3.48 StructureDefinition: Shared Health Patient
The official URL for this profile is:
http://sharedhealth.exchange/fhir/StructureDefinition/profile-patient
3.48.2 Formal Views of Profile Content
Download Excel representation
Description of Profiles, Differentials, Snapshots and how the different presentations work.
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This structure is derived from Patient
| Name | Card. | Type | Constraints and Usage |
|---|---|---|---|
 Patient | 0..* | Definition: Demographics and other administrative information about an individual or animal receiving care or other health-related services. Comments: Patient will contain two identifiers. One will represent the creator's local identifier and the second will be the jurisdication health number. | |
 id | 1..1 | id | Definition: The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments: Conformance Rule: This will usually be a GUID and is assigned by the sending application. It should ideally be the same in all messages referring to the same patient record. |
| identifier | 1..2 | Identifier | Slice: Unordered, Open by value:type Definition: The identifier for the patient as known to the sending application. Comments: Conformance Rule: Sender local patient identifier MAY be stored by the receiving application and used for linking Conformance Rule: This must follow the OID format: [Vendor].[ApplicationInstance].1. The branch, “.1” is appended to create a unique namespace for the Patient Identifer Conformance Rule: Location EMR/PMS Patient ID: EMR's and PMS MUST include the local patient ID in the message. This will require an identifier system issued by the EMR and PMS by Application Instance ID. Usage Note: This MUST be stored by PMS/EMR and echoed back in subsequent messages (e.g. eRAR, discontinue, refuse to fill) that relate to this patient. This is intended to provide assistance in automation for PMS/EMR who receive this information, however each vendor can determine the level of automation that is appropriate for them. If an EMR chooses to use the PMS Patient ID (or conversely, the PMS uses the EMR ID) for automatic linking, they should also validate using other demographic data provided in the message as a precaution. |
| identifier (SenderPatientIdentifier) | 1..1 | Shared Health Person Identifier | Definition: A technical identifier - identifies some entity uniquely and unambiguously. Comments: Conformance Rule: Sender local patient identifier MAY be stored by the receiving application and used for linking Conformance Rule: Location EMR/PMS Patient ID: EMR's and PMS MUST include the local patient ID in the message. This will require an identifier system issued by the EMR and PMS by Application Instance ID. Usage Notes: This MUST be stored by PMS/EMR and echoed back in subsequent messages (e.g. eRAR, discontinue, refuse to fill) that relate to this patient. This is intended to provide assistance in automation for PMS/EMR who receive this information, however each vendor can determine the level of automation that is appropriate for them. If an EMR chooses to use the PMS Patient ID (or conversely, the PMS uses the EMR ID) for automatic linking, they should also validate using other demographic data provided in the message as a precaution. When prescribing narcotics and controlled substances in Ontario, only the Jurisdictional Health Card number (of those allowed by Ontario regulation) can be conveyed as part of the Patient Resource. If a prescriber wishes to include another type of identification, this can be conveyed using the Prescriber Instructions. In future, the full set of identifier types will be supported within the messaging standard. For MedDialog, this identifier MUST be stored and echoed back in all subsequent communications (replies/forwards) within a given Thread. |
  type | 1..1 | Shared Health CodeableConcept Code | Binding: SharedIdentifierType (extensible) Required Pattern: {"coding":[{"system":"http://hl7.org/fhir/v2/0203","code":"MR"}]} Definition: A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. Comments: See children for fixed values. |
 coding | 0..* | Coding | Definition: A reference to a code defined by a terminology system. Comments: Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true. |
| system | 1..1 | uri | Definition: The identification of the code system that defines the meaning of the symbol in the code. Comments: The system will be a standard OID that can be found on the terminology gateway here: https://tgateway.infoway-inforoute.ca/html/singlesubset.html?id=2.16.840.1.113883.2.20.3.422&versionid=20170626 |
 code | 1..1 | 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). |
| text | 0..1 | string | Definition: A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Comments: Very often the text is the same as a displayName of one of the codings. |
| system | 1..1 | uri | Example' General': http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri Definition: Establishes the namespace in which set of possible id values is unique. Comments: Conformance Rule: This will generally be an OID of the form [Vendor OID].[Application Instance node].1.Suggested format: A branch, “.1” is appended to create a unique namespace for the Patient ID. |
 value | 1..1 | string | Example' General': 123456 Example' ???': 123456 Definition: The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments: If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. |
