FHIR Implementation Guide for NJSAMS


1.0.0 - release

NJSAMS - Local Development build (v1.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: NJSAMSPatient - Detailed Descriptions

Active as of 2025-06-23

Definitions for the NJSAMSPatient resource profile.

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

0. Patient
Definition

The US Core Patient Profile is based upon the core FHIR Patient Resource and designed to meet the applicable patient demographic data elements from the 2015 Edition Common Clinical Data Set.


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

ShortInformation about an individual or animal receiving health care services
Control0..*
Must Supportfalse
Alternate NamesSubjectOfCare Client Resident
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource 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-6: A resource should have narrative for robust management (text.`div`.exists())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
njsams-client-id-system-required: At least one patient identifier system is https://fhir.njsams.rutgers.edu/NJSAMS-fhir/client-id (identifier.where(system = 'https://fhir.njsams.rutgers.edu/NJSAMS-fhir/client-id').exists())
njsams-ssn-required: At least one patient identifier system is http://hl7.org/fhir/sid/us-ssn (identifier.where(system = 'http://hl7.org/fhir/sid/us-ssn').exists())
njsams-drivers-license-optional: An optional New Jersey drivers license ( identifier.count() = 2 or ( identifier.count() > 2 and identifier.where(system = 'urn:oid:2.16.840.1.113883.4.3.34').exists() ) )
2. Patient.implicitRules
Definition

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

ShortA set of rules under which this content was created
Comments

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

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

The base language in which the resource is written.

ShortLanguage of the resource content
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Control10..1
This element is affected by the following invariants: ele-1
BindingThe codes SHOULD be taken from CommonLanguageshttp://hl7.org/fhir/ValueSet/languages
(preferred to http://hl7.org/fhir/ValueSet/languages)

A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. Patient.language.extension:other
Slice Nameother
Definition

User specified language

ShortExtension
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(OtherLanguage) (Extension Type: string)
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. Patient.language.extension:other.extension
Definition

An Extension


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

ShortExtensionAdditional content defined by implementations
Comments

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

Control0..0*
This element is affected by the following invariants: ele-1
TypeExtension
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Patient.language.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
    • 10. Patient.language.extension:other.url
    Definition

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

    Shortidentifies the meaning of the extension
    Comments

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

    Control1..1
    Typeuri
    XML FormatIn the XML format, this property is represented as an attribute.
    Fixed Valuehttps://fhir.njsams.rutgers.edu/NJSAMS-fhir/StructureDefinition/OtherLanguage
    12. Patient.language.extension:other.value[x]
    Definition

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

    ShortValue of extension
    Control0..1
    This element is affected by the following invariants: ele-1
    Typestring, 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, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    14. Patient.extension
    Definition

    An Extension


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

    ShortExtensionAdditional content defined by implementations
    Comments

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

    Control40..*
    This element is affected by the following invariants: ele-1
    TypeExtension
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis element introduces a set of slices on Patient.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
      • 16. Patient.extension:race
      Slice Namerace
      Definition

      Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The race codes used to represent these concepts are based upon the CDC Race and Ethnicity Code Set Version 1.0 which includes over 900 concepts for representing race and ethnicity of which 921 reference race. The race concepts are grouped by and pre-mapped to the 5 OMB race categories:

      • American Indian or Alaska Native
      • Asian
      • Black or African American
      • Native Hawaiian or Other Pacific Islander
      • White.
      ShortUS Core Race Extension
      Control1..1
      This element is affected by the following invariants: ele-1
      TypeExtension(US Core Race Extension) (Complex Extension)
      Must Supporttrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      18. Patient.extension:race.extension
      Definition

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

      ShortAdditional content defined by implementations
      Comments

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

      Control10..*
      This element is affected by the following invariants: ele-1
      TypeExtension
      Standard StatusNormative (from Normative)
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on Patient.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
        • 20. Patient.extension:race.extension:ombCategory
        Slice NameombCategory
        Definition

        An Extension

        ShortExtensionAdditional content defined by implementations
        Control0..5*
        This element is affected by the following invariants: ele-1
        TypeExtension
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        22. Patient.extension:race.extension:ombCategory.url
        Definition

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

        Shortidentifies the meaning of the extension
        Comments

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

        Control1..1
        Typeuri
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        Fixed ValueombCategory
        24. Patient.extension:race.extension:ombCategory.value[x]
        Definition

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

        ShortValue of extension
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        SlicingThis element introduces a set of slices on Patient.extension.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
        • type @ $this
          • 26. Patient.extension:race.extension:ombCategory.value[x]:valueCoding
          Slice NamevalueCoding
          Definition

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

          ShortValue of extension
          Control10..1
          This element is affected by the following invariants: ele-1
          BindingThe codes SHALL be taken from For codes, see OMB Race Categories
          (required to http://hl7.org/fhir/us/core/ValueSet/omb-race-category)

          The 5 race category codes according to the OMB Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, Statistical Policy Directive No. 15, as revised, October 30, 1997.

          TypeCoding, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          28. Patient.extension:race.extension:ombCategory.value[x]:valueCoding.system
          Definition

          The identification of the code system that defines the meaning of the symbol in the code.

          ShortIdentity of the terminology system
          Comments

          The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

          Control0..1
          This element is affected by the following invariants: ele-1
          Typeuri
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Need to be unambiguous about the source of the definition of the symbol.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          30. Patient.extension:race.extension:ombCategory.value[x]:valueCoding.code
          Definition

          A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

          ShortSymbol in syntax defined by the system
          Comments

          Note that FHIR strings SHALL NOT exceed 1MB in size

          Control0..1
          This element is affected by the following invariants: ele-1
          Typecode
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Need to refer to a particular code in the system.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          32. Patient.extension:race.extension:detailed
          Slice Namedetailed
          Definition

          The 900+ CDC race codes that are grouped under one of the 5 OMB race category codes:.

          ShortExtended race codesAdditional content defined by implementations
          Comments

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

          Control0..*
          This element is affected by the following invariants: ele-1
          TypeExtension
          Standard StatusNormative (from Normative)
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          34. Patient.extension:race.extension:detailed.url
          Definition

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

          Shortidentifies the meaning of the extension
          Comments

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

          Control1..1
          Typeuri
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          Fixed Valuedetailed
          36. Patient.extension:race.extension:detailed.value[x]
          Definition

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

          ShortValue of extension
          Control0..1
          This element is affected by the following invariants: ele-1
          TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          SlicingThis element introduces a set of slices on Patient.extension.extension.value[x]. The slices areUnordered and , and can be differentiated using the following discriminators:
          • type @ $this
            • 38. Patient.extension:race.extension:detailed.value[x]:valueCoding
            Slice NamevalueCoding
            Definition

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

            ShortValue of extension
            Control10..1
            This element is affected by the following invariants: ele-1
            BindingThe codes SHALL be taken from For codes, see Detailed Race
            (required to http://hl7.org/fhir/us/core/ValueSet/detailed-race)
            TypeCoding, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            40. Patient.extension:race.extension:text
            Slice Nametext
            Definition

            An Extension

            ShortExtensionAdditional content defined by implementations
            Control10..1*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Must Supporttrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            42. Patient.extension:race.extension:text.url
            Definition

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

            Shortidentifies the meaning of the extension
            Comments

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

            Control1..1
            Typeuri
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            Fixed Valuetext
            44. Patient.extension:race.extension:text.value[x]
            Definition

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

            ShortValue of extension
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            SlicingThis element introduces a set of slices on Patient.extension.extension.value[x]. The slices areUnordered and , and can be differentiated using the following discriminators:
            • type @ $this
              • 46. Patient.extension:race.extension:text.value[x]:valueString
              Slice NamevalueString
              Definition

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

              ShortValue of extension
              Control10..1
              This element is affected by the following invariants: ele-1
              Typestring, 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, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              48. Patient.extension:race.url
              Definition

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

              Shortidentifies the meaning of the extension
              Comments

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

              Control1..1
              Typeuri
              XML FormatIn the XML format, this property is represented as an attribute.
              Fixed Valuehttp://hl7.org/fhir/us/core/StructureDefinition/us-core-race
              50. Patient.extension:race.value[x]
              Definition

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

              ShortValue of extension
              Control0..01
              This element is affected by the following invariants: ele-1
              TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              52. Patient.extension:ethnicity
              Slice Nameethnicity
              Definition

              Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The ethnicity codes used to represent these concepts are based upon the CDC ethnicity and Ethnicity Code Set Version 1.0 which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity. The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories: - Hispanic or Latino - Not Hispanic or Latino.

              ShortUS Core ethnicity Extension
              Control1..1
              This element is affected by the following invariants: ele-1
              TypeExtension(US Core Ethnicity Extension) (Complex Extension)
              Must Supporttrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              54. Patient.extension:ethnicity.extension
              Definition

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

              ShortAdditional content defined by implementations
              Comments

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

              Control10..*
              This element is affected by the following invariants: ele-1
              TypeExtension
              Standard StatusNormative (from Normative)
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingThis element introduces a set of slices on Patient.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
                • 56. Patient.extension:ethnicity.extension:ombCategory
                Slice NameombCategory
                Definition

                An Extension

                ShortExtensionAdditional content defined by implementations
                Control0..1*
                This element is affected by the following invariants: ele-1
                TypeExtension
                Must Supporttrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                58. Patient.extension:ethnicity.extension:ombCategory.url
                Definition

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

                Shortidentifies the meaning of the extension
                Comments

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

                Control1..1
                Typeuri
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                Fixed ValueombCategory
                60. Patient.extension:ethnicity.extension:ombCategory.value[x]
                Definition

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

                ShortValue of extension
                Control10..1
                This element is affected by the following invariants: ele-1
                BindingThe codes SHALL be taken from For codes, see OMB Ethnicity Categories
                (required to http://hl7.org/fhir/us/core/ValueSet/omb-ethnicity-category)
                TypeCoding, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                62. Patient.extension:ethnicity.extension:ombCategory.value[x].system
                Definition

                The identification of the code system that defines the meaning of the symbol in the code.

                ShortIdentity of the terminology system
                Comments

                The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                Control0..1
                This element is affected by the following invariants: ele-1
                Typeuri
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                Need to be unambiguous about the source of the definition of the symbol.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                64. Patient.extension:ethnicity.extension:ombCategory.value[x].code
                Definition

                A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                ShortSymbol in syntax defined by the system
                Comments

                Note that FHIR strings SHALL NOT exceed 1MB in size

                Control0..1
                This element is affected by the following invariants: ele-1
                Typecode
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                Need to refer to a particular code in the system.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                66. Patient.extension:ethnicity.extension:detailed
                Slice Namedetailed
                Definition

                The 41 CDC ethnicity codes that are grouped under one of the 2 OMB ethnicity category codes.

                ShortExtended ethnicity codesAdditional content defined by implementations
                Comments

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

                Control0..*
                This element is affected by the following invariants: ele-1
                TypeExtension
                Standard StatusNormative (from Normative)
                Alternate Namesextensions, user content
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                68. Patient.extension:ethnicity.extension:detailed.url
                Definition

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

                Shortidentifies the meaning of the extension
                Comments

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

                Control1..1
                Typeuri
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                Fixed Valuedetailed
                70. Patient.extension:ethnicity.extension:detailed.value[x]
                Definition

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

                ShortValue of extension
                Control10..1
                This element is affected by the following invariants: ele-1
                BindingThe codes SHALL be taken from For codes, see Detailed ethnicity
                (required to http://hl7.org/fhir/us/core/ValueSet/detailed-ethnicity)
                TypeCoding, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                72. Patient.extension:ethnicity.extension:text
                Slice Nametext
                Definition

                An Extension

                ShortExtensionAdditional content defined by implementations
                Control10..1*
                This element is affected by the following invariants: ele-1
                TypeExtension
                Must Supporttrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                74. Patient.extension:ethnicity.extension:text.url
                Definition

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

                Shortidentifies the meaning of the extension
                Comments

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

                Control1..1
                Typeuri
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                Fixed Valuetext
                76. Patient.extension:ethnicity.extension:text.value[x]
                Definition

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

                ShortValue of extension
                Control10..1
                This element is affected by the following invariants: ele-1
                Typestring, 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, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                78. Patient.extension:ethnicity.url
                Definition

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

                Shortidentifies the meaning of the extension
                Comments

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

                Control1..1
                Typeuri
                XML FormatIn the XML format, this property is represented as an attribute.
                Fixed Valuehttp://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity
                80. Patient.extension:ethnicity.value[x]
                Definition

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

                ShortValue of extension
                Control0..01
                This element is affected by the following invariants: ele-1
                TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                82. Patient.extension:birthsex
                Slice Namebirthsex
                Definition

                A code classifying the person's sex assigned at birth as specified by the Office of the National Coordinator for Health IT (ONC).

