanName |
Is Modifier | false |
Must Support | false |
Summary | true |
Requirements | Need to be able to track the patient by multiple names. Examples are your official name and a partner name. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
36. Patient.telecom | |
Definition | A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted. |
Short | Cannot include any telecom information in the resource as part of the de-identified data.A contact detail for the individual |
Comments | A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone). |
Control | 0..0* |
Type | ContactPoint |
Is Modifier | false |
Must Support | false |
Summary | true |
Requirements | People have (primary) ways to contact them in some way such as phone, email. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
38. Patient.birthDate | |
Definition | The date of birth for the individual. |
Short | Cannot include any date of birth information in the resource as part of the de-identified data.The date of birth for the individual |
Comments | At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternity/infant care systems). |
Control | 0..01 |
Type | date |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | false |
Summary | true |
Requirements | Age of the individual drives many clinical processes. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
LOINC Code | 21112-8 |
40. Patient.deceased[x] | |
Definition | Indicates if the individual is deceased or not. |
Short | Indicates if the individual is deceased or not |
Comments | If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive. |
Control | 0..1 |
Type | boolean, dateTime |
[x] Note | See Choice of Data Types for further information about how to use [x] |
Is Modifier | true because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different. |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
Slicing | This element introduces a set of slices on Patient.deceased[x] . The slices are unordered and Closed, and can be differentiated using the following discriminators: |
42. Patient.deceased[x]:deceasedBoolean | |
Slice Name | deceasedBoolean |
Definition | Indicates if the individual is deceased or not. |
Short | Can only have deceased boolean.Indicates if the individual is deceased or not |
Comments | If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive. |
Control | 0..1 |
Type | boolean, dateTime |
[x] Note | See Choice of Data Types for further information about how to use [x] |
Is Modifier | true because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different. |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | true |
Summary | true |
Requirements | The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
44. Patient.address | |
Definition | An address for the individual. |
Short | Included only to support zip codeAn address for the individual |
Comments | Patient may have multiple addresses with different uses or applicable periods. |
Control | 10..1* |
Type | Address |
Is Modifier | false |
Must Support | true |
Summary | true |
Requirements | May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
46. Patient.address.use | |
Definition | The purpose of this address. |
Short | home | work | temp | old | billing - purpose of this address |
Comments | Applications can assume that an address is current unless it explicitly says that it is temporary or old. |
Control | 0..1 |
Binding | The codes SHALL be taken from AddressUsehttp://hl7.org/fhir/ValueSet/address-use|4.0.1 The use of an address. |
Type | code |
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | Allows an appropriate address to be chosen from a list of many. |
Example | <br/><b>General</b>:home |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
48. Patient.address.text | |
Definition | Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts. |
Short | Text cannot be included in the profileText representation of the address |
Comments | Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part. |
Control | 0..01 |
Type | string |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | false |
Summary | true |
Requirements | A renderable, unencoded form. |
Example | <br/><b>General</b>:137 Nowhere Street, Erewhon 9132 |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
50. Patient.address.line | |
Definition | This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information. |
Short | Street names cannot be included in the profileStreet name, number, direction & P.O. Box etc. |
Control | 0..0* |
Type | string |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | false |
Summary | true |
Example | <br/><b>General</b>:137 Nowhere Street |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
52. Patient.address.postalCode | |
Definition | A postal code designating a region defined by the postal service. |
Short | ZipCode must be included in the profilePostal code for area |
Control | 10..1 |
Type | string |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | true |
Summary | true |
Alternate Names | Zip |
Example | <br/><b>General</b>:9132 |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
54. Patient.address.postalCode.extension:dataAbsentReason | |
Slice Name | dataAbsentReason |
Definition | Provides a reason why the expected value or elements in the element that is extended are missing. |
Short | Reason why the data is not present |
Control | 0..1 This element is affected by the following invariants: ele-1 |
Type | Extension(Why value is missing) (Extension Type: code) |
Is Modifier | false |
Must Support | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() )ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
LOINC Code | |
56. Patient.address.postalCode.extension:dataAbsentReason.extension | |