| identifier (JurisidictionalHealthNumber) | 0..1 | Shared Health Person Identifier | Definition: A technical identifier - identifies some entity uniquely and unambiguously. Comments: Binding: Shared Health Patient Jurisdictional Health Number Identifiers (required). Conformance Rule: This will be the OID representing the jurisdictional health number. Usage Note: If both a federal and provincial health number are available, provide the provincial health number. |
| extension | 0..* | Extension | Slice: Unordered, Open by value:url Definition: An Extension |
| extension (phn-version) | 0..1 | Patient PHN version | Definition: Indicates the version number associated with a provincial health numner |
| type | 1..1 | Shared Health CodeableConcept Code | Binding: SharedIdentifierType (extensible) Required Pattern: {"coding":[{"system":"http://hl7.org/fhir/v2/0203","code":"JHN"}]} Definition: A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. Comments: |
| coding | 0..* | Coding | Definition: A reference to a code defined by a terminology system. Comments: Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true. |
| system | 1..1 | uri | Definition: The identification of the code system that defines the meaning of the symbol in the code. Comments: The system will be a standard OID that can be found on the terminology gateway here: https://tgateway.infoway-inforoute.ca/html/singlesubset.html?id=2.16.840.1.113883.2.20.3.422&versionid=20170626 |
| code | 1..1 | 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). |
| text | 0..1 | string | Definition: A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Comments: Very often the text is the same as a displayName of one of the codings. |
| system | 1..1 | uri | Binding: SharedPatientJurisdictionalHealthIdentifierType (required) Example' General': http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri Definition: Establishes the namespace in which set of possible id values is unique. |
| value | 1..1 | string | Example' General': 123456 Example' ???': 123456 Definition: The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments: Conformance Rule: This is the human readable Patient Identifier from the sending system |
| name | 1..3 | Shared Health HumanName | Slice: Unordered, Open by value:use Definition: A human's name with the ability to identify parts and usage. Comments: Conformance Rule: There are explicit conformance rules defined to structure the name values. Please refer to Shared Health HumanName profile for these details. |
| name (LegalName) | 1..1 | Shared Health HumanName | Definition: A human's name with the ability to identify parts and usage. Comments: This data type is used to support both Practitioner names and Patient names. These name values are used for SAML validation (Practitioner) and eFax generation, and possibly patient matching algorithms. Conformance Rule: For the purpose of presentation, the data elements will be organized as Prefix + Given1 + Given2 + Family + Suffix. |
| use | 1..1 | code | Binding: SharedNameUse (required) Fixed Value: official Definition: Identifies the purpose for this name. Comments: Fixed value: official |
| family | 1..1 | string | 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. Comments: Conformance rule: Family is not to include professional designations |
| given | 1..2 | string | Definition: Given name. Comments: Conformance Rule: Given name(s) is not to include profession designations |
| prefix | 0..1 | string | 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. Comments: Conformance Rule: Prefix or Suffix must be used for Practitioner to represent the appropriate professional designation. |
| suffix | 0..1 | string | 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. Comments: Conformance Rule: Prefix or Suffix must be used for Practitioner to represent the appropriate professional designation. |
| telecom | 0..* | Shared Health ContactPoint | cpt-2: A system is required if a value is provided. Definition: Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc. Comments: Conformance Rule: There are explicit conformance rules defined to format the value. Please refer to Shared Health ContactPoint profile for these details. Conformance Rule: Only a value of 'phone' is supported for PrescribeIT™. The inclusion of email or fax information is prohibited. |
| gender | 1..1 | code | Binding: AdministrativeGender (required) Definition: Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes. Comments: Conformance Rule: Mandatory. Codes are from FHIR and system URL is http://hl7.org/fhir/administrative-gender Conformance Rule: Vendors must support a minimum set of codes.The gender may not match the biological sex as determined by genetics, or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than M and F, though the vast majority of systems and contexts only support M and F. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific gender aspect of interest (anatomical, chromosonal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosonal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overrideable error, not a hard error. |
| birthDate | 1..1 | date | Definition: The date of birth for the individual. Comments: Usage Note: It is expected that the real date of birth is known by the prescriber and pharmacy and that the full date of birth must be submitted. |