                ShortOptional Extensions Element
                Comments

                The codes required are intended to present birth sex (i.e., the sex recorded on the patient’s birth certificate) and not gender identity or reassigned sex.

                Control0..1
                This element is affected by the following invariants: ele-1
                TypeExtension(US Core Birth Sex Extension) (Extension Type: Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta)
                Is Modifierfalse
                Must Supportfalse
                Standard StatusNormative (from Normative)
                Alternate Namesextensions, user content
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                84. Patient.extension:us-citizenship
                Slice Nameus-citizenship
                Definition

                Is the patient a US citizen

                ShortExtension
                Control1..1
                This element is affected by the following invariants: ele-1
                TypeExtension(USCitizenship) (Extension Type: boolean)
                Must Supporttrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                86. Patient.extension:us-citizenship.extension
                Definition

                An Extension


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

                ShortExtensionAdditional content defined by implementations
                Comments

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

                Control0..0*
                This element is affected by the following invariants: ele-1
                TypeExtension
                Alternate Namesextensions, user content
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                SlicingThis element introduces a set of slices on Patient.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                  • 88. Patient.extension:us-citizenship.url
                  Definition

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

                  Shortidentifies the meaning of the extension
                  Comments

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

                  Control1..1
                  Typeuri
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Fixed Valuehttps://fhir.njsams.rutgers.edu/NJSAMS-fhir/StructureDefinition/USCitizenship
                  90. Patient.extension:us-citizenship.value[x]
                  Definition

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

                  ShortValue of extension
                  Control0..1
                  This element is affected by the following invariants: ele-1
                  Typeboolean, 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, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, Expression, Signature, unsignedInt, time
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  92. Patient.extension:income-eligibility-screening
                  Slice Nameincome-eligibility-screening
                  Definition

                  Does the patient wish to complete income eligibility and screening

                  ShortExtension
                  Control1..1
                  This element is affected by the following invariants: ele-1
                  TypeExtension(IncomeEligibilityScreening) (Extension Type: boolean)
                  Must Supporttrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  94. Patient.extension:income-eligibility-screening.extension
                  Definition

                  An Extension


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

                  ShortExtensionAdditional content defined by implementations
                  Comments

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

                  Control0..0*
                  This element is affected by the following invariants: ele-1
                  TypeExtension
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  SlicingThis element introduces a set of slices on Patient.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                    • 96. Patient.extension:income-eligibility-screening.url
                    Definition

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

                    Shortidentifies the meaning of the extension
                    Comments

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

                    Control1..1
                    Typeuri
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Fixed Valuehttps://fhir.njsams.rutgers.edu/NJSAMS-fhir/StructureDefinition/IncomeEligibilityScreening
                    98. Patient.extension:income-eligibility-screening.value[x]
                    Definition

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

                    ShortValue of extension
                    Control0..1
                    This element is affected by the following invariants: ele-1
                    Typeboolean, 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, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, Expression, Signature, unsignedInt, time
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    100. Patient.extension:gender-identity
                    Slice Namegender-identity
                    Definition

                    Additional Gender

                    ShortExtension
                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeExtension(GenderIdentity) (Extension Type: Coding)
                    Must Supporttrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    102. Patient.modifierExtension
                    Definition

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

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

                    ShortExtensions that cannot be ignored
                    Comments

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

                    Control0..*
                    This element is affected by the following invariants: ele-1
                    TypeExtension
                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                    Standard StatusNormative (from Normative)
                    Requirements

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

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

                      An identifier for this patient.

                      ShortAn identifier for this patient
                      NoteThis is a business identifier, not a resource identifier (see discussion)
                      Control20..*
                      This element is affected by the following invariants: ele-1
                      TypeIdentifier
                      Must Supporttrue
                      Summarytrue
                      Requirements

                      Patients are almost always assigned specific numerical identifiers.

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

                        An identifier for this patient.

                        ShortSSNAn identifier for this patient
                        NoteThis is a business identifier, not a resource identifier (see discussion)
                        Control10..1*
                        This element is affected by the following invariants: ele-1
                        TypeIdentifier
                        Must Supporttrue
                        Summarytrue
                        Requirements

                        Patients are almost always assigned specific numerical identifiers.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        108. Patient.identifier:ssn.use
                        Definition

                        The purpose of this identifier.

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

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

                        Control0..1
                        This element is affected by the following invariants: ele-1
                        BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
                        (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                        Identifies the purpose for this identifier, if known .

                        Typecode
                        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

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

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        110. Patient.identifier:ssn.system
                        Definition

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

                        ShortThe namespace for the identifier value
                        Comments

                        Identifier.system is always case sensitive.

                        Control10..1
                        This element is affected by the following invariants: ele-1
                        Typeuri
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        Requirements

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

                        Pattern Valuehttp://hl7.org/fhir/sid/us-ssn
                        Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        112. Patient.identifier:ssn.value
                        Definition

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

                        ShortThe value that is unique within the system.
                        Comments

                        If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                        Control10..1
                        This element is affected by the following invariants: ele-1
                        Typestring
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        Example<br/><b>General</b>:123456
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        114. Patient.identifier:njsams
                        Slice Namenjsams
                        Definition

                        An identifier for this patient.

                        ShortNJSAMS client IdAn identifier for this patient
                        NoteThis is a business identifier, not a resource identifier (see discussion)
                        Control10..1*
                        This element is affected by the following invariants: ele-1
                        TypeIdentifier
                        Must Supporttrue
                        Summarytrue
                        Requirements

                        Patients are almost always assigned specific numerical identifiers.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        116. Patient.identifier:njsams.use
                        Definition

                        The purpose of this identifier.

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

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

                        Control0..1
                        This element is affected by the following invariants: ele-1
                        BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
                        (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                        Identifies the purpose for this identifier, if known .

                        Typecode
                        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

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

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        118. Patient.identifier:njsams.system
                        Definition

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

                        ShortThe namespace for the identifier value
                        Comments

                        Identifier.system is always case sensitive.

                        Control10..1
                        This element is affected by the following invariants: ele-1
                        Typeuri
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        Requirements

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

                        Pattern Valuehttps://fhir.njsams.rutgers.edu/NJSAMS-fhir/client-id
                        Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        120. Patient.identifier:njsams.value
                        Definition

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

                        ShortThe value that is unique within the system.
                        Comments

                        If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                        Control10..1
                        This element is affected by the following invariants: ele-1
                        Typestring
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        Example<br/><b>General</b>:123456
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        122. Patient.identifier:license
                        Slice Namelicense
                        Definition

                        An identifier for this patient.

                        ShortNJ State drivers licenseAn identifier for this patient
                        NoteThis is a business identifier, not a resource identifier (see discussion)
                        Control0..1*
                        This element is affected by the following invariants: ele-1
                        TypeIdentifier
                        Must Supporttrue
                        Summarytrue
                        Requirements

                        Patients are almost always assigned specific numerical identifiers.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        124. Patient.identifier:license.use
                        Definition

                        The purpose of this identifier.

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

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

                        Control0..1
                        This element is affected by the following invariants: ele-1
                        BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
                        (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                        Identifies the purpose for this identifier, if known .

                        Typecode
                        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

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

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        126. Patient.identifier:license.system
                        Definition

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

                        ShortThe namespace for the identifier value
                        Comments

                        Identifier.system is always case sensitive.

                        Control10..1
                        This element is affected by the following invariants: ele-1
                        Typeuri
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        Requirements

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

                        Pattern Valueurn:oid:2.16.840.1.113883.4.3.34
                        Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        128. Patient.identifier:license.value
                        Definition

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

                        ShortThe value that is unique within the system.
                        Comments

                        If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                        Control10..1
                        This element is affected by the following invariants: ele-1
                        Typestring
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        Example<br/><b>General</b>:123456
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        130. Patient.active
                        Definition

                        Whether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules.

                        It is often used to filter patient lists to exclude inactive patients

                        Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death.

                        ShortWhether this patient's record is in active use
                        Comments

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

                        Control0..1
                        This element is affected by the following invariants: ele-1
                        Typeboolean
                        Is Modifiertrue because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

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

                        Meaning if MissingThis resource is generally assumed to be active if no value is provided for the active element
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        132. Patient.name
                        Definition

                        A name associated with the individual.

                        ShortA name associated with the patient
                        Comments

                        A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.

                        Control10..*
                        This element is affected by the following invariants: ele-1
                        TypeHumanName
                        Must Supporttrue
                        Summarytrue
                        Requirements

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

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        us-core-8: Either Patient.name.given and/or Patient.name.family SHALL be present or a Data Absent Reason Extension SHALL be present. ((family.exists() or given.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists())
                        134. Patient.name.use
                        Definition

                        Identifies the purpose for this name.

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

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

                        Control0..1
                        This element is affected by the following invariants: ele-1
                        BindingThe codes SHALL be taken from NameUsehttp://hl7.org/fhir/ValueSet/name-use|4.0.1
                        (required to http://hl7.org/fhir/ValueSet/name-use|4.0.1)

                        The use of a human name.

                        Typecode
                        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

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

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

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

                        ShortFamily name (often called 'Surname')
                        Comments

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

                        Control10..1
                        This element is affected by the following invariants: ele-1, us-core-8
                        Typestring
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        Alternate Namessurname
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        138. Patient.name.given
                        Definition

                        Given name.

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

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

                        Control10..*
                        This element is affected by the following invariants: ele-1, us-core-8
                        Typestring
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        Alternate Namesfirst name, middle name
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        140. Patient.telecom
                        Definition

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

                        ShortA contact detail for the individual
                        Comments

                        A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).

                        Control0..*
                        This element is affected by the following invariants: ele-1
                        TypeContactPoint
                        Must Supportfalse
                        Summarytrue
                        Requirements

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

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        cpt-2: A system is required if a value is provided. (value.empty() or system.exists())
                        cpt-2: A system is required if a value is provided. (value.empty() or system.exists())
                        142. Patient.telecom.system
                        Definition

                        Telecommunications form for contact point - what communications system is required to make use of the contact.

                        Shortphone | fax | email | pager | url | sms | other
                        Comments

                        Note that FHIR strings SHALL NOT exceed 1MB in size

                        Control10..1
                        This element is affected by the following invariants: ele-1, cpt-2
                        BindingThe codes SHALL be taken from ContactPointSystemhttp://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
                        (required to http://hl7.org/fhir/ValueSet/contact-point-system)

                        Telecommunications form for contact point.

                        Typecode
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        144. Patient.telecom.value
                        Definition

                        The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

                        ShortThe actual contact point details
                        Comments

                        Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

                        Control10..1
                        This element is affected by the following invariants: ele-1
                        Typestring
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        Requirements

                        Need to support legacy numbers that are not in a tightly controlled format.

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

                        Identifies the purpose for the contact point.

                        Shorthome | work | temp | old | mobile - purpose of this contact point
                        Comments

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

                        Control0..1
                        This element is affected by the following invariants: ele-1
                        BindingThe codes SHALL be taken from ContactPointUsehttp://hl7.org/fhir/ValueSet/contact-point-use|4.0.1
                        (required to http://hl7.org/fhir/ValueSet/contact-point-use)

                        Use of contact point.