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Short | ExtensionAdditional content defined by implementations |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Control | 0..0* |
Type | Extension |
Is Modifier | false |
Summary | false |
Alternate Names | extensions, user content |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
Slicing | This element introduces a set of slices on Patient.address.postalCode.extension.extension . The slices are unordered and Open, and can be differentiated using the following discriminators: |
58. Patient.address.postalCode.extension:dataAbsentReason.url | |
Definition | Source of the definition for the extension code - a logical name or a URL. |
Short | identifies the meaning of the extension |
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
Control | 1..1 |
Type | uri |
Is Modifier | false |
XML Format | In the XML format, this property is represented as an attribute. |
Summary | false |
Fixed Value | http://hl7.org/fhir/StructureDefinition/data-absent-reason |
60. Patient.address.postalCode.extension:dataAbsentReason.value[x] | |
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
Short | Value of extension |
Control | 10..1 |
Binding | The codes SHALL be taken from For codes, see DataAbsentReason Used to specify why the normally expected content of the data element is missing. |
Type | code, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time |
[x] Note | See Choice of Data Types for further information about how to use [x] |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | true |
Summary | false |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
62. Patient.maritalStatus | |
Definition | This field contains a patient's most recent marital (civil) status. |
Short | Cannot include information not required for UDS+Marital (civil) status of a patient |
Control | 0..01 |
Binding | Unless not suitable, these codes SHALL be taken from Marital Status Codeshttp://hl7.org/fhir/ValueSet/marital-status The domestic partnership status of a person. |
Type | CodeableConcept |
Is Modifier | false |
Must Support | false |
Summary | false |
Requirements | Most, if not all systems capture it. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
64. Patient.multipleBirth[x] | |
Definition | Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer). |
Short | Cannot include information not required for UDS+Whether patient is part of a multiple birth |
Comments | Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in triplets would be valueInteger=2 and the third born would have valueInteger=3 If a boolean value was provided for this triplets example, then all 3 patient records would have valueBoolean=true (the ordering is not indicated). |
Control | 0..01 |
Type | Choice of: boolean, integer |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | false |
Summary | false |
Requirements | For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
66. Patient.photo | |
Definition | Image of the patient. |
Short | Cannot include information not required for UDS+Image of the patient |
Comments | Guidelines:
|
Control | 0..0* |
Type | Attachment |
Is Modifier | false |
Must Support | false |
Summary | false |
Requirements | Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
68. Patient.contact | |
Definition | A contact party (e.g. guardian, partner, friend) for the patient. |
Short | Cannot include information not required for UDS+A contact party (e.g. guardian, partner, friend) for the patient |
Comments | Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact. |
Control | 0..0* |
Type | BackboneElement |
Is Modifier | false |
Must Support | false |
Summary | false |
Requirements | Need to track people you can contact about the patient. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) pat-1: SHALL at least contain a contact's details or a reference to an organization ( name.exists() or telecom.exists() or address.exists() or organization.exists() )pat-1: SHALL at least contain a contact's details or a reference to an organization (name.exists() or telecom.exists() or address.exists() or organization.exists()) |
71. Patient.communication | |
Definition | A language which may be used to communicate with the patient about his or her health. |
Short | A language which may be used to communicate with the patient about his or her health |
Comments | If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required. |
Control | 0..* |
Type | BackboneElement |
Is Modifier | false |
Summary | false |
Requirements | If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
73. Patient.communication.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Short | Extensions that cannot be ignored even if unrecognized |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Control | 0..* |
Type | Extension |
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
Summary | true |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
Alternate Names | extensions, user content, modifiers |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
75. Patient.communication.language | |
Definition | The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English. |
Short | Language must be included in the profileThe language which can be used to communicate with the patient about his or her health |
Comments | The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type. |
Control | 1..1 |
Binding | Unless not suitable, these codes SHALL be taken from The codes SHOULD be taken from Language codes with language and optionally a region modifierhttp://hl7.org/fhir/ValueSet/languages The set of languages that the patient uses A human language. |
Type | CodeableConcept |
Is Modifier | false |
Must Support | true |