| address | 0..1 | Shared Health Address | Definition: An address expressed using postal conventions (as opposed to GPS or other location definition formats). This data type may be used to convey addresses for use in delivering mail as well as for visiting locations and which might not be valid for mail delivery. There are a variety of postal address formats defined around the world. Comments: Conformance Rule: There are explicit conformance rules defined to structure the address values. Please refer to Shared Health Address profile for these details. Conformance Rule: Patient address is optional, however, if it is available in the EMR, it MUST be provided, as complete as possible. Patient address will appear on the eFax. |
This structure is derived from Patient
Summary
Mandatory: 9 elements (2 nested mandatory elements)
Must-Support: 18 elements
Fixed Value: 1 element
Structures
This structure refers to these other structures:
- http://sharedhealth.exchange/fhir/StructureDefinition/dtprofile-identifier-person
- http://sharedhealth.exchange/fhir/StructureDefinition/dtprofile-codeableconcept-code
- http://sharedhealth.exchange/fhir/StructureDefinition/dtprofile-humanname
- http://sharedhealth.exchange/fhir/StructureDefinition/dtprofile-contactpoint
- http://sharedhealth.exchange/fhir/StructureDefinition/dtprofile-address
Extensions
This structure refers to these extensions:
Slices
This structure defines the following Slices:
- The element Patient.identifier is sliced based on the value of value:type
- The element Patient.name is sliced based on the value of value:use
This structure is derived from Patient
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
 Patient | S | 0..* | Information about an individual or animal receiving health care services | |
 id | SΣ | 1..1 | id | Logical id of this artifact |
 meta | Σ | 0..1 | Meta | Metadata about the resource |
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
| language | 0..1 | code | Language of the resource content Binding: http://tools.ietf.org/html/bcp47 (required) | |
| text | I | 0..1 | Narrative | Text summary of the resource, for human interpretation |
 contained | 0..* | Resource | Contained, inline Resources | |
 extension | 0..* | Extension | Additional Content defined by implementations | |
 modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
 identifier | SΣ | Identifier | Local medical record number Slice: Unordered, Open by value:type | |
| identifier | S | 1..1 | Shared Health Person Identifier | An identifier intended for computation |
| id | 0..1 | id | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| use | ?!Σ | 0..1 | code | usual | official | temp | secondary (If known) Binding: IdentifierUse (required) |
| type | S | 1..1 | Shared Health CodeableConcept Code | Concept - reference to a terminology or just text Binding: SharedIdentifierType (extensible) Required Pattern: {"coding":[{"system":"http://hl7.org/fhir/v2/0203","code":"MR"}]} |
| id | 0..1 | id | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| coding | SΣ | 0..* | Coding | Code defined by a terminology system |
| id | 0..1 | id | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| system | SΣ | 1..1 | uri | Identity of the terminology system |
| version | Σ | 0..1 | string | Version of the system - if relevant |
| code | SΣ | 1..1 | code | Symbol in syntax defined by the system |
| display | Σ | 0..1 | string | Representation defined by the system |
| userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user |
| text | SΣ | 0..1 | string | Plain text representation of the concept |
| system | SΣ | 1..1 | uri | The namespace for the identifier Example General': http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri |
| value | SΣ | 1..1 | string | The value that is unique Example General': 123456 Example ???': 123456 |
| period | Σ | 0..1 | Period | Time period when id is/was valid for use |
 assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) |
| identifier | S | 0..1 | Shared Health Person Identifier | An identifier intended for computation |
| id | 0..1 | id | xml:id (or equivalent in JSON) | |
| extension | S | 0..* | Extension | Extension Slice: Unordered, Open by value:url |
| ext-patient-phn-version | S | 0..1 | string | Patient PHN version URL: http://sharedhealth.exchange/fhir/StructureDefinition/ext-patient-phn-version |
| use | ?!Σ | 0..1 | code | usual | official | temp | secondary (If known) Binding: IdentifierUse (required) |
| type | S | 1..1 | Shared Health CodeableConcept Code | Concept - reference to a terminology or just text Binding: SharedIdentifierType (extensible) Required Pattern: {"coding":[{"system":"http://hl7.org/fhir/v2/0203","code":"JHN"}]} |
| id | 0..1 | id | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| coding | SΣ | 0..* | Coding | Code defined by a terminology system |
| id | 0..1 | id | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| system | SΣ | 1..1 | uri | Identity of the terminology system |
| version | Σ | 0..1 | string | Version of the system - if relevant |
| code | SΣ | 1..1 | code | Symbol in syntax defined by the system |
| display | Σ | 0..1 | string | Representation defined by the system |
| userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user |