                        Typecode
                        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        Requirements

                        Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

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

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

                        Shortmale | female | other | unknown
                        Comments

                        The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex.

                        Control10..1
                        This element is affected by the following invariants: ele-1
                        BindingThe codes SHALL be taken from AdministrativeGenderhttp://hl7.org/fhir/ValueSet/administrative-gender|4.0.1
                        (required to http://hl7.org/fhir/ValueSet/administrative-gender)

                        The gender of a person used for administrative purposes.

                        Typecode
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        Requirements

                        Needed for identification of the individual, in combination with (at least) name and birth date.

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

                        The date of birth for the individual.

                        ShortThe 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).

                        Control10..1
                        This element is affected by the following invariants: ele-1
                        Typedate
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        Requirements

                        Age of the individual drives many clinical processes.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        LOINC Code21112-8
                        152. Patient.deceased[x]
                        Definition

                        Indicates if the individual is deceased or not.

                        ShortIndicates if the individual is deceased or not
                        Comments

                        If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.

                        Control0..1
                        This element is affected by the following invariants: ele-1
                        TypeChoice of: boolean, dateTime
                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                        Is Modifiertrue because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

                        The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.

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

                        An address for the individual.

                        ShortAn address for the individual
                        Comments

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

                        Control10..*
                        This element is affected by the following invariants: ele-1
                        TypeAddress
                        Must Supporttrue
                        Summarytrue
                        Requirements

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

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

                        An Extension


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

                        ShortExtensionAdditional content defined by implementations
                        Comments

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

                        Control10..*
                        This element is affected by the following invariants: ele-1
                        TypeExtension
                        Alternate Namesextensions, user content
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        SlicingThis element introduces a set of slices on Patient.address.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                          • 158. Patient.address.extension:municipality
                          Slice Namemunicipality
                          Definition

                          The municipality where the patient resides

                          ShortExtension
                          Control1..1
                          This element is affected by the following invariants: ele-1
                          TypeExtension(DistrictMunicipality) (Extension Type: Coding)
                          Must Supporttrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          160. Patient.address.use
                          Definition

                          The purpose of this address.

                          Shorthome | 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.

                          Control0..1
                          This element is affected by the following invariants: ele-1
                          BindingThe codes SHALL be taken from AddressUsehttp://hl7.org/fhir/ValueSet/address-use|4.0.1
                          (required to http://hl7.org/fhir/ValueSet/address-use|4.0.1)

                          The use of an address.

                          Typecode
                          Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Requirements

                          Allows an appropriate address to be chosen from a list of many.

                          Example<br/><b>General</b>:home
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          162. 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.

                          ShortStreet name, number, direction & P.O. Box etc.
                          Comments

                          Note that FHIR strings SHALL NOT exceed 1MB in size

                          Control0..*
                          This element is affected by the following invariants: ele-1
                          Typestring
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Example<br/><b>General</b>:137 Nowhere Street
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          164. Patient.address.city
                          Definition

                          The name of the city, town, suburb, village or other community or delivery center.

                          ShortName of city, town etc.
                          Comments

                          Note that FHIR strings SHALL NOT exceed 1MB in size

                          Control0..1
                          This element is affected by the following invariants: ele-1
                          Typestring
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Alternate NamesMunicpality
                          Example<br/><b>General</b>:Erewhon
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          166. Patient.address.district
                          Definition

                          The name of the administrative area (county).

                          ShortDistrict 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.

                          Control0..1
                          This element is affected by the following invariants: ele-1
                          Typestring
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Alternate NamesCounty
                          Example<br/><b>General</b>:Madison
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          168. 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).

                          ShortSub-unit of country (abbreviations ok)
                          Comments

                          Note that FHIR strings SHALL NOT exceed 1MB in size

                          Control10..1
                          This element is affected by the following invariants: ele-1
                          BindingUnless not suitable, these codes SHALL be taken from For codes, see USPS Two Letter Alphabetic Codes
                          (extensible to http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state)

                          Two Letter USPS alphabetic codes.

                          Typestring
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Alternate NamesProvince, Territory
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          170. Patient.address.postalCode
                          Definition

                          A postal code designating a region defined by the postal service.

                          ShortUS Zip CodesPostal code for area
                          Comments

                          Note that FHIR strings SHALL NOT exceed 1MB in size

                          Control0..1
                          This element is affected by the following invariants: ele-1
                          Typestring
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Alternate NamesZip, Zip Code
                          Example<br/><b>General</b>:9132
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          172. Patient.address.period
                          Definition

                          Time period when address was/is in use.

                          ShortTime period when address was/is in use
                          Comments

                          A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                          Period is not used for a duration (a measure of elapsed time). See Duration.

                          Control0..1
                          This element is affected by the following invariants: ele-1
                          TypePeriod
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          Allows addresses to be placed in historical context.

                          Example<br/><b>General</b>:{ "start" : "2010-03-23", "end" : "2010-07-01" }
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
                          per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
                          174. Patient.maritalStatus
                          Definition

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

                          ShortMarital (civil) status of a patient
                          Comments

                          Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                          Control10..1
                          This element is affected by the following invariants: ele-1
                          BindingUnless not suitable, these codes SHALL be taken from Marital Status Codeshttp://hl7.org/fhir/ValueSet/marital-status
                          (extensible to http://hl7.org/fhir/ValueSet/marital-status)

                          The domestic partnership status of a person.

                          TypeCodeableConcept
                          Must Supporttrue
                          Requirements

                          Most, if not all systems capture it.

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

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

                          ShortA language which may be used to communicate with the patient about his or her health
                          Comments

                          If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.

                          Control0..*
                          This element is affected by the following invariants: ele-1
                          TypeBackboneElement
                          Must Supportfalse
                          Requirements

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

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

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

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

                          ShortExtensions that cannot be ignored even if unrecognized
                          Comments

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

                          Control0..*
                          This element is affected by the following invariants: ele-1
                          TypeExtension
                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                          Summarytrue
                          Requirements

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

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

                          The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English.

                          ShortThe language which can be used to communicate with the patient about his or her health
                          Comments

                          The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.

                          Control1..1
                          This element is affected by the following invariants: ele-1
                          BindingUnless 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
                          (extensible to http://hl7.org/fhir/us/core/ValueSet/simple-language)

                          A human language.

                          Additional BindingsPurpose
                          AllLanguagesMax Binding
                          TypeCodeableConcept
                          Must Supporttrue
                          Requirements

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

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

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

                          ShortLink to another patient resource that concerns the same actual person
                          Comments

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

                          Control0..*
                          This element is affected by the following invariants: ele-1
                          TypeBackboneElement
                          Is Modifiertrue because This element is labeled as a modifier because it might not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'
                          Summarytrue
                          Requirements

                          There are multiple use cases:

                          • Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and
                          • Distribution of patient information across multiple servers.
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          184. Patient.link.modifierExtension
                          Definition

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

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

                          ShortExtensions that cannot be ignored even if unrecognized
                          Comments

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

                          Control0..*
                          This element is affected by the following invariants: ele-1
                          TypeExtension
                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                          Summarytrue
                          Requirements

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

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

                          The other patient resource that the link refers to.

                          ShortThe other patient or related person resource that the link refers to
                          Comments

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

                          Control1..1
                          This element is affected by the following invariants: ele-1
                          TypeReference(Patient, RelatedPerson)
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                          ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                          188. Patient.link.type
                          Definition

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

                          Shortreplaced-by | replaces | refer | seealso
                          Comments

                          Note that FHIR strings SHALL NOT exceed 1MB in size

                          Control1..1
                          This element is affected by the following invariants: ele-1
                          BindingThe codes SHALL be taken from LinkTypehttp://hl7.org/fhir/ValueSet/link-type|4.0.1
                          (required to http://hl7.org/fhir/ValueSet/link-type|4.0.1)

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

                          Typecode
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

                          0. Patient
                          2. Patient.language
                          Control1..?
                          4. Patient.language.extension:other
                          Slice Nameother
                          6. Patient.language.extension:other.value[x]
                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                          8. Patient.extension
                          Control4..?
                          10. Patient.extension:race
                          Slice Namerace
                          Control1..?
                          12. Patient.extension:race.extension:ombCategory
                          Slice NameombCategory
                          14. Patient.extension:race.extension:ombCategory.value[x]:valueCoding
                          Slice NamevalueCoding
                          TypeCoding
                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                          16. Patient.extension:race.extension:ombCategory.value[x]:valueCoding.system
                          18. Patient.extension:race.extension:ombCategory.value[x]:valueCoding.code
                          20. Patient.extension:race.extension:text
                          Slice Nametext
                          22. Patient.extension:ethnicity
                          Slice Nameethnicity
                          Control1..?
                          24. Patient.extension:ethnicity.extension:ombCategory
                          Slice NameombCategory
                          26. Patient.extension:ethnicity.extension:ombCategory.value[x]
                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                          28. Patient.extension:ethnicity.extension:ombCategory.value[x].system
                          30. Patient.extension:ethnicity.extension:ombCategory.value[x].code
                          32. Patient.extension:ethnicity.extension:text
                          Slice Nametext
                          34. Patient.extension:us-citizenship
                          Slice Nameus-citizenship
                          36. Patient.extension:us-citizenship.value[x]
                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                          38. Patient.extension:income-eligibility-screening
                          Slice Nameincome-eligibility-screening
                          40. Patient.extension:income-eligibility-screening.value[x]
                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                          42. Patient.extension:gender-identity
                          Slice Namegender-identity
                          44. Patient.identifier:ssn
                          Slice Namessn
                          NoteThis is a business identifier, not a resource identifier (see discussion)
                          46. Patient.identifier:ssn.system
                          48. Patient.identifier:ssn.value
                          50. Patient.identifier:njsams
                          Slice Namenjsams
                          NoteThis is a business identifier, not a resource identifier (see discussion)
                          52. Patient.identifier:njsams.system
                          54. Patient.identifier:njsams.value
                          56. Patient.identifier:license
                          Slice Namelicense
                          NoteThis is a business identifier, not a resource identifier (see discussion)
                          58. Patient.identifier:license.system
                          60. Patient.identifier:license.value
                          62. Patient.active
                          64. Patient.name
                          66. Patient.name.family
                          68. Patient.name.given
                          70. Patient.telecom
                          72. Patient.gender
                          74. Patient.birthDate
                          LOINC Code
                          76. Patient.address
                          78. Patient.address.extension
                          Control1..?
                          80. Patient.address.extension:municipality
                          Slice Namemunicipality
                          Control1..?
                          82. Patient.address.line
                          84. Patient.address.city
                          86. Patient.address.district
                          88. Patient.address.state
                          90. Patient.address.postalCode
                          92. Patient.maritalStatus
                          Control1..?

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

                          0. Patient
                          Definition

                          The US Core Patient Profile is based upon the core FHIR Patient Resource and designed to meet the applicable patient demographic data elements from the 2015 Edition Common Clinical Data Set.

                          ShortInformation about an individual or animal receiving health care services
                          Control0..*
                          Must Supportfalse
                          Alternate NamesSubjectOfCare Client Resident
                          Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                          dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                          dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource 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-6: A resource should have narrative for robust management (text.`div`.exists())
                          dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                          njsams-client-id-system-required: At least one patient identifier system is https://fhir.njsams.rutgers.edu/NJSAMS-fhir/client-id (identifier.where(system = 'https://fhir.njsams.rutgers.edu/NJSAMS-fhir/client-id').exists())
                          njsams-ssn-required: At least one patient identifier system is http://hl7.org/fhir/sid/us-ssn (identifier.where(system = 'http://hl7.org/fhir/sid/us-ssn').exists())
                          njsams-drivers-license-optional: An optional New Jersey drivers license ( identifier.count() = 2 or ( identifier.count() > 2 and identifier.where(system = 'urn:oid:2.16.840.1.113883.4.3.34').exists() ) )
                          2. Patient.id
                          Definition

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

                          ShortLogical id of this artifact
                          Comments

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

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

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

                          ShortMetadata about the resource
                          Control0..1
                          This element is affected by the following invariants: ele-1
                          TypeMeta
                          Summarytrue
                          Invariantsele-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.