Summary | false |
Requirements | Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
77. Patient.generalPractitioner | |
Definition | Patient's nominated care provider. |
Short | Cannot include information not required for UDS+Patient's nominated primary care provider |
Comments | This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues. Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type. |
Control | 0..0* |
Type | Reference(Organization, Practitioner, PractitionerRole) |
Is Modifier | false |
Must Support | false |
Summary | false |
Alternate Names | careProvider |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
79. Patient.managingOrganization | |
Definition | Organization that is the custodian of the patient record. |
Short | Cannot include information not required for UDS+Organization that is the custodian of the patient record |
Comments | There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association). |
Control | 0..01 |
Type | Reference(Organization) |
Is Modifier | false |
Must Support | false |
Summary | true |
Requirements | Need to know who recognizes this patient record, manages and updates it. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
81. Patient.link | |
Definition | Link to another patient resource that concerns the same actual patient. |
Short | Cannot include information not required for UDS+Link to another patient resource that concerns the same actual person |
Comments | There is no assumption that linked patient records have mutual links. |
Control | 0..0* |
Type | BackboneElement |
Is Modifier | true because This element is labeled as a modifier because it might not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by' |
Must Support | false |
Summary | true |
Requirements | There are multiple use cases:
|
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
Guidance on how to interpret the contents of this table can be found here
0. Patient | |||||
Definition | The UDS+ profile is based on the **FHIR Patient resource and establishes the core elements, extensions, vocabularies and value sets for representing patients for UDS+ program. | ||||
Short | De-Identified UDS Plus Patient | ||||
Control | 0..* | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | SubjectOfCare Client Resident | ||||
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty() )dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource ( contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() )dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated ( contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() )dom-5: If a resource is contained in another resource, it SHALL NOT have a security label ( contained.meta.security.empty() )dom-6: A resource should have narrative for robust management ( text.`div`.exists() ) | ||||
2. Patient.id | |||||
Definition | De-dentified patient identifier. | ||||
Short | The de-identified patient identifier created by the health center to send data to HRSA. | ||||
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation. | ||||
Control | 0..1 | ||||
Type | id | ||||
Is Modifier | false | ||||
Must Support | true | ||||
Summary | true | ||||
4. Patient.meta | |||||
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. | ||||
Short | Metadata about the resource | ||||
Control | 0..1 | ||||
Type | Meta | ||||
Is Modifier | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
6. Patient.implicitRules | |||||
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. | ||||
Short | A set of rules under which this content was created | ||||
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. | ||||
Control | 0..1 | ||||
Type | uri | ||||
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
8. Patient.language | |||||
Definition | The base language in which the resource is written. | ||||
Short | Language of the resource content | ||||
Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). | ||||
Control | 0..1 | ||||
Binding | The codes SHOULD be taken from CommonLanguages A human language.
| ||||
Type | code | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
10. Patient.text | |||||
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. | ||||
Short | Cannot include any text in the resource as part of the de-identified data. | ||||
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. | ||||
Control | 0..0 | ||||
Type | Narrative | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | false | ||||
Alternate Names | narrative, html, xhtml, display | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
12. Patient.contained | |||||
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. | ||||
Short | Cannot include any contained resources in the resource as part of the de-identified data. | ||||
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. | ||||
Control | 0..0 | ||||
Type | Resource | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | false | ||||
Alternate Names | inline resources, anonymous resources, contained resources | ||||
14. Patient.extension | |||||
Definition | An Extension | ||||
Short | Extension | ||||
Control | 4..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
Slicing | This element introduces a set of slices on Patient.extension . The slices are unordered and Open, and can be differentiated using the following discriminators: | ||||
16. Patient.extension:uds-plus-race | |||||
Slice Name | uds-plus-race | ||||
Definition | Indicates the race of the Patient | ||||
Short | Indicates the race of the Patient. | ||||
Control | 1..1 This element is affected by the following invariants: ele-1 | ||||
Type | Extension(UDS Plus Race Extension) (Complex Extension) | ||||
Is Modifier | false | ||||