| text | SΣ | 0..1 | string | Plain text representation of the concept |
| system | SΣ | 1..1 | uri | The namespace for the identifier Binding: SharedPatientJurisdictionalHealthIdentifierType (required) Example General': http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri |
| value | SΣ | 1..1 | string | The value that is unique Example General': 123456 Example ???': 123456 |
| period | Σ | 0..1 | Period | Time period when id is/was valid for use |
| assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) |
| active | ?!Σ | 0..1 | boolean | Whether this patient's record is in active use |
| name | SΣ | Shared Health HumanName | Name of a human - parts and usage Slice: Unordered, Open by value:use | |
| name | S | 1..1 | Shared Health HumanName | Name of a human - parts and usage |
| id | 0..1 | id | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| use | ?!SΣ | 1..1 | code | Legal name Binding: SharedNameUse (required) Fixed Value: official |
| text | Σ | 0..1 | string | Text representation of the full name |
| family | SΣ | 1..1 | string | Family name (often called 'Surname') |
| given | SΣ | 1..2 | string | Given names (not always 'first'). Includes middle names |
| prefix | SΣ | 0..1 | string | Parts that come before the name |
| suffix | SΣ | 0..1 | string | Parts that come after the name |
| period | Σ | 0..1 | Period | Time period when name was/is in use |
| telecom | SI | 0..* | Shared Health ContactPoint | Details of a Technology mediated contact point (phone, fax, email, etc.) |
| gender | SΣ | 1..1 | code | male | female | other | unknown Binding: AdministrativeGender (required) |
| birthDate | SΣ | 1..1 | date | The date of birth for the individual |
 deceased[x] | ?!Σ | 0..1 | boolean, dateTime | Indicates if the individual is deceased or not |
| address | S | 0..1 | Shared Health Address | An address expressed using postal conventions (as opposed to GPS or other location definition formats) |
| maritalStatus | 0..1 | CodeableConcept | Marital (civil) status of a patient Binding: Marital Status Codes (required) | |
| multipleBirth[x] | 0..1 | boolean, integer | Whether patient is part of a multiple birth | |
| photo | 0..* | Attachment | Image of the patient | |
| contact | I | 0..* | BackboneElement | A contact party (e.g. guardian, partner, friend) for the patient pat-1: SHALL at least contain a contact's details or a reference to an organization |
| id | 0..1 | id | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored |
| relationship | 0..* | CodeableConcept | The kind of relationship Binding: PatientContactRelationship (extensible) | |
| name | 0..1 | HumanName | A name associated with the contact person | |
| telecom | 0..* | ContactPoint | A contact detail for the person | |
| address | 0..1 | Address | Address for the contact person | |
| gender | 0..1 | code | male | female | other | unknown Binding: AdministrativeGender (required) | |
| organization | I | 0..1 | Reference(Organization) | Organization that is associated with the contact |
| period | 0..1 | Period | The period during which this contact person or organization is valid to be contacted relating to this patient | |
| animal | ?!Σ | 0..1 | BackboneElement | This patient is known to be an animal (non-human) |
| id | 0..1 | id | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored |
| species | Σ | 1..1 | CodeableConcept | E.g. Dog, Cow Binding: AnimalSpecies (example) |
| breed | Σ | 0..1 | CodeableConcept | E.g. Poodle, Angus Binding: AnimalBreeds (example) |
| genderStatus | Σ | 0..1 | CodeableConcept | E.g. Neutered, Intact Binding: GenderStatus (example) |
| communication | 0..* | BackboneElement | A list of Languages which may be used to communicate with the patient about his or her health | |
| id | 0..1 | id | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored |
| language | 1..1 | CodeableConcept | The language which can be used to communicate with the patient about his or her health Binding: http://tools.ietf.org/html/bcp47 (required) | |
| preferred | 0..1 | boolean | Language preference indicator | |
| careProvider | 0..* | Reference(Organization | Practitioner) | Patient's nominated primary care provider | |
| managingOrganization | Σ | 0..1 | Reference(Organization) | Organization that is the custodian of the patient record |
| link | ?! | 0..* | BackboneElement | Link to another patient resource that concerns the same actual person |
 id | 0..1 | id | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored |
| other | ?! | 1..1 | Reference(Patient) | The other patient resource that the link refers to |
| type | ?! | 1..1 | code | replace | refer | seealso - type of link Binding: LinkType (required) |
| Documentation for this format | ||||
Grid View
This structure is derived from Patient
| Name | Card. | Type | Constraints and Usage |
|---|---|---|---|
| Patient | 0..* | Definition: Demographics and other administrative information about an individual or animal receiving care or other health-related services. Comments: Patient will contain two identifiers. One will represent the creator's local identifier and the second will be the jurisdication health number. | |
| id | 1..1 | id | Definition: The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments: Conformance Rule: This will usually be a GUID and is assigned by the sending application. It should ideally be the same in all messages referring to the same patient record. |