                          ShortA set of rules under which this content was created
                          Comments

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

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

                          The base language in which the resource is written.

                          ShortLanguage of the resource content
                          Comments

                          Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

                          Control1..1
                          This element is affected by the following invariants: ele-1
                          BindingThe codes SHOULD be taken from CommonLanguages
                          (preferred to http://hl7.org/fhir/ValueSet/languages)

                          A human language.

                          Additional BindingsPurpose
                          AllLanguagesMax Binding
                          Typecode
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          10. Patient.language.id
                          Definition

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

                          ShortUnique id for inter-element referencing
                          Control0..1
                          Typestring
                          XML FormatIn the XML format, this property is represented as an attribute.
                          12. Patient.language.extension
                          Definition

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

                          ShortAdditional content defined by implementations
                          Comments

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

                          Control0..*
                          This element is affected by the following invariants: ele-1
                          TypeExtension
                          Standard StatusNormative (from Normative)
                          Alternate Namesextensions, user content
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          SlicingThis element introduces a set of slices on Patient.language.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                            • 14. Patient.language.extension:other
                            Slice Nameother
                            Definition

                            User specified language

                            ShortExtension
                            Control0..1
                            This element is affected by the following invariants: ele-1
                            TypeExtension(OtherLanguage) (Extension Type: string)
                            Must Supporttrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            16. Patient.language.extension:other.id
                            Definition

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

                            ShortUnique id for inter-element referencing
                            Control0..1
                            Typestring
                            XML FormatIn the XML format, this property is represented as an attribute.
                            18. Patient.language.extension:other.extension
                            Definition

                            An Extension

                            ShortExtension
                            Control0..0
                            This element is affected by the following invariants: ele-1
                            TypeExtension
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            SlicingThis element introduces a set of slices on Patient.language.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                              • 20. Patient.language.extension:other.url
                              Definition

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

                              Shortidentifies the meaning of the extension
                              Comments

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

                              Control1..1
                              Typeuri
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Fixed Valuehttps://fhir.njsams.rutgers.edu/NJSAMS-fhir/StructureDefinition/OtherLanguage
                              22. Patient.language.extension:other.value[x]
                              Definition

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

                              ShortValue of extension
                              Control0..1
                              This element is affected by the following invariants: ele-1
                              Typestring
                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              24. Patient.language.value
                              Definition

                              Primitive value for code

                              ShortPrimitive value for code
                              Control0..1
                              Typecode
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Max Length:1048576
                              26. Patient.text
                              Definition

                              A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

                              ShortText summary of the resource, for human interpretation
                              Comments

                              Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

                              Control0..1
                              This element is affected by the following invariants: ele-1
                              TypeNarrative
                              Alternate Namesnarrative, html, xhtml, display
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              28. Patient.contained
                              Definition

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

                              ShortContained, inline Resources
                              Comments

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

                              Control0..*
                              TypeResource
                              Alternate Namesinline resources, anonymous resources, contained resources
                              30. Patient.extension
                              Definition

                              An Extension

                              ShortExtension
                              Control4..*
                              This element is affected by the following invariants: ele-1
                              TypeExtension
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              SlicingThis element introduces a set of slices on Patient.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                                • 32. Patient.extension:race
                                Slice Namerace
                                Definition

                                Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The race codes used to represent these concepts are based upon the CDC Race and Ethnicity Code Set Version 1.0 which includes over 900 concepts for representing race and ethnicity of which 921 reference race. The race concepts are grouped by and pre-mapped to the 5 OMB race categories:

                                • American Indian or Alaska Native
                                • Asian
                                • Black or African American
                                • Native Hawaiian or Other Pacific Islander
                                • White.
                                ShortUS Core Race Extension
                                Control1..1
                                This element is affected by the following invariants: ele-1
                                TypeExtension(US Core Race Extension) (Complex Extension)
                                Must Supporttrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                34. Patient.extension:race.id
                                Definition

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

                                ShortUnique id for inter-element referencing
                                Control0..1
                                Typestring
                                XML FormatIn the XML format, this property is represented as an attribute.
                                36. Patient.extension:race.extension
                                Definition

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

                                ShortAdditional content defined by implementations
                                Comments

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

                                Control1..*
                                This element is affected by the following invariants: ele-1
                                TypeExtension
                                Standard StatusNormative (from Normative)
                                Alternate Namesextensions, user content
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                SlicingThis element introduces a set of slices on Patient.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                  • 38. Patient.extension:race.extension:ombCategory
                                  Slice NameombCategory
                                  Definition

                                  An Extension

                                  ShortExtension
                                  Control0..5
                                  This element is affected by the following invariants: ele-1
                                  TypeExtension
                                  Must Supporttrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  40. Patient.extension:race.extension:ombCategory.id
                                  Definition

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

                                  ShortUnique id for inter-element referencing
                                  Control0..1
                                  Typestring
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  42. Patient.extension:race.extension:ombCategory.extension
                                  Definition

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

                                  ShortAdditional content defined by implementations
                                  Comments

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

                                  Control0..*
                                  This element is affected by the following invariants: ele-1
                                  TypeExtension
                                  Standard StatusNormative (from Normative)
                                  Alternate Namesextensions, user content
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  SlicingThis element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                    • 44. Patient.extension:race.extension:ombCategory.url
                                    Definition

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

                                    Shortidentifies the meaning of the extension
                                    Comments

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

                                    Control1..1
                                    Typeuri
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    Fixed ValueombCategory
                                    46. Patient.extension:race.extension:ombCategory.value[x]
                                    Definition

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

                                    ShortValue of extension
                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    SlicingThis element introduces a set of slices on Patient.extension.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                    • type @ $this
                                      • 48. Patient.extension:race.extension:ombCategory.value[x]:valueCoding
                                      Slice NamevalueCoding
                                      Definition

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

                                      ShortValue of extension
                                      Control1..1
                                      This element is affected by the following invariants: ele-1
                                      BindingThe codes SHALL be taken from OMB Race Categories
                                      (required to http://hl7.org/fhir/us/core/ValueSet/omb-race-category)

                                      The 5 race category codes according to the OMB Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, Statistical Policy Directive No. 15, as revised, October 30, 1997.

                                      TypeCoding
                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      50. Patient.extension:race.extension:ombCategory.value[x]:valueCoding.id
                                      Definition

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

                                      ShortUnique id for inter-element referencing
                                      Control0..1
                                      Typestring
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      52. Patient.extension:race.extension:ombCategory.value[x]:valueCoding.extension
                                      Definition

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

                                      ShortAdditional content defined by implementations
                                      Comments

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

                                      Control0..*
                                      This element is affected by the following invariants: ele-1
                                      TypeExtension
                                      Standard StatusNormative (from Normative)
                                      Alternate Namesextensions, user content
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      SlicingThis element introduces a set of slices on Patient.extension.extension.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                        • 54. Patient.extension:race.extension:ombCategory.value[x]:valueCoding.system
                                        Definition

                                        The identification of the code system that defines the meaning of the symbol in the code.

                                        ShortIdentity of the terminology system
                                        Comments

                                        The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        Typeuri
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Requirements

                                        Need to be unambiguous about the source of the definition of the symbol.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        56. Patient.extension:race.extension:ombCategory.value[x]:valueCoding.version
                                        Definition

                                        The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                        ShortVersion of the system - if relevant
                                        Comments

                                        Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                        NoteThis is a business version Id, not a resource version Id (see discussion)
                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        Typestring
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        58. Patient.extension:race.extension:ombCategory.value[x]:valueCoding.code
                                        Definition

                                        A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                        ShortSymbol in syntax defined by the system
                                        Comments

                                        Note that FHIR strings SHALL NOT exceed 1MB in size

                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        Typecode
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Requirements

                                        Need to refer to a particular code in the system.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        60. Patient.extension:race.extension:ombCategory.value[x]:valueCoding.display
                                        Definition

                                        A representation of the meaning of the code in the system, following the rules of the system.

                                        ShortRepresentation defined by the system
                                        Comments

                                        Note that FHIR strings SHALL NOT exceed 1MB in size

                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        Typestring
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Requirements

                                        Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        62. Patient.extension:race.extension:ombCategory.value[x]:valueCoding.userSelected
                                        Definition

                                        Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                        ShortIf this coding was chosen directly by the user
                                        Comments

                                        Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        Typeboolean
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Requirements

                                        This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        64. Patient.extension:race.extension:detailed
                                        Slice Namedetailed
                                        Definition

                                        The 900+ CDC race codes that are grouped under one of the 5 OMB race category codes:.

                                        ShortExtended race codes
                                        Comments

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

                                        Control0..*
                                        This element is affected by the following invariants: ele-1
                                        TypeExtension
                                        Standard StatusNormative (from Normative)
                                        Alternate Namesextensions, user content
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        66. Patient.extension:race.extension:detailed.id
                                        Definition

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

                                        ShortUnique id for inter-element referencing
                                        Control0..1
                                        Typestring
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        68. Patient.extension:race.extension:detailed.extension
                                        Definition

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

                                        ShortAdditional content defined by implementations
                                        Comments

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

                                        Control0..*
                                        This element is affected by the following invariants: ele-1
                                        TypeExtension
                                        Standard StatusNormative (from Normative)
                                        Alternate Namesextensions, user content
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        SlicingThis element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • value @ url
                                          • 70. Patient.extension:race.extension:detailed.url
                                          Definition

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

                                          Shortidentifies the meaning of the extension
                                          Comments

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

                                          Control1..1
                                          Typeuri
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          Fixed Valuedetailed
                                          72. Patient.extension:race.extension:detailed.value[x]
                                          Definition

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

                                          ShortValue of extension
                                          Control0..1
                                          This element is affected by the following invariants: ele-1
                                          TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          SlicingThis element introduces a set of slices on Patient.extension.extension.value[x]. The slices areUnordered and , and can be differentiated using the following discriminators:
                                          • type @ $this
                                            • 74. Patient.extension:race.extension:detailed.value[x]:valueCoding
                                            Slice NamevalueCoding
                                            Definition

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

                                            ShortValue of extension
                                            Control1..1
                                            This element is affected by the following invariants: ele-1
                                            BindingThe codes SHALL be taken from Detailed Race
                                            (required to http://hl7.org/fhir/us/core/ValueSet/detailed-race)
                                            TypeCoding
                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            76. Patient.extension:race.extension:text
                                            Slice Nametext
                                            Definition

                                            An Extension

                                            ShortExtension
                                            Control1..1
                                            This element is affected by the following invariants: ele-1
                                            TypeExtension
                                            Must Supporttrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            78. Patient.extension:race.extension:text.id
                                            Definition

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

                                            ShortUnique id for inter-element referencing
                                            Control0..1
                                            Typestring
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            80. Patient.extension:race.extension:text.extension
                                            Definition

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

                                            ShortAdditional content defined by implementations
                                            Comments

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

                                            Control0..*
                                            This element is affected by the following invariants: ele-1
                                            TypeExtension
                                            Standard StatusNormative (from Normative)
                                            Alternate Namesextensions, user content
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            SlicingThis element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • value @ url
                                              • 82. Patient.extension:race.extension:text.url
                                              Definition

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

                                              Shortidentifies the meaning of the extension
                                              Comments

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

                                              Control1..1
                                              Typeuri
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              Fixed Valuetext
                                              84. Patient.extension:race.extension:text.value[x]
                                              Definition

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

                                              ShortValue of extension
                                              Control0..1
                                              This element is affected by the following invariants: ele-1
                                              TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              SlicingThis element introduces a set of slices on Patient.extension.extension.value[x]. The slices areUnordered and , and can be differentiated using the following discriminators:
                                              • type @ $this
                                                • 86. Patient.extension:race.extension:text.value[x]:valueString
                                                Slice NamevalueString
                                                Definition

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

                                                ShortValue of extension
                                                Control1..1
                                                This element is affected by the following invariants: ele-1
                                                Typestring
                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                88. Patient.extension:race.url
                                                Definition

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

                                                Shortidentifies the meaning of the extension
                                                Comments

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

                                                Control1..1
                                                Typeuri
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                Fixed Valuehttp://hl7.org/fhir/us/core/StructureDefinition/us-core-race
                                                90. Patient.extension:race.value[x]
                                                Definition

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

                                                ShortValue of extension
                                                Control0..0
                                                This element is affected by the following invariants: ele-1
                                                TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                92. Patient.extension:ethnicity
                                                Slice Nameethnicity
                                                Definition

                                                Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The ethnicity codes used to represent these concepts are based upon the CDC ethnicity and Ethnicity Code Set Version 1.0 which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity. The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories: - Hispanic or Latino - Not Hispanic or Latino.