Must Support | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
18. Patient.extension:uds-plus-ethnicty | |||||
Slice Name | uds-plus-ethnicty | ||||
Definition | Indicates the ethnicity of the Patient | ||||
Short | Indicates the ethnicity of the Patient. | ||||
Control | 1..1 This element is affected by the following invariants: ele-1 | ||||
Type | Extension(UDS Plus Ethnicity Extension) (Complex Extension) | ||||
Is Modifier | false | ||||
Must Support | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
20. Patient.extension:uds-plus-birthsex | |||||
Slice Name | uds-plus-birthsex | ||||
Definition | Indicates the birth sex of the Patient | ||||
Short | Indicates the birth sex of the Patient. | ||||
Control | 1..1 This element is affected by the following invariants: ele-1 | ||||
Type | Extension(UDS Plus Birth Sex Extension) (Extension Type: code) | ||||
Is Modifier | false | ||||
Must Support | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
22. Patient.extension:uds-plus-age-extension | |||||
Slice Name | uds-plus-age-extension | ||||
Definition | Indicates the age of the Patient computed based on date of birth at a specific time | ||||
Short | Age of the Patient computed using birthDate and the reporting period reference | ||||
Control | 1..1 This element is affected by the following invariants: ele-1 | ||||
Type | Extension(UDS Plus Age Extension) (Extension Type: Quantity) | ||||
Is Modifier | false | ||||
Must Support | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
24. Patient.extension:uds-plus-gender-identity-extension | |||||
Slice Name | uds-plus-gender-identity-extension | ||||
Definition | Indicates the gender identity of the Patient at a specific time | ||||
Short | Gender Identity of the pateient | ||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
Type | Extension(UDS Plus Gender Identity Extension) (Extension Type: CodeableConcept) | ||||
Is Modifier | false | ||||
Must Support | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
26. Patient.extension:uds-plus-agriculture-worker-status | |||||
Slice Name | uds-plus-agriculture-worker-status | ||||
Definition | Indicates the agriculture worker status of the patient. | ||||
Short | Agriculture Status of the patient | ||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
Type | Extension(UDS Plus Agriculture Worker Status Extension) (Extension Type: code) | ||||
Is Modifier | false | ||||
Must Support | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
28. Patient.extension:uds-plus-housing-status | |||||
Slice Name | uds-plus-housing-status | ||||
Definition | Indicates the housing status of the Patient at a specific time | ||||
Short | Housing Status of the patient | ||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
Type | Extension(UDS Plus Housing Status Extension) (Extension Type: code) | ||||
Is Modifier | false | ||||
Must Support | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
30. Patient.extension:uds-plus-veteran-status | |||||
Slice Name | uds-plus-veteran-status | ||||
Definition | Indicates the Veteran status of the Patient, populate with true when the patient is a veteran | ||||
Short | Veteran Status of the patient | ||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
Type | Extension(UDS Plus Veteran Status Extension) (Extension Type: boolean) | ||||
Is Modifier | false | ||||
Must Support | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
32. Patient.modifierExtension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | ||||
Short | Extensions that cannot be ignored | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them | ||||
Summary | false | ||||
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
34. Patient.identifier | |||||
Definition | An identifier for this patient. | ||||
Short | Cannot include any identifier in the resource as part of the de-identified data. | ||||
Note | This is a business identifier, not a resource identifier (see discussion) | ||||
Control | 0..0 | ||||
Type | Identifier | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | true | ||||
Requirements | Patients are almost always assigned specific numerical identifiers. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
36. Patient.active | |||||
Definition | Whether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules. It is often used to filter patient lists to exclude inactive patients Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death. | ||||
Short | Whether this patient's record is in active use | ||||
Comments | If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient. | ||||
Control | 0..1 | ||||
Type | boolean | ||||
Is Modifier | true because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Need to be able to mark a patient record as not to be used because it was created in error. | ||||
Meaning if Missing | This resource is generally assumed to be active if no value is provided for the active element | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
38. Patient.name | |||||
Definition | A name associated with the individual. | ||||
Short | Cannot include any name in the resource as part of the de-identified data. | ||||
Comments | A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns. | ||||
Control | 0..0 | ||||
Type | HumanName | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | true | ||||
Requirements | Need to be able to track the patient by multiple names. Examples are your official name and a partner name. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
40. Patient.telecom | |||||
Definition | A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted. | ||||
Short | Cannot include any telecom information in the resource as part of the de-identified data. | ||||