| identifier | 1..2 | Identifier | Slice: Unordered, Open by value:type Definition: The identifier for the patient as known to the sending application. Comments: Conformance Rule: Sender local patient identifier MAY be stored by the receiving application and used for linking Conformance Rule: This must follow the OID format: [Vendor].[ApplicationInstance].1. The branch, “.1” is appended to create a unique namespace for the Patient Identifer Conformance Rule: Location EMR/PMS Patient ID: EMR's and PMS MUST include the local patient ID in the message. This will require an identifier system issued by the EMR and PMS by Application Instance ID. Usage Note: This MUST be stored by PMS/EMR and echoed back in subsequent messages (e.g. eRAR, discontinue, refuse to fill) that relate to this patient. This is intended to provide assistance in automation for PMS/EMR who receive this information, however each vendor can determine the level of automation that is appropriate for them. If an EMR chooses to use the PMS Patient ID (or conversely, the PMS uses the EMR ID) for automatic linking, they should also validate using other demographic data provided in the message as a precaution. |
| identifier (SenderPatientIdentifier) | 1..1 | Shared Health Person Identifier | Definition: A technical identifier - identifies some entity uniquely and unambiguously. Comments: Conformance Rule: Sender local patient identifier MAY be stored by the receiving application and used for linking Conformance Rule: Location EMR/PMS Patient ID: EMR's and PMS MUST include the local patient ID in the message. This will require an identifier system issued by the EMR and PMS by Application Instance ID. Usage Notes: This MUST be stored by PMS/EMR and echoed back in subsequent messages (e.g. eRAR, discontinue, refuse to fill) that relate to this patient. This is intended to provide assistance in automation for PMS/EMR who receive this information, however each vendor can determine the level of automation that is appropriate for them. If an EMR chooses to use the PMS Patient ID (or conversely, the PMS uses the EMR ID) for automatic linking, they should also validate using other demographic data provided in the message as a precaution. When prescribing narcotics and controlled substances in Ontario, only the Jurisdictional Health Card number (of those allowed by Ontario regulation) can be conveyed as part of the Patient Resource. If a prescriber wishes to include another type of identification, this can be conveyed using the Prescriber Instructions. In future, the full set of identifier types will be supported within the messaging standard. For MedDialog, this identifier MUST be stored and echoed back in all subsequent communications (replies/forwards) within a given Thread. |
| type | 1..1 | Shared Health CodeableConcept Code | Binding: SharedIdentifierType (extensible) Required Pattern: {"coding":[{"system":"http://hl7.org/fhir/v2/0203","code":"MR"}]} Definition: A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. Comments: See children for fixed values. |
| coding | 0..* | Coding | Definition: A reference to a code defined by a terminology system. Comments: Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true. |
| system | 1..1 | uri | Definition: The identification of the code system that defines the meaning of the symbol in the code. Comments: The system will be a standard OID that can be found on the terminology gateway here: https://tgateway.infoway-inforoute.ca/html/singlesubset.html?id=2.16.840.1.113883.2.20.3.422&versionid=20170626 |
| code | 1..1 | 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). |
| text | 0..1 | string | Definition: A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Comments: Very often the text is the same as a displayName of one of the codings. |
| system | 1..1 | uri | Example' General': http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri Definition: Establishes the namespace in which set of possible id values is unique. Comments: Conformance Rule: This will generally be an OID of the form [Vendor OID].[Application Instance node].1.Suggested format: A branch, “.1” is appended to create a unique namespace for the Patient ID. |
| value | 1..1 | string | Example' General': 123456 Example' ???': 123456 Definition: The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments: If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. |
| identifier (JurisidictionalHealthNumber) | 0..1 | Shared Health Person Identifier | Definition: A technical identifier - identifies some entity uniquely and unambiguously. Comments: Binding: Shared Health Patient Jurisdictional Health Number Identifiers (required). Conformance Rule: This will be the OID representing the jurisdictional health number. Usage Note: If both a federal and provincial health number are available, provide the provincial health number. |
| extension | 0..* | Extension | Slice: Unordered, Open by value:url Definition: An Extension |
| extension (phn-version) | 0..1 | Patient PHN version | Definition: Indicates the version number associated with a provincial health numner |
| type | 1..1 | Shared Health CodeableConcept Code | Binding: SharedIdentifierType (extensible) Required Pattern: {"coding":[{"system":"http://hl7.org/fhir/v2/0203","code":"JHN"}]} Definition: A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. Comments: |