                                                ShortUS Core ethnicity Extension
                                                Control1..1
                                                This element is affected by the following invariants: ele-1
                                                TypeExtension(US Core Ethnicity Extension) (Complex Extension)
                                                Must Supporttrue
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                94. Patient.extension:ethnicity.id
                                                Definition

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

                                                ShortUnique id for inter-element referencing
                                                Control0..1
                                                Typestring
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                96. Patient.extension:ethnicity.extension
                                                Definition

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

                                                ShortAdditional content defined by implementations
                                                Comments

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

                                                Control1..*
                                                This element is affected by the following invariants: ele-1
                                                TypeExtension
                                                Standard StatusNormative (from Normative)
                                                Alternate Namesextensions, user content
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                SlicingThis element introduces a set of slices on Patient.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                • value @ url
                                                  • 98. Patient.extension:ethnicity.extension:ombCategory
                                                  Slice NameombCategory
                                                  Definition

                                                  An Extension

                                                  ShortExtension
                                                  Control0..1
                                                  This element is affected by the following invariants: ele-1
                                                  TypeExtension
                                                  Must Supporttrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  100. Patient.extension:ethnicity.extension:ombCategory.id
                                                  Definition

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

                                                  ShortUnique id for inter-element referencing
                                                  Control0..1
                                                  Typestring
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  102. Patient.extension:ethnicity.extension:ombCategory.extension
                                                  Definition

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

                                                  ShortAdditional content defined by implementations
                                                  Comments

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

                                                  Control0..*
                                                  This element is affected by the following invariants: ele-1
                                                  TypeExtension
                                                  Standard StatusNormative (from Normative)
                                                  Alternate Namesextensions, user content
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  SlicingThis element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                  • value @ url
                                                    • 104. Patient.extension:ethnicity.extension:ombCategory.url
                                                    Definition

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

                                                    Shortidentifies the meaning of the extension
                                                    Comments

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

                                                    Control1..1
                                                    Typeuri
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                    Fixed ValueombCategory
                                                    106. Patient.extension:ethnicity.extension:ombCategory.value[x]
                                                    Definition

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

                                                    ShortValue of extension
                                                    Control1..1
                                                    This element is affected by the following invariants: ele-1
                                                    BindingThe codes SHALL be taken from OMB Ethnicity Categories
                                                    (required to http://hl7.org/fhir/us/core/ValueSet/omb-ethnicity-category)
                                                    TypeCoding
                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    108. Patient.extension:ethnicity.extension:ombCategory.value[x].id
                                                    Definition

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

                                                    ShortUnique id for inter-element referencing
                                                    Control0..1
                                                    Typestring
                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                    110. Patient.extension:ethnicity.extension:ombCategory.value[x].extension
                                                    Definition

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

                                                    ShortAdditional content defined by implementations
                                                    Comments

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

                                                    Control0..*
                                                    This element is affected by the following invariants: ele-1
                                                    TypeExtension
                                                    Standard StatusNormative (from Normative)
                                                    Alternate Namesextensions, user content
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    SlicingThis element introduces a set of slices on Patient.extension.extension.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                    • value @ url
                                                      • 112. Patient.extension:ethnicity.extension:ombCategory.value[x].system
                                                      Definition

                                                      The identification of the code system that defines the meaning of the symbol in the code.

                                                      ShortIdentity of the terminology system
                                                      Comments

                                                      The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                                                      Control0..1
                                                      This element is affected by the following invariants: ele-1
                                                      Typeuri
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Summarytrue
                                                      Requirements

                                                      Need to be unambiguous about the source of the definition of the symbol.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      114. Patient.extension:ethnicity.extension:ombCategory.value[x].version
                                                      Definition

                                                      The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                                      ShortVersion of the system - if relevant
                                                      Comments

                                                      Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                                      NoteThis is a business version Id, not a resource version Id (see discussion)
                                                      Control0..1
                                                      This element is affected by the following invariants: ele-1
                                                      Typestring
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Summarytrue
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      116. Patient.extension:ethnicity.extension:ombCategory.value[x].code
                                                      Definition

                                                      A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                                      ShortSymbol in syntax defined by the system
                                                      Comments

                                                      Note that FHIR strings SHALL NOT exceed 1MB in size

                                                      Control0..1
                                                      This element is affected by the following invariants: ele-1
                                                      Typecode
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Summarytrue
                                                      Requirements

                                                      Need to refer to a particular code in the system.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      118. Patient.extension:ethnicity.extension:ombCategory.value[x].display
                                                      Definition

                                                      A representation of the meaning of the code in the system, following the rules of the system.

                                                      ShortRepresentation defined by the system
                                                      Comments

                                                      Note that FHIR strings SHALL NOT exceed 1MB in size

                                                      Control0..1
                                                      This element is affected by the following invariants: ele-1
                                                      Typestring
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Summarytrue
                                                      Requirements

                                                      Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      120. Patient.extension:ethnicity.extension:ombCategory.value[x].userSelected
                                                      Definition

                                                      Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                                      ShortIf this coding was chosen directly by the user
                                                      Comments

                                                      Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                                                      Control0..1
                                                      This element is affected by the following invariants: ele-1
                                                      Typeboolean
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Summarytrue
                                                      Requirements

                                                      This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      122. Patient.extension:ethnicity.extension:detailed
                                                      Slice Namedetailed
                                                      Definition

                                                      The 41 CDC ethnicity codes that are grouped under one of the 2 OMB ethnicity category codes.

                                                      ShortExtended ethnicity codes
                                                      Comments

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

                                                      Control0..*
                                                      This element is affected by the following invariants: ele-1
                                                      TypeExtension
                                                      Standard StatusNormative (from Normative)
                                                      Alternate Namesextensions, user content
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      124. Patient.extension:ethnicity.extension:detailed.id
                                                      Definition

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

                                                      ShortUnique id for inter-element referencing
                                                      Control0..1
                                                      Typestring
                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                      126. Patient.extension:ethnicity.extension:detailed.extension
                                                      Definition

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

                                                      ShortAdditional content defined by implementations
                                                      Comments

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

                                                      Control0..*
                                                      This element is affected by the following invariants: ele-1
                                                      TypeExtension
                                                      Standard StatusNormative (from Normative)
                                                      Alternate Namesextensions, user content
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      SlicingThis element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                      • value @ url
                                                        • 128. Patient.extension:ethnicity.extension:detailed.url
                                                        Definition

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

                                                        Shortidentifies the meaning of the extension
                                                        Comments

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

                                                        Control1..1
                                                        Typeuri
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        Fixed Valuedetailed
                                                        130. Patient.extension:ethnicity.extension:detailed.value[x]
                                                        Definition

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

                                                        ShortValue of extension
                                                        Control1..1
                                                        This element is affected by the following invariants: ele-1
                                                        BindingThe codes SHALL be taken from Detailed ethnicity
                                                        (required to http://hl7.org/fhir/us/core/ValueSet/detailed-ethnicity)
                                                        TypeCoding
                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        132. Patient.extension:ethnicity.extension:text
                                                        Slice Nametext
                                                        Definition

                                                        An Extension

                                                        ShortExtension
                                                        Control1..1
                                                        This element is affected by the following invariants: ele-1
                                                        TypeExtension
                                                        Must Supporttrue
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        134. Patient.extension:ethnicity.extension:text.id
                                                        Definition

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

                                                        ShortUnique id for inter-element referencing
                                                        Control0..1
                                                        Typestring
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        136. Patient.extension:ethnicity.extension:text.extension
                                                        Definition

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

                                                        ShortAdditional content defined by implementations
                                                        Comments

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

                                                        Control0..*
                                                        This element is affected by the following invariants: ele-1
                                                        TypeExtension
                                                        Standard StatusNormative (from Normative)
                                                        Alternate Namesextensions, user content
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        SlicingThis element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                        • value @ url
                                                          • 138. Patient.extension:ethnicity.extension:text.url
                                                          Definition

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

                                                          Shortidentifies the meaning of the extension
                                                          Comments

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

                                                          Control1..1
                                                          Typeuri
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                          Fixed Valuetext
                                                          140. Patient.extension:ethnicity.extension:text.value[x]
                                                          Definition

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

                                                          ShortValue of extension
                                                          Control1..1
                                                          This element is affected by the following invariants: ele-1
                                                          Typestring
                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          142. Patient.extension:ethnicity.url
                                                          Definition

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

                                                          Shortidentifies the meaning of the extension
                                                          Comments

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

                                                          Control1..1
                                                          Typeuri
                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                          Fixed Valuehttp://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity
                                                          144. Patient.extension:ethnicity.value[x]
                                                          Definition

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

                                                          ShortValue of extension
                                                          Control0..0
                                                          This element is affected by the following invariants: ele-1
                                                          TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          146. Patient.extension:birthsex
                                                          Slice Namebirthsex
                                                          Definition

                                                          A code classifying the person's sex assigned at birth as specified by the Office of the National Coordinator for Health IT (ONC).

                                                          ShortOptional Extensions Element
                                                          Comments

                                                          The codes required are intended to present birth sex (i.e., the sex recorded on the patient’s birth certificate) and not gender identity or reassigned sex.

                                                          Control0..1
                                                          This element is affected by the following invariants: ele-1
                                                          TypeExtension(US Core Birth Sex Extension) (Extension Type: Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta)
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Standard StatusNormative (from Normative)
                                                          Alternate Namesextensions, user content
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          148. Patient.extension:us-citizenship
                                                          Slice Nameus-citizenship
                                                          Definition

                                                          Is the patient a US citizen

                                                          ShortExtension
                                                          Control1..1
                                                          This element is affected by the following invariants: ele-1
                                                          TypeExtension(USCitizenship) (Extension Type: boolean)
                                                          Must Supporttrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          150. Patient.extension:us-citizenship.id
                                                          Definition

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

                                                          ShortUnique id for inter-element referencing
                                                          Control0..1
                                                          Typestring
                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                          152. Patient.extension:us-citizenship.extension
                                                          Definition

                                                          An Extension

                                                          ShortExtension
                                                          Control0..0
                                                          This element is affected by the following invariants: ele-1
                                                          TypeExtension
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          SlicingThis element introduces a set of slices on Patient.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                          • value @ url
                                                            • 154. Patient.extension:us-citizenship.url
                                                            Definition

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

                                                            Shortidentifies the meaning of the extension
                                                            Comments

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

                                                            Control1..1
                                                            Typeuri
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            Fixed Valuehttps://fhir.njsams.rutgers.edu/NJSAMS-fhir/StructureDefinition/USCitizenship
                                                            156. Patient.extension:us-citizenship.value[x]
                                                            Definition

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

                                                            ShortValue of extension
                                                            Control0..1
                                                            This element is affected by the following invariants: ele-1
                                                            Typeboolean
                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            158. Patient.extension:income-eligibility-screening
                                                            Slice Nameincome-eligibility-screening
                                                            Definition

                                                            Does the patient wish to complete income eligibility and screening

                                                            ShortExtension
                                                            Control1..1
                                                            This element is affected by the following invariants: ele-1
                                                            TypeExtension(IncomeEligibilityScreening) (Extension Type: boolean)
                                                            Must Supporttrue
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            160. Patient.extension:income-eligibility-screening.id
                                                            Definition

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

                                                            ShortUnique id for inter-element referencing
                                                            Control0..1
                                                            Typestring
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            162. Patient.extension:income-eligibility-screening.extension
                                                            Definition

                                                            An Extension

                                                            ShortExtension
                                                            Control0..0
                                                            This element is affected by the following invariants: ele-1
                                                            TypeExtension
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            SlicingThis element introduces a set of slices on Patient.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                            • value @ url
                                                              • 164. Patient.extension:income-eligibility-screening.url
                                                              Definition

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

                                                              Shortidentifies the meaning of the extension
                                                              Comments

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

                                                              Control1..1
                                                              Typeuri
                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                              Fixed Valuehttps://fhir.njsams.rutgers.edu/NJSAMS-fhir/StructureDefinition/IncomeEligibilityScreening
                                                              166. Patient.extension:income-eligibility-screening.value[x]
                                                              Definition

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

                                                              ShortValue of extension
                                                              Control0..1
                                                              This element is affected by the following invariants: ele-1
                                                              Typeboolean
                                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              168. Patient.extension:gender-identity
                                                              Slice Namegender-identity
                                                              Definition

                                                              Additional Gender

                                                              ShortExtension
                                                              Control0..1
                                                              This element is affected by the following invariants: ele-1
                                                              TypeExtension(GenderIdentity) (Extension Type: Coding)
                                                              Must Supporttrue
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                              170. Patient.modifierExtension
                                                              Definition

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

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

                                                              ShortExtensions that cannot be ignored
                                                              Comments

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

                                                              Control0..*
                                                              This element is affected by the following invariants: ele-1
                                                              TypeExtension
                                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                                                              Standard StatusNormative (from Normative)
                                                              Requirements

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

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

                                                                An identifier for this patient.