Comments | A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone). | ||||
Control | 0..0 | ||||
Type | ContactPoint | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | true | ||||
Requirements | People have (primary) ways to contact them in some way such as phone, email. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
42. Patient.gender | |||||
Definition | Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes. | ||||
Short | male | female | other | unknown | ||||
Comments | The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex. | ||||
Control | 0..1 | ||||
Binding | The codes SHALL be taken from AdministrativeGender The gender of a person used for administrative purposes. | ||||
Type | code | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Needed for identification of the individual, in combination with (at least) name and birth date. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
44. Patient.birthDate | |||||
Definition | The date of birth for the individual. | ||||
Short | Cannot include any date of birth information in the resource as part of the de-identified data. | ||||
Comments | At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternity/infant care systems). | ||||
Control | 0..0 | ||||
Type | date | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Must Support | false | ||||
Summary | true | ||||
Requirements | Age of the individual drives many clinical processes. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
LOINC Code | 21112-8 | ||||
46. Patient.deceased[x] | |||||
Definition | Indicates if the individual is deceased or not. | ||||
Short | Indicates if the individual is deceased or not | ||||
Comments | If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive. | ||||
Control | 0..1 | ||||
Type | boolean | ||||
[x] Note | See Choice of Data Types for further information about how to use [x] | ||||
Is Modifier | true because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different. | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
Slicing | This element introduces a set of slices on Patient.deceased[x] . The slices are unordered and Closed, and can be differentiated using the following discriminators: | ||||
48. Patient.deceased[x]:deceasedBoolean | |||||
Slice Name | deceasedBoolean | ||||
Definition | Indicates if the individual is deceased or not. | ||||
Short | Can only have deceased boolean. | ||||
Comments | If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive. | ||||
Control | 0..1 | ||||
Type | boolean | ||||
[x] Note | See Choice of Data Types for further information about how to use [x] | ||||
Is Modifier | true because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different. | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Must Support | true | ||||
Summary | true | ||||
Requirements | The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
50. Patient.address | |||||
Definition | An address for the individual. | ||||
Short | Included only to support zip code | ||||
Comments | Patient may have multiple addresses with different uses or applicable periods. | ||||
Control | 1..1 | ||||
Type | Address | ||||
Is Modifier | false | ||||
Must Support | true | ||||
Summary | true | ||||
Requirements | May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
52. Patient.address.id | |||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
54. Patient.address.extension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | ||||
Short | Additional content defined by implementations | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
Slicing | This element introduces a set of slices on Patient.address.extension . The slices are unordered and Open, and can be differentiated using the following discriminators: | ||||
56. Patient.address.use | |||||
Definition | The purpose of this address. | ||||
Short | home | work | temp | old | billing - purpose of this address | ||||
Comments | Applications can assume that an address is current unless it explicitly says that it is temporary or old. | ||||
Control | 0..1 | ||||
Binding | The codes SHALL be taken from AddressUse The use of an address. | ||||
Type | code | ||||
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | Allows an appropriate address to be chosen from a list of many. | ||||
Example | <br/><b>General</b>:home | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
58. Patient.address.type | |||||
Definition | Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both. | ||||
Short | postal | physical | both | ||||
Comments | The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource). | ||||
Control | 0..1 | ||||
Binding | The codes SHALL be taken from AddressType The type of an address (physical / postal). | ||||
Type | code | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Example | <br/><b>General</b>:both | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
60. Patient.address.text | |||||
Definition | Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts. | ||||
Short | Text cannot be included in the profile | ||||
Comments | Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part. | ||||
Control | 0..0 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Must Support | false | ||||
Summary | true | ||||
Requirements | A renderable, unencoded form. | ||||
Example | <br/><b>General</b>:137 Nowhere Street, Erewhon 9132 | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
62. Patient.address.line | |||||
Definition | This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information. | ||||
Short | Street names cannot be included in the profile | ||||
Control | 0..0 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Must Support | false | ||||
Summary | true | ||||