| coding | 0..* | Coding | Definition: A reference to a code defined by a terminology system. Comments: Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true. |
| system | 1..1 | uri | Definition: The identification of the code system that defines the meaning of the symbol in the code. Comments: The system will be a standard OID that can be found on the terminology gateway here: https://tgateway.infoway-inforoute.ca/html/singlesubset.html?id=2.16.840.1.113883.2.20.3.422&versionid=20170626 |
| code | 1..1 | 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). |
| text | 0..1 | string | Definition: A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Comments: Very often the text is the same as a displayName of one of the codings. |
| system | 1..1 | uri | Binding: SharedPatientJurisdictionalHealthIdentifierType (required) Example' General': http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri Definition: Establishes the namespace in which set of possible id values is unique. |
| value | 1..1 | string | Example' General': 123456 Example' ???': 123456 Definition: The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments: Conformance Rule: This is the human readable Patient Identifier from the sending system |
| name | 1..3 | Shared Health HumanName | Slice: Unordered, Open by value:use Definition: A human's name with the ability to identify parts and usage. Comments: Conformance Rule: There are explicit conformance rules defined to structure the name values. Please refer to Shared Health HumanName profile for these details. |
| name (LegalName) | 1..1 | Shared Health HumanName | Definition: A human's name with the ability to identify parts and usage. Comments: This data type is used to support both Practitioner names and Patient names. These name values are used for SAML validation (Practitioner) and eFax generation, and possibly patient matching algorithms. Conformance Rule: For the purpose of presentation, the data elements will be organized as Prefix + Given1 + Given2 + Family + Suffix. |
| use | 1..1 | code | Binding: SharedNameUse (required) Fixed Value: official Definition: Identifies the purpose for this name. Comments: Fixed value: official |
| family | 1..1 | string | 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. Comments: Conformance rule: Family is not to include professional designations |
| given | 1..2 | string | Definition: Given name. Comments: Conformance Rule: Given name(s) is not to include profession designations |
| prefix | 0..1 | string | 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. Comments: Conformance Rule: Prefix or Suffix must be used for Practitioner to represent the appropriate professional designation. |
| suffix | 0..1 | string | 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. Comments: Conformance Rule: Prefix or Suffix must be used for Practitioner to represent the appropriate professional designation. |
| telecom | 0..* | Shared Health ContactPoint | cpt-2: A system is required if a value is provided. Definition: Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc. Comments: Conformance Rule: There are explicit conformance rules defined to format the value. Please refer to Shared Health ContactPoint profile for these details. Conformance Rule: Only a value of 'phone' is supported for PrescribeIT™. The inclusion of email or fax information is prohibited. |
| gender | 1..1 | code | Binding: AdministrativeGender (required) Definition: Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes. Comments: Conformance Rule: Mandatory. Codes are from FHIR and system URL is http://hl7.org/fhir/administrative-gender Conformance Rule: Vendors must support a minimum set of codes.The gender may not match the biological sex as determined by genetics, or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than M and F, though the vast majority of systems and contexts only support M and F. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific gender aspect of interest (anatomical, chromosonal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosonal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overrideable error, not a hard error. |
| birthDate | 1..1 | date | Definition: The date of birth for the individual. Comments: Usage Note: It is expected that the real date of birth is known by the prescriber and pharmacy and that the full date of birth must be submitted. |
| address | 0..1 | Shared Health Address | Definition: An address expressed using postal conventions (as opposed to GPS or other location definition formats). This data type may be used to convey addresses for use in delivering mail as well as for visiting locations and which might not be valid for mail delivery. There are a variety of postal address formats defined around the world. Comments: Conformance Rule: There are explicit conformance rules defined to structure the address values. Please refer to Shared Health Address profile for these details. Conformance Rule: Patient address is optional, however, if it is available in the EMR, it MUST be provided, as complete as possible. Patient address will appear on the eFax. |
This structure is derived from Patient
Summary
Mandatory: 9 elements (2 nested mandatory elements)
Must-Support: 18 elements
Fixed Value: 1 element
Structures