                                                                ShortAn identifier for this patient
                                                                NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                Control2..*
                                                                This element is affected by the following invariants: ele-1
                                                                TypeIdentifier
                                                                Must Supporttrue
                                                                Summarytrue
                                                                Requirements

                                                                Patients are almost always assigned specific numerical identifiers.

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

                                                                  An identifier for this patient.

                                                                  ShortSSN
                                                                  NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                  Control1..1
                                                                  This element is affected by the following invariants: ele-1
                                                                  TypeIdentifier
                                                                  Must Supporttrue
                                                                  Summarytrue
                                                                  Requirements

                                                                  Patients are almost always assigned specific numerical identifiers.

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

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

                                                                  ShortUnique id for inter-element referencing
                                                                  Control0..1
                                                                  Typestring
                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                  178. Patient.identifier:ssn.extension
                                                                  Definition

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

                                                                  ShortAdditional content defined by implementations
                                                                  Comments

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

                                                                  Control0..*
                                                                  This element is affected by the following invariants: ele-1
                                                                  TypeExtension
                                                                  Standard StatusNormative (from Normative)
                                                                  Alternate Namesextensions, user content
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  SlicingThis element introduces a set of slices on Patient.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                  • value @ url
                                                                    • 180. Patient.identifier:ssn.use
                                                                    Definition

                                                                    The purpose of this identifier.

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

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

                                                                    Control0..1
                                                                    This element is affected by the following invariants: ele-1
                                                                    BindingThe codes SHALL be taken from IdentifierUse
                                                                    (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                                                                    Identifies the purpose for this identifier, if known .

                                                                    Typecode
                                                                    Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summarytrue
                                                                    Requirements

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

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    182. Patient.identifier:ssn.type
                                                                    Definition

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

                                                                    ShortDescription of identifier
                                                                    Comments

                                                                    This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                                                                    Control0..1
                                                                    This element is affected by the following invariants: ele-1
                                                                    BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                                                    (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

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

                                                                    TypeCodeableConcept
                                                                    Summarytrue
                                                                    Requirements

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

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    184. Patient.identifier:ssn.system
                                                                    Definition

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

                                                                    ShortThe namespace for the identifier value
                                                                    Comments

                                                                    Identifier.system is always case sensitive.

                                                                    Control1..1
                                                                    This element is affected by the following invariants: ele-1
                                                                    Typeuri
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Must Supporttrue
                                                                    Summarytrue
                                                                    Requirements

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

                                                                    Pattern Valuehttp://hl7.org/fhir/sid/us-ssn
                                                                    Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    186. Patient.identifier:ssn.value
                                                                    Definition

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

                                                                    ShortThe value that is unique within the system.
                                                                    Comments

                                                                    If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                                                                    Control1..1
                                                                    This element is affected by the following invariants: ele-1
                                                                    Typestring
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Must Supporttrue
                                                                    Summarytrue
                                                                    Example<br/><b>General</b>:123456
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    188. Patient.identifier:ssn.period
                                                                    Definition

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

                                                                    ShortTime period when id is/was valid for use
                                                                    Comments

                                                                    A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                                                                    Period is not used for a duration (a measure of elapsed time). See Duration.

                                                                    Control0..1
                                                                    This element is affected by the following invariants: ele-1
                                                                    TypePeriod
                                                                    Summarytrue
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
                                                                    190. Patient.identifier:ssn.assigner
                                                                    Definition

                                                                    Organization that issued/manages the identifier.

                                                                    ShortOrganization that issued id (may be just text)
                                                                    Comments

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

                                                                    Control0..1
                                                                    This element is affected by the following invariants: ele-1
                                                                    TypeReference(Organization)
                                                                    Summarytrue
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                                                    192. Patient.identifier:njsams
                                                                    Slice Namenjsams
                                                                    Definition

                                                                    An identifier for this patient.

                                                                    ShortNJSAMS client Id
                                                                    NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                    Control1..1
                                                                    This element is affected by the following invariants: ele-1
                                                                    TypeIdentifier
                                                                    Must Supporttrue
                                                                    Summarytrue
                                                                    Requirements

                                                                    Patients are almost always assigned specific numerical identifiers.

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

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

                                                                    ShortUnique id for inter-element referencing
                                                                    Control0..1
                                                                    Typestring
                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                    196. Patient.identifier:njsams.extension
                                                                    Definition

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

                                                                    ShortAdditional content defined by implementations
                                                                    Comments

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

                                                                    Control0..*
                                                                    This element is affected by the following invariants: ele-1
                                                                    TypeExtension
                                                                    Standard StatusNormative (from Normative)
                                                                    Alternate Namesextensions, user content
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                    SlicingThis element introduces a set of slices on Patient.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                    • value @ url
                                                                      • 198. Patient.identifier:njsams.use
                                                                      Definition

                                                                      The purpose of this identifier.

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

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

                                                                      Control0..1
                                                                      This element is affected by the following invariants: ele-1
                                                                      BindingThe codes SHALL be taken from IdentifierUse
                                                                      (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                                                                      Identifies the purpose for this identifier, if known .

                                                                      Typecode
                                                                      Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                      Summarytrue
                                                                      Requirements

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

                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      200. Patient.identifier:njsams.type
                                                                      Definition

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

                                                                      ShortDescription of identifier
                                                                      Comments

                                                                      This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                                                                      Control0..1
                                                                      This element is affected by the following invariants: ele-1
                                                                      BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                                                      (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

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

                                                                      TypeCodeableConcept
                                                                      Summarytrue
                                                                      Requirements

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

                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      202. Patient.identifier:njsams.system
                                                                      Definition

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

                                                                      ShortThe namespace for the identifier value
                                                                      Comments

                                                                      Identifier.system is always case sensitive.

                                                                      Control1..1
                                                                      This element is affected by the following invariants: ele-1
                                                                      Typeuri
                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                      Must Supporttrue
                                                                      Summarytrue
                                                                      Requirements

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

                                                                      Pattern Valuehttps://fhir.njsams.rutgers.edu/NJSAMS-fhir/client-id
                                                                      Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      204. Patient.identifier:njsams.value
                                                                      Definition

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

                                                                      ShortThe value that is unique within the system.
                                                                      Comments

                                                                      If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                                                                      Control1..1
                                                                      This element is affected by the following invariants: ele-1
                                                                      Typestring
                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                      Must Supporttrue
                                                                      Summarytrue
                                                                      Example<br/><b>General</b>:123456
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      206. Patient.identifier:njsams.period
                                                                      Definition

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

                                                                      ShortTime period when id is/was valid for use
                                                                      Comments

                                                                      A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                                                                      Period is not used for a duration (a measure of elapsed time). See Duration.

                                                                      Control0..1
                                                                      This element is affected by the following invariants: ele-1
                                                                      TypePeriod
                                                                      Summarytrue
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
                                                                      208. Patient.identifier:njsams.assigner
                                                                      Definition

                                                                      Organization that issued/manages the identifier.

                                                                      ShortOrganization that issued id (may be just text)
                                                                      Comments

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

                                                                      Control0..1
                                                                      This element is affected by the following invariants: ele-1
                                                                      TypeReference(Organization)
                                                                      Summarytrue
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                                                      210. Patient.identifier:license
                                                                      Slice Namelicense
                                                                      Definition

                                                                      An identifier for this patient.

                                                                      ShortNJ State drivers license
                                                                      NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                      Control0..1
                                                                      This element is affected by the following invariants: ele-1
                                                                      TypeIdentifier
                                                                      Must Supporttrue
                                                                      Summarytrue
                                                                      Requirements

                                                                      Patients are almost always assigned specific numerical identifiers.

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

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

                                                                      ShortUnique id for inter-element referencing
                                                                      Control0..1
                                                                      Typestring
                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                      214. Patient.identifier:license.extension
                                                                      Definition

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

                                                                      ShortAdditional content defined by implementations
                                                                      Comments

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

                                                                      Control0..*
                                                                      This element is affected by the following invariants: ele-1
                                                                      TypeExtension
                                                                      Standard StatusNormative (from Normative)
                                                                      Alternate Namesextensions, user content
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                      SlicingThis element introduces a set of slices on Patient.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                      • value @ url
                                                                        • 216. Patient.identifier:license.use
                                                                        Definition

                                                                        The purpose of this identifier.

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

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

                                                                        Control0..1
                                                                        This element is affected by the following invariants: ele-1
                                                                        BindingThe codes SHALL be taken from IdentifierUse
                                                                        (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                                                                        Identifies the purpose for this identifier, if known .

                                                                        Typecode
                                                                        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Summarytrue
                                                                        Requirements

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

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        218. Patient.identifier:license.type
                                                                        Definition

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

                                                                        ShortDescription of identifier
                                                                        Comments

                                                                        This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                                                                        Control0..1
                                                                        This element is affected by the following invariants: ele-1
                                                                        BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                                                        (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

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

                                                                        TypeCodeableConcept
                                                                        Summarytrue
                                                                        Requirements

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

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        220. Patient.identifier:license.system
                                                                        Definition

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

                                                                        ShortThe namespace for the identifier value
                                                                        Comments

                                                                        Identifier.system is always case sensitive.

                                                                        Control1..1
                                                                        This element is affected by the following invariants: ele-1
                                                                        Typeuri
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Must Supporttrue
                                                                        Summarytrue
                                                                        Requirements

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

                                                                        Pattern Valueurn:oid:2.16.840.1.113883.4.3.34
                                                                        Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        222. Patient.identifier:license.value
                                                                        Definition

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

                                                                        ShortThe value that is unique within the system.
                                                                        Comments

                                                                        If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                                                                        Control1..1
                                                                        This element is affected by the following invariants: ele-1
                                                                        Typestring
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Must Supporttrue
                                                                        Summarytrue
                                                                        Example<br/><b>General</b>:123456
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        224. Patient.identifier:license.period
                                                                        Definition

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

                                                                        ShortTime period when id is/was valid for use
                                                                        Comments

                                                                        A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                                                                        Period is not used for a duration (a measure of elapsed time). See Duration.

                                                                        Control0..1
                                                                        This element is affected by the following invariants: ele-1
                                                                        TypePeriod
                                                                        Summarytrue
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
                                                                        226. Patient.identifier:license.assigner
                                                                        Definition

                                                                        Organization that issued/manages the identifier.

                                                                        ShortOrganization that issued id (may be just text)
                                                                        Comments

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

                                                                        Control0..1
                                                                        This element is affected by the following invariants: ele-1
                                                                        TypeReference(Organization)
                                                                        Summarytrue
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                                                        228. Patient.active
                                                                        Definition

                                                                        Whether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules.

                                                                        It is often used to filter patient lists to exclude inactive patients

                                                                        Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death.

                                                                        ShortWhether this patient's record is in active use
                                                                        Comments

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

                                                                        Control0..1
                                                                        This element is affected by the following invariants: ele-1
                                                                        Typeboolean
                                                                        Is Modifiertrue because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Summarytrue
                                                                        Requirements

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

                                                                        Meaning if MissingThis resource is generally assumed to be active if no value is provided for the active element
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        230. Patient.name
                                                                        Definition

                                                                        A name associated with the individual.

                                                                        ShortA name associated with the patient
                                                                        Comments

                                                                        A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.

                                                                        Control1..*
                                                                        This element is affected by the following invariants: ele-1
                                                                        TypeHumanName
                                                                        Must Supporttrue
                                                                        Summarytrue
                                                                        Requirements

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

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        us-core-8: Either Patient.name.given and/or Patient.name.family SHALL be present or a Data Absent Reason Extension SHALL be present. ((family.exists() or given.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists())
                                                                        232. Patient.name.id
                                                                        Definition

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

                                                                        ShortUnique id for inter-element referencing
                                                                        Control0..1
                                                                        Typestring
                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                        234. Patient.name.extension
                                                                        Definition

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

                                                                        ShortAdditional content defined by implementations
                                                                        Comments

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

                                                                        Control0..*
                                                                        This element is affected by the following invariants: ele-1
                                                                        TypeExtension
                                                                        Standard StatusNormative (from Normative)
                                                                        Alternate Namesextensions, user content
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                        SlicingThis element introduces a set of slices on Patient.name.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                        • value @ url
                                                                          • 236. Patient.name.use
                                                                          Definition

                                                                          Identifies the purpose for this name.

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

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

                                                                          Control0..1
                                                                          This element is affected by the following invariants: ele-1
                                                                          BindingThe codes SHALL be taken from NameUse
                                                                          (required to http://hl7.org/fhir/ValueSet/name-use|4.0.1)

                                                                          The use of a human name.

                                                                          Typecode
                                                                          Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          Requirements

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

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

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

                                                                          ShortText representation of the full name
                                                                          Comments

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

                                                                          Control0..1
                                                                          This element is affected by the following invariants: ele-1
                                                                          Typestring
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          Requirements

                                                                          A renderable, unencoded form.

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

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

                                                                          ShortFamily name (often called 'Surname')
                                                                          Comments

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

                                                                          Control1..1
                                                                          This element is affected by the following invariants: ele-1, us-core-8
                                                                          Typestring
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Must Supporttrue
                                                                          Summarytrue
                                                                          Alternate Namessurname
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          242. Patient.name.given
                                                                          Definition

                                                                          Given name.

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

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

                                                                          Control1..*
                                                                          This element is affected by the following invariants: ele-1, us-core-8
                                                                          Typestring
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Must Supporttrue
                                                                          Summarytrue
                                                                          Alternate Namesfirst name, middle name
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          244. Patient.name.prefix
                                                                          Definition

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

                                                                          ShortParts that come before the name
                                                                          Comments

                                                                          Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                          Control0..*
                                                                          This element is affected by the following invariants: ele-1
                                                                          Typestring
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          246. Patient.name.suffix
                                                                          Definition

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

                                                                          ShortParts that come after the name
                                                                          Comments

                                                                          Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                          Control0..*
                                                                          This element is affected by the following invariants: ele-1
                                                                          Typestring
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Must Supportfalse
                                                                          Summarytrue
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          248. Patient.name.period
                                                                          Definition

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

                                                                          ShortTime period when name was/is in use
                                                                          Comments

                                                                          A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                                                                          Period is not used for a duration (a measure of elapsed time). See Duration.

                                                                          Control0..1
                                                                          This element is affected by the following invariants: ele-1
                                                                          TypePeriod
                                                                          Must Supportfalse
                                                                          Summarytrue
                                                                          Requirements

                                                                          Allows names to be placed in historical context.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
                                                                          250. Patient.telecom
                                                                          Definition

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

                                                                          ShortA contact detail for the individual
                                                                          Comments

                                                                          A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).

                                                                          Control0..*
                                                                          This element is affected by the following invariants: ele-1
                                                                          TypeContactPoint
                                                                          Must Supportfalse
                                                                          Summarytrue
                                                                          Requirements

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

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          cpt-2: A system is required if a value is provided. (value.empty() or system.exists())
                                                                          252. Patient.telecom.id
                                                                          Definition

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

                                                                          ShortUnique id for inter-element referencing
                                                                          Control0..1
                                                                          Typestring
                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                          254. Patient.telecom.extension
                                                                          Definition

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

                                                                          ShortAdditional content defined by implementations
                                                                          Comments

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

                                                                          Control0..*
                                                                          This element is affected by the following invariants: ele-1
                                                                          TypeExtension
                                                                          Standard StatusNormative (from Normative)
                                                                          Alternate Namesextensions, user content
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                          SlicingThis element introduces a set of slices on Patient.telecom.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                          • value @ url
                                                                            • 256. Patient.telecom.system
                                                                            Definition

                                                                            Telecommunications form for contact point - what communications system is required to make use of the contact.

                                                                            Shortphone | fax | email | pager | url | sms | other
                                                                            Comments

                                                                            Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                            Control1..1
                                                                            This element is affected by the following invariants: ele-1, cpt-2
                                                                            BindingThe codes SHALL be taken from ContactPointSystem
                                                                            (required to http://hl7.org/fhir/ValueSet/contact-point-system)

                                                                            Telecommunications form for contact point.

                                                                            Typecode
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Must Supporttrue
                                                                            Summarytrue
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            258. Patient.telecom.value
                                                                            Definition

                                                                            The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

                                                                            ShortThe actual contact point details
                                                                            Comments

                                                                            Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

                                                                            Control1..1
                                                                            This element is affected by the following invariants: ele-1
                                                                            Typestring
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Must Supporttrue
                                                                            Summarytrue
                                                                            Requirements

                                                                            Need to support legacy numbers that are not in a tightly controlled format.

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

                                                                            Identifies the purpose for the contact point.

                                                                            Shorthome | work | temp | old | mobile - purpose of this contact point
                                                                            Comments

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

                                                                            Control0..1
                                                                            This element is affected by the following invariants: ele-1
                                                                            BindingThe codes SHALL be taken from ContactPointUse
                                                                            (required to http://hl7.org/fhir/ValueSet/contact-point-use)

                                                                            Use of contact point.

                                                                            Typecode
                                                                            Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Must Supporttrue
                                                                            Summarytrue
                                                                            Requirements

                                                                            Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

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

                                                                            Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.

                                                                            ShortSpecify preferred order of use (1 = highest)
                                                                            Comments

                                                                            Note that rank does not necessarily follow the order in which the contacts are represented in the instance.

                                                                            Control0..1
                                                                            This element is affected by the following invariants: ele-1
                                                                            TypepositiveInt
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summarytrue
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            264. Patient.telecom.period
                                                                            Definition

                                                                            Time period when the contact point was/is in use.

                                                                            ShortTime period when the contact point was/is in use
                                                                            Comments

                                                                            A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                                                                            Period is not used for a duration (a measure of elapsed time). See Duration.

                                                                            Control0..1
                                                                            This element is affected by the following invariants: ele-1
                                                                            TypePeriod
                                                                            Summarytrue
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
                                                                            266. Patient.gender
                                                                            Definition

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

                                                                            Shortmale | female | other | unknown
                                                                            Comments

                                                                            The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex.

                                                                            Control1..1
                                                                            This element is affected by the following invariants: ele-1
                                                                            BindingThe codes SHALL be taken from AdministrativeGender
                                                                            (required to http://hl7.org/fhir/ValueSet/administrative-gender)

                                                                            The gender of a person used for administrative purposes.

                                                                            Typecode
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Must Supporttrue
                                                                            Summarytrue
                                                                            Requirements

                                                                            Needed for identification of the individual, in combination with (at least) name and birth date.

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

                                                                            The date of birth for the individual.

                                                                            ShortThe 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).

                                                                            Control1..1
                                                                            This element is affected by the following invariants: ele-1
                                                                            Typedate
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Must Supporttrue
                                                                            Summarytrue
                                                                            Requirements

                                                                            Age of the individual drives many clinical processes.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            LOINC Code21112-8
                                                                            270. Patient.deceased[x]
                                                                            Definition

                                                                            Indicates if the individual is deceased or not.

                                                                            ShortIndicates if the individual is deceased or not
                                                                            Comments

                                                                            If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.

                                                                            Control0..1
                                                                            This element is affected by the following invariants: ele-1
                                                                            TypeChoice of: boolean, dateTime
                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                            Is Modifiertrue because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summarytrue
                                                                            Requirements

                                                                            The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.

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

                                                                            An address for the individual.

                                                                            ShortAn address for the individual
                                                                            Comments

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

                                                                            Control1..*
                                                                            This element is affected by the following invariants: ele-1
                                                                            TypeAddress
                                                                            Must Supporttrue
                                                                            Summarytrue
                                                                            Requirements

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

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            274. 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.

                                                                            ShortUnique id for inter-element referencing
                                                                            Control0..1
                                                                            Typestring
                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                            276. Patient.address.extension
                                                                            Definition

                                                                            An Extension

                                                                            ShortExtension
                                                                            Control1..*
                                                                            This element is affected by the following invariants: ele-1
                                                                            TypeExtension
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                            SlicingThis element introduces a set of slices on Patient.address.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                            • value @ url
                                                                              • 278. Patient.address.extension:municipality
                                                                              Slice Namemunicipality
                                                                              Definition

                                                                              The municipality where the patient resides

                                                                              ShortExtension
                                                                              Control1..1
                                                                              This element is affected by the following invariants: ele-1
                                                                              TypeExtension(DistrictMunicipality) (Extension Type: Coding)
                                                                              Must Supporttrue
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                              280. Patient.address.use
                                                                              Definition

                                                                              The purpose of this address.

                                                                              Shorthome | 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.

                                                                              Control0..1
                                                                              This element is affected by the following invariants: ele-1
                                                                              BindingThe codes SHALL be taken from AddressUse
                                                                              (required to http://hl7.org/fhir/ValueSet/address-use|4.0.1)

                                                                              The use of an address.

                                                                              Typecode
                                                                              Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Summarytrue
                                                                              Requirements

                                                                              Allows an appropriate address to be chosen from a list of many.

                                                                              Example<br/><b>General</b>:home
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              282. 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.

                                                                              Shortpostal | 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).

                                                                              Control0..1
                                                                              This element is affected by the following invariants: ele-1
                                                                              BindingThe codes SHALL be taken from AddressType
                                                                              (required to http://hl7.org/fhir/ValueSet/address-type|4.0.1)

                                                                              The type of an address (physical / postal).

                                                                              Typecode
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Summarytrue
                                                                              Example<br/><b>General</b>:both
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              284. 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.

                                                                              ShortText 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.

                                                                              Control0..1
                                                                              This element is affected by the following invariants: ele-1
                                                                              Typestring
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Summarytrue
                                                                              Requirements

                                                                              A renderable, unencoded form.

                                                                              Example<br/><b>General</b>:137 Nowhere Street, Erewhon 9132
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              286. 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.

                                                                              ShortStreet name, number, direction & P.O. Box etc.
                                                                              Comments

                                                                              Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                              Control0..*
                                                                              This element is affected by the following invariants: ele-1
                                                                              Typestring
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Must Supporttrue
                                                                              Summarytrue
                                                                              Example<br/><b>General</b>:137 Nowhere Street
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              288. Patient.address.city
                                                                              Definition

                                                                              The name of the city, town, suburb, village or other community or delivery center.

                                                                              ShortName of city, town etc.
                                                                              Comments

                                                                              Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                              Control0..1
                                                                              This element is affected by the following invariants: ele-1
                                                                              Typestring
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Must Supporttrue
                                                                              Summarytrue
                                                                              Alternate NamesMunicpality
                                                                              Example<br/><b>General</b>:Erewhon
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              290. Patient.address.district
                                                                              Definition

                                                                              The name of the administrative area (county).

                                                                              ShortDistrict 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.

                                                                              Control0..1
                                                                              This element is affected by the following invariants: ele-1
                                                                              Typestring
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Must Supporttrue
                                                                              Summarytrue
                                                                              Alternate NamesCounty
                                                                              Example<br/><b>General</b>:Madison
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              292. 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).

                                                                              ShortSub-unit of country (abbreviations ok)
                                                                              Comments

                                                                              Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                              Control1..1
                                                                              This element is affected by the following invariants: ele-1
                                                                              BindingUnless not suitable, these codes SHALL be taken from USPS Two Letter Alphabetic Codes
                                                                              (extensible to http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state)

                                                                              Two Letter USPS alphabetic codes.

                                                                              Typestring
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Must Supporttrue
                                                                              Summarytrue
                                                                              Alternate NamesProvince, Territory
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              294. Patient.address.postalCode
                                                                              Definition

                                                                              A postal code designating a region defined by the postal service.

                                                                              ShortUS Zip Codes
                                                                              Comments

                                                                              Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                              Control0..1
                                                                              This element is affected by the following invariants: ele-1
                                                                              Typestring
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Must Supporttrue
                                                                              Summarytrue
                                                                              Alternate NamesZip, Zip Code
                                                                              Example<br/><b>General</b>:9132
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              296. Patient.address.country
                                                                              Definition

                                                                              Country - a nation as commonly understood or generally accepted.

                                                                              ShortCountry (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.

                                                                              Control0..1
                                                                              This element is affected by the following invariants: ele-1
                                                                              Typestring
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Summarytrue
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              298. Patient.address.period
                                                                              Definition

                                                                              Time period when address was/is in use.

                                                                              ShortTime period when address was/is in use
                                                                              Comments

                                                                              A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                                                                              Period is not used for a duration (a measure of elapsed time). See Duration.

                                                                              Control0..1
                                                                              This element is affected by the following invariants: ele-1
                                                                              TypePeriod
                                                                              Must Supporttrue
                                                                              Summarytrue
                                                                              Requirements

                                                                              Allows addresses to be placed in historical context.

                                                                              Example<br/><b>General</b>:{ "start" : "2010-03-23", "end" : "2010-07-01" }
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
                                                                              300. Patient.maritalStatus
                                                                              Definition

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

                                                                              ShortMarital (civil) status of a patient
                                                                              Comments

                                                                              Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                                                                              Control1..1
                                                                              This element is affected by the following invariants: ele-1
                                                                              BindingUnless not suitable, these codes SHALL be taken from Marital Status Codes
                                                                              (extensible to http://hl7.org/fhir/ValueSet/marital-status)

                                                                              The domestic partnership status of a person.

                                                                              TypeCodeableConcept
                                                                              Must Supporttrue
                                                                              Requirements

                                                                              Most, if not all systems capture it.

                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              302. Patient.multipleBirth[x]
                                                                              Definition

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

                                                                              ShortWhether patient is part of a multiple birth
                                                                              Comments

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

                                                                              Control0..1
                                                                              This element is affected by the following invariants: ele-1
                                                                              TypeChoice of: boolean, integer
                                                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Requirements

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

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

                                                                              Image of the patient.

                                                                              ShortImage of the patient
                                                                              Comments

                                                                              Guidelines:

                                                                              • Use id photos, not clinical photos.
                                                                              • Limit dimensions to thumbnail.
                                                                              • Keep byte count low to ease resource updates.
                                                                              Control0..*
                                                                              This element is affected by the following invariants: ele-1
                                                                              TypeAttachment
                                                                              Requirements

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

                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              att-1: If the Attachment has data, it SHALL have a contentType (data.empty() or contentType.exists())
                                                                              306. Patient.contact
                                                                              Definition

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

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

                                                                              Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.

                                                                              Control0..*
                                                                              This element is affected by the following invariants: ele-1
                                                                              TypeBackboneElement
                                                                              Requirements

                                                                              Need to track people you can contact about the patient.

                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              pat-1: SHALL at least contain a contact's details or a reference to an organization (name.exists() or telecom.exists() or address.exists() or organization.exists())
                                                                              308. Patient.contact.id
                                                                              Definition

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

                                                                              ShortUnique id for inter-element referencing
                                                                              Control0..1
                                                                              Typestring
                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                              310. Patient.contact.extension
                                                                              Definition

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

                                                                              ShortAdditional content defined by implementations
                                                                              Comments

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

                                                                              Control0..*
                                                                              This element is affected by the following invariants: ele-1
                                                                              TypeExtension
                                                                              Standard StatusNormative (from Normative)
                                                                              Alternate Namesextensions, user content
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                              SlicingThis element introduces a set of slices on Patient.contact.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                              • value @ url
                                                                                • 312. Patient.contact.modifierExtension
                                                                                Definition

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

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

                                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                                Comments

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

                                                                                Control0..*
                                                                                This element is affected by the following invariants: ele-1
                                                                                TypeExtension
                                                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                Summarytrue
                                                                                Requirements

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

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

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

                                                                                ShortThe kind of relationship
                                                                                Comments

                                                                                Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                                                                                Control0..*
                                                                                This element is affected by the following invariants: ele-1
                                                                                BindingUnless not suitable, these codes SHALL be taken from PatientContactRelationship
                                                                                (extensible to http://hl7.org/fhir/ValueSet/patient-contactrelationship)

                                                                                The nature of the relationship between a patient and a contact person for that patient.

                                                                                TypeCodeableConcept
                                                                                Requirements

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

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

                                                                                A name associated with the contact person.

                                                                                ShortA name associated with the contact person
                                                                                Comments

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

                                                                                Control0..1
                                                                                This element is affected by the following invariants: ele-1
                                                                                TypeHumanName
                                                                                Requirements

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

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

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

                                                                                ShortA contact detail for the person
                                                                                Comments

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

                                                                                Control0..*
                                                                                This element is affected by the following invariants: ele-1
                                                                                TypeContactPoint
                                                                                Requirements

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

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                cpt-2: A system is required if a value is provided. (value.empty() or system.exists())
                                                                                320. Patient.contact.address
                                                                                Definition

                                                                                Address for the contact person.

                                                                                ShortAddress for the contact person
                                                                                Comments

                                                                                Note: address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource).

                                                                                Control0..1
                                                                                This element is affected by the following invariants: ele-1
                                                                                TypeAddress
                                                                                Requirements

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

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

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

                                                                                Shortmale | female | other | unknown
                                                                                Comments

                                                                                Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                Control0..1
                                                                                This element is affected by the following invariants: ele-1
                                                                                BindingThe codes SHALL be taken from AdministrativeGender
                                                                                (required to http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1)

                                                                                The gender of a person used for administrative purposes.

                                                                                Typecode
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Requirements

                                                                                Needed to address the person correctly.

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

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

                                                                                ShortOrganization that is associated with the contact
                                                                                Comments

                                                                                References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

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

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

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                                                                326. Patient.contact.period
                                                                                Definition

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

                                                                                ShortThe period during which this contact person or organization is valid to be contacted relating to this patient
                                                                                Comments

                                                                                A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                                                                                Period is not used for a duration (a measure of elapsed time). See Duration.

                                                                                Control0..1
                                                                                This element is affected by the following invariants: ele-1
                                                                                TypePeriod
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
                                                                                328. Patient.communication
                                                                                Definition

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

                                                                                ShortA language which may be used to communicate with the patient about his or her health
                                                                                Comments

                                                                                If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.

                                                                                Control0..*
                                                                                This element is affected by the following invariants: ele-1
                                                                                TypeBackboneElement
                                                                                Must Supportfalse
                                                                                Requirements

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

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

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

                                                                                ShortUnique id for inter-element referencing
                                                                                Control0..1
                                                                                Typestring
                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                332. Patient.communication.extension
                                                                                Definition

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

                                                                                ShortAdditional content defined by implementations
                                                                                Comments

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

                                                                                Control0..*
                                                                                This element is affected by the following invariants: ele-1
                                                                                TypeExtension
                                                                                Standard StatusNormative (from Normative)
                                                                                Alternate Namesextensions, user content
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                SlicingThis element introduces a set of slices on Patient.communication.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                • value @ url
                                                                                  • 334. Patient.communication.modifierExtension
                                                                                  Definition

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

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

                                                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                                                  Comments

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

                                                                                  Control0..*
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  TypeExtension
                                                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                  Summarytrue
                                                                                  Requirements

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

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

                                                                                  The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English.

                                                                                  ShortThe language which can be used to communicate with the patient about his or her health
                                                                                  Comments

                                                                                  The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.

                                                                                  Control1..1
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  BindingUnless not suitable, these codes SHALL be taken from Language codes with language and optionally a region modifier
                                                                                  (extensible to http://hl7.org/fhir/us/core/ValueSet/simple-language)

                                                                                  A human language.

                                                                                  Additional BindingsPurpose
                                                                                  AllLanguagesMax Binding
                                                                                  TypeCodeableConcept
                                                                                  Must Supporttrue
                                                                                  Requirements

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

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

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

                                                                                  ShortLanguage preference indicator
                                                                                  Comments

                                                                                  This language is specifically identified for communicating healthcare information.

                                                                                  Control0..1
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  Typeboolean
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Requirements

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

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

                                                                                  Patient's nominated care provider.

                                                                                  ShortPatient's nominated primary care provider
                                                                                  Comments

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

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

                                                                                  Control0..*
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  TypeReference(Organization, Practitioner, PractitionerRole)
                                                                                  Alternate NamescareProvider
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                                                                  342. Patient.managingOrganization
                                                                                  Definition

                                                                                  Organization that is the custodian of the patient record.

                                                                                  ShortOrganization that is the custodian of the patient record
                                                                                  Comments

                                                                                  There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association).

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

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

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                                                                  344. Patient.link
                                                                                  Definition

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

                                                                                  ShortLink to another patient resource that concerns the same actual person
                                                                                  Comments

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

                                                                                  Control0..*
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  TypeBackboneElement
                                                                                  Is Modifiertrue because This element is labeled as a modifier because it might not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  There are multiple use cases:

                                                                                  • Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and
                                                                                  • Distribution of patient information across multiple servers.
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  346. Patient.link.id
                                                                                  Definition

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

                                                                                  ShortUnique id for inter-element referencing
                                                                                  Control0..1
                                                                                  Typestring
                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                  348. Patient.link.extension
                                                                                  Definition

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

                                                                                  ShortAdditional content defined by implementations
                                                                                  Comments

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

                                                                                  Control0..*
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  TypeExtension
                                                                                  Standard StatusNormative (from Normative)
                                                                                  Alternate Namesextensions, user content
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  SlicingThis element introduces a set of slices on Patient.link.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                  • value @ url
                                                                                    • 350. Patient.link.modifierExtension
                                                                                    Definition

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

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

                                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                                    Comments

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

                                                                                    Control0..*
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    TypeExtension
                                                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                    Summarytrue
                                                                                    Requirements

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

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

                                                                                    The other patient resource that the link refers to.

                                                                                    ShortThe other patient or related person resource that the link refers to
                                                                                    Comments

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

                                                                                    Control1..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    TypeReference(Patient, RelatedPerson)
                                                                                    Summarytrue
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                                                                    354. Patient.link.type
                                                                                    Definition

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

                                                                                    Shortreplaced-by | replaces | refer | seealso
                                                                                    Comments

                                                                                    Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                    Control1..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    BindingThe codes SHALL be taken from LinkType
                                                                                    (required to http://hl7.org/fhir/ValueSet/link-type|4.0.1)

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

                                                                                    Typecode
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summarytrue
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))