Example | <br/><b>General</b>:137 Nowhere Street | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
64. Patient.address.city | |||||
Definition | The name of the city, town, suburb, village or other community or delivery center. | ||||
Short | Name of city, town etc. | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Alternate Names | Municpality | ||||
Example | <br/><b>General</b>:Erewhon | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
66. Patient.address.district | |||||
Definition | The name of the administrative area (county). | ||||
Short | District name (aka county) | ||||
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. | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Alternate Names | County | ||||
Example | <br/><b>General</b>:Madison | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
68. Patient.address.state | |||||
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 (e.g. US 2 letter state codes). | ||||
Short | Sub-unit of country (abbreviations ok) | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Alternate Names | Province, Territory | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
70. Patient.address.postalCode | |||||
Definition | A postal code designating a region defined by the postal service. | ||||
Short | ZipCode must be included in the profile | ||||
Control | 1..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Must Support | true | ||||
Summary | true | ||||
Alternate Names | Zip | ||||
Example | <br/><b>General</b>:9132 | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
72. Patient.address.postalCode.id | |||||
Definition | unique id for the element within a resource (for internal references) | ||||
Short | xml:id (or equivalent in JSON) | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
74. Patient.address.postalCode.extension | |||||
Definition | An Extension | ||||
Short | Extension | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
Slicing | This element introduces a set of slices on Patient.address.postalCode.extension . The slices are unordered and Open, and can be differentiated using the following discriminators: | ||||
76. Patient.address.postalCode.extension:dataAbsentReason | |||||
Slice Name | dataAbsentReason | ||||
Definition | Provides a reason why the expected value or elements in the element that is extended are missing. | ||||
Short | Reason why the data is not present | ||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
Type | Extension(Why value is missing) (Extension Type: code) | ||||
Is Modifier | false | ||||
Must Support | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
78. Patient.address.postalCode.extension:dataAbsentReason.id | |||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
80. Patient.address.postalCode.extension:dataAbsentReason.extension | |||||
Definition | An Extension | ||||
Short | Extension | ||||
Control | 0..0 | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
Slicing | This element introduces a set of slices on Patient.address.postalCode.extension.extension . The slices are unordered and Open, and can be differentiated using the following discriminators: | ||||
82. Patient.address.postalCode.extension:dataAbsentReason.url | |||||
Definition | Source of the definition for the extension code - a logical name or a URL. | ||||
Short | identifies the meaning of the extension | ||||
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. | ||||
Control | 1..1 | ||||
Type | uri | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
Fixed Value | http://hl7.org/fhir/StructureDefinition/data-absent-reason | ||||
84. Patient.address.postalCode.extension:dataAbsentReason.value[x] | |||||
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). | ||||
Short | Value of extension | ||||
Control | 1..1 | ||||
Binding | The codes SHALL be taken from DataAbsentReason Used to specify why the normally expected content of the data element is missing. | ||||
Type | code | ||||
[x] Note | See Choice of Data Types for further information about how to use [x] | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Must Support | true | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
86. Patient.address.postalCode.value | |||||
Definition | The actual value | ||||
Short | Primitive value for string | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
Max Length | 1048576 | ||||
88. Patient.address.country | |||||
Definition | Country - a nation as commonly understood or generally accepted. | ||||
Short | Country (e.g. can be ISO 3166 2 or 3 letter code) | ||||
Comments | ISO 3166 3 letter codes can be used in place of a human readable country name. | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
90. Patient.address.period | |||||
Definition | Time period when address was/is in use. | ||||
Short | Time period when address was/is in use | ||||
Control | 0..1 | ||||
Type | Period | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Allows addresses to be placed in historical context. | ||||
Example | <br/><b>General</b>:<valuePeriod xmlns="http://hl7.org/fhir"><br/> <start value="2010-03-23"/><br/> <end value="2010-07-01"/><br/></valuePeriod><br/> | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
92. Patient.maritalStatus | |||||
Definition | This field contains a patient's most recent marital (civil) status. | ||||
Short | Cannot include information not required for UDS+ | ||||
Control | 0..0 | ||||
Binding | Unless not suitable, these codes SHALL be taken from Marital Status Codes The domestic partnership status of a person. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | false | ||||
Requirements | Most, if not all systems capture it. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
94. Patient.multipleBirth[x] | |||||