This structure refers to these other structures:
- http://sharedhealth.exchange/fhir/StructureDefinition/dtprofile-identifier-person
- http://sharedhealth.exchange/fhir/StructureDefinition/dtprofile-codeableconcept-code
- http://sharedhealth.exchange/fhir/StructureDefinition/dtprofile-humanname
- http://sharedhealth.exchange/fhir/StructureDefinition/dtprofile-contactpoint
- http://sharedhealth.exchange/fhir/StructureDefinition/dtprofile-address
Extensions
This structure refers to these extensions:
Slices
This structure defines the following Slices:
- The element Patient.identifier is sliced based on the value of value:type
- The element Patient.name is sliced based on the value of value:use
Differential View
This structure is derived from Patient
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Patient | S | 0..* | Information about an individual or animal receiving health care services | |
| id | SΣ | 1..1 | id | Logical id of this artifact |
| meta | Σ | 0..1 | Meta | Metadata about the resource |
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
| language | 0..1 | code | Language of the resource content Binding: http://tools.ietf.org/html/bcp47 (required) | |
| text | I | 0..1 | Narrative | Text summary of the resource, for human interpretation |
| contained | 0..* | Resource | Contained, inline Resources | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
| identifier | SΣ | Identifier | Local medical record number Slice: Unordered, Open by value:type | |
| identifier | S | 1..1 | Shared Health Person Identifier | An identifier intended for computation |
| id | 0..1 | id | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| use | ?!Σ | 0..1 | code | usual | official | temp | secondary (If known) Binding: IdentifierUse (required) |
| type | S | 1..1 | Shared Health CodeableConcept Code | Concept - reference to a terminology or just text Binding: SharedIdentifierType (extensible) Required Pattern: {"coding":[{"system":"http://hl7.org/fhir/v2/0203","code":"MR"}]} |
| id | 0..1 | id | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| coding | SΣ | 0..* | Coding | Code defined by a terminology system |
| id | 0..1 | id | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| system | SΣ | 1..1 | uri | Identity of the terminology system |
| version | Σ | 0..1 | string | Version of the system - if relevant |
| code | SΣ | 1..1 | code | Symbol in syntax defined by the system |
| display | Σ | 0..1 | string | Representation defined by the system |
| userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user |
| text | SΣ | 0..1 | string | Plain text representation of the concept |
| system | SΣ | 1..1 | uri | The namespace for the identifier Example General': http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri |
| value | SΣ | 1..1 | string | The value that is unique Example General': 123456 Example ???': 123456 |
| period | Σ | 0..1 | Period | Time period when id is/was valid for use |
| assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) |
| identifier | S | 0..1 | Shared Health Person Identifier | An identifier intended for computation |
| id | 0..1 | id | xml:id (or equivalent in JSON) | |
| extension | S | 0..* | Extension | Extension Slice: Unordered, Open by value:url |
| ext-patient-phn-version | S | 0..1 | string | Patient PHN version URL: http://sharedhealth.exchange/fhir/StructureDefinition/ext-patient-phn-version |
| use | ?!Σ | 0..1 | code | usual | official | temp | secondary (If known) Binding: IdentifierUse (required) |
| type | S | 1..1 | Shared Health CodeableConcept Code | Concept - reference to a terminology or just text Binding: SharedIdentifierType (extensible) Required Pattern: {"coding":[{"system":"http://hl7.org/fhir/v2/0203","code":"JHN"}]} |
| id | 0..1 | id | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| coding | SΣ | 0..* | Coding | Code defined by a terminology system |
| id | 0..1 | id | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| system | SΣ | 1..1 | uri | Identity of the terminology system |
| version | Σ | 0..1 | string | Version of the system - if relevant |
| code | SΣ | 1..1 | code | Symbol in syntax defined by the system |
| display | Σ | 0..1 | string | Representation defined by the system |
| userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user |
| text | SΣ | 0..1 | string | Plain text representation of the concept |
| system | SΣ | 1..1 | uri | The namespace for the identifier Binding: SharedPatientJurisdictionalHealthIdentifierType (required) Example General': http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri |
| value | SΣ | 1..1 | string | The value that is unique Example General': 123456 Example ???': 123456 |
| period | Σ | 0..1 | Period | Time period when id is/was valid for use |
| assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) |
| active | ?!Σ | 0..1 | boolean | Whether this patient's record is in active use |
| name | SΣ | Shared Health HumanName | Name of a human - parts and usage Slice: Unordered, Open by value:use | |
| name | S | 1..1 | Shared Health HumanName | Name of a human - parts and usage |
| id | 0..1 | id | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| use | ?!SΣ | 1..1 | code | Legal name Binding: SharedNameUse (required) Fixed Value: official |
| text | Σ | 0..1 | string | Text representation of the full name |
| family | SΣ | 1..1 | string | Family name (often called 'Surname') |
| given | SΣ | 1..2 | string | Given names (not always 'first'). Includes middle names |
| prefix | SΣ | 0..1 | string | Parts that come before the name |
| suffix | SΣ | 0..1 | string | Parts that come after the name |
| period | Σ | 0..1 | Period | Time period when name was/is in use |
| telecom | SI | 0..* | Shared Health ContactPoint | Details of a Technology mediated contact point (phone, fax, email, etc.) |
| gender | SΣ | 1..1 | code | male | female | other | unknown Binding: AdministrativeGender (required) |
| birthDate | SΣ | 1..1 | date | The date of birth for the individual |
| deceased[x] | ?!Σ | 0..1 | boolean, dateTime | Indicates if the individual is deceased or not |
| address | S | 0..1 | Shared Health Address | An address expressed using postal conventions (as opposed to GPS or other location definition formats) |
| maritalStatus | 0..1 | CodeableConcept | Marital (civil) status of a patient Binding: Marital Status Codes (required) | |
| multipleBirth[x] | 0..1 | boolean, integer | Whether patient is part of a multiple birth | |
| photo | 0..* | Attachment | Image of the patient | |
| contact | I | 0..* | BackboneElement | A contact party (e.g. guardian, partner, friend) for the patient pat-1: SHALL at least contain a contact's details or a reference to an organization |
| id | 0..1 | id | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored |
| relationship | 0..* | CodeableConcept | The kind of relationship Binding: PatientContactRelationship (extensible) | |
| name | 0..1 | HumanName | A name associated with the contact person | |
| telecom | 0..* | ContactPoint | A contact detail for the person | |
| address | 0..1 | Address | Address for the contact person | |
| gender | 0..1 | code | male | female | other | unknown Binding: AdministrativeGender (required) | |
| organization | I | 0..1 | Reference(Organization) | Organization that is associated with the contact |
| period | 0..1 | Period | The period during which this contact person or organization is valid to be contacted relating to this patient | |
| animal | ?!Σ | 0..1 | BackboneElement | This patient is known to be an animal (non-human) |
| id | 0..1 | id | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored |
| species | Σ | 1..1 | CodeableConcept | E.g. Dog, Cow Binding: AnimalSpecies (example) |
| breed | Σ | 0..1 | CodeableConcept | E.g. Poodle, Angus Binding: AnimalBreeds (example) |
| genderStatus | Σ | 0..1 | CodeableConcept | E.g. Neutered, Intact Binding: GenderStatus (example) |
| communication | 0..* | BackboneElement | A list of Languages which may be used to communicate with the patient about his or her health | |
| id | 0..1 | id | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored |
| language | 1..1 | CodeableConcept | The language which can be used to communicate with the patient about his or her health Binding: http://tools.ietf.org/html/bcp47 (required) | |
| preferred | 0..1 | boolean | Language preference indicator | |
| careProvider | 0..* | Reference(Organization | Practitioner) | Patient's nominated primary care provider | |
| managingOrganization | Σ | 0..1 | Reference(Organization) | Organization that is the custodian of the patient record |
| link | ?! | 0..* | BackboneElement | Link to another patient resource that concerns the same actual person |
| id | 0..1 | id | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored |
| other | ?! | 1..1 | Reference(Patient) | The other patient resource that the link refers to |
| type | ?! | 1..1 | code | replace | refer | seealso - type of link Binding: LinkType (required) |
| Documentation for this format | ||||
Other representations of profile: Schematron
3.48.3 Terminology Bindings
Terminology Bindings
| Path | Name | Conformance | ValueSet |
| Patient.language | ?ext | required | http://tools.ietf.org/html/bcp47 |
| Patient.identifier.use | IdentifierUse | required | IdentifierUse |
| Patient.identifier.type | SharedIdentifierType | extensible | SharedIdentifierType |
| Patient.identifier.use | IdentifierUse | required | IdentifierUse |
| Patient.identifier.type | SharedIdentifierType | extensible | SharedIdentifierType |
| Patient.identifier.system | SharedPatientJurisdictionalHealthIdentifierType | required | SharedPatientJurisdictionalHealthIdentifierType |
| Patient.name.use | SharedNameUse | required | SharedNameUse |
| Patient.gender | AdministrativeGender | required | AdministrativeGender |
| Patient.maritalStatus | Marital Status Codes | required | Marital Status Codes |
| Patient.contact.relationship | PatientContactRelationship | extensible | PatientContactRelationship |
| Patient.contact.gender | AdministrativeGender | required | AdministrativeGender |
| Patient.animal.species | AnimalSpecies | example | AnimalSpecies |
| Patient.animal.breed | AnimalBreeds | example | AnimalBreeds |
| Patient.animal.genderStatus | GenderStatus | example | GenderStatus |
| Patient.communication.language | ?ext | required | http://tools.ietf.org/html/bcp47 |
| Patient.link.type | LinkType | required | LinkType |
3.48.4 Constraints
Constraints
| Id | Path | Details | Requirements |
| cpt-2 | Patient.telecom | A system is required if a value is provided. : value.empty() or system.exists() | |
| pat-1 | Patient.contact | 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() |