Definition | Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer). | ||||
Short | Cannot include information not required for UDS+ | ||||
Comments | Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in triplets would be valueInteger=2 and the third born would have valueInteger=3 If a boolean value was provided for this triplets example, then all 3 patient records would have valueBoolean=true (the ordering is not indicated). | ||||
Control | 0..0 | ||||
Type | Choice of: boolean, integer | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Must Support | false | ||||
Summary | false | ||||
Requirements | For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
96. Patient.photo | |||||
Definition | Image of the patient. | ||||
Short | Cannot include information not required for UDS+ | ||||
Comments | Guidelines:
| ||||
Control | 0..0 | ||||
Type | Attachment | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | false | ||||
Requirements | Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
98. Patient.contact | |||||
Definition | A contact party (e.g. guardian, partner, friend) for the patient. | ||||
Short | Cannot include information not required for UDS+ | ||||
Comments | Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact. | ||||
Control | 0..0 | ||||
Type | BackboneElement | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | false | ||||
Requirements | Need to track people you can contact about the patient. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )pat-1: SHALL at least contain a contact's details or a reference to an organization ( name.exists() or telecom.exists() or address.exists() or organization.exists() ) | ||||
110. Patient.communication | |||||
Definition | A language which may be used to communicate with the patient about his or her health. | ||||
Short | A language which may be used to communicate with the patient about his or her health | ||||
Comments | If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required. | ||||
Control | 0..* | ||||
Type | BackboneElement | ||||
Is Modifier | false | ||||
Summary | false | ||||
Requirements | If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
112. Patient.communication.id | |||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
114. Patient.communication.extension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | ||||
Short | Additional content defined by implementations | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
116. Patient.communication.modifierExtension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | ||||
Short | Extensions that cannot be ignored even if unrecognized | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | ||||
Summary | true | ||||
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. | ||||
Alternate Names | extensions, user content, modifiers | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
118. Patient.communication.language | |||||
Definition | The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English. | ||||
Short | Language must be included in the profile | ||||
Comments | The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type. | ||||
Control | 1..1 | ||||
Binding | Unless not suitable, these codes SHALL be taken from Language codes with language and optionally a region modifier The set of languages that the patient uses | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Must Support | true | ||||
Summary | false | ||||
Requirements | Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
120. Patient.communication.preferred | |||||
Definition | Indicates whether or not the patient prefers this language (over other languages he masters up a certain level). | ||||
Short | Language preference indicator | ||||
Comments | This language is specifically identified for communicating healthcare information. | ||||
Control | 0..1 | ||||
Type | boolean | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | false | ||||
Requirements | People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
122. Patient.generalPractitioner | |||||
Definition | Patient's nominated care provider. | ||||
Short | Cannot include information not required for UDS+ | ||||
Comments | This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues. Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type. | ||||
Control | 0..0 | ||||
Type | Reference(Organization, Practitioner, PractitionerRole) | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | false | ||||
Alternate Names | careProvider | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
124. Patient.managingOrganization | |||||
Definition | Organization that is the custodian of the patient record. | ||||
Short | Cannot include information not required for UDS+ | ||||
Comments | There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association). | ||||
Control | 0..0 | ||||
Type | Reference(Organization) | ||||
Is Modifier | false | ||||
Must Support | false | ||||
Summary | true | ||||
Requirements | Need to know who recognizes this patient record, manages and updates it. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
126. Patient.link | |||||
Definition | Link to another patient resource that concerns the same actual patient. | ||||
Short | Cannot include information not required for UDS+ | ||||
Comments | There is no assumption that linked patient records have mutual links. | ||||
Control | 0..0 | ||||
Type | BackboneElement | ||||
Is Modifier | true because This element is labeled as a modifier because it might not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by' | ||||
Must Support | false | ||||
Summary | true | ||||
Requirements | There are multiple use cases:
| ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |