Shared Health Specification and Guide Version 5.0

 

The official URL for this profile is:

http://sharedhealth.exchange/fhir/StructureDefinition/profile-patient

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Description of Profiles, Differentials, Snapshots and how the different presentations work.

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This structure is derived from Patient

NameCard.TypeConstraints and Usage
.  Patient 0..*PatientDefinition:
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..1idDefinition:
The logical id of the resource, as used in the URL for the resource.


Comments:
Usage Note: This will usually be a GUID and is assigned by the sending application.

..  identifier 1..2IdentifierSlice: Unordered, Open by value:type.coding.code, value:type.coding.system
Definition:
The identifier for the patient as known to the sending application.

..  identifier
     (senderPatientIdentifier)
1..1Shared Health Person IdentifierDefinition:
A technical identifier - identifies some entity uniquely and unambiguously.


Comments:
Conformance Rule: Patient.identifier(senderPatientIdentifier) 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. Renewal Request, 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.

...  type 1..1Shared Health CodeableConcept CodeBinding: SharedIdentifierType (20190415) (extensible)
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 1..1CodingDefinition:
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..1uriFixed Value: http://hl7.org/fhir/v2/0203
Definition:
The identification of the code system that defines the meaning of the symbol in the code.


Comments:
Fixed value: http://hl7.org/fhir/v2/0203

.....  code 1..1codeFixed Value: MR
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).


Comments:
Fixed value: MR

....  text 0..1stringDefinition:
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..1urisenderPatientIdentifier-branch-1: This must be an OID ending in .1
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 must be an OID of the form [Vendor OID].[Application Instance node].1 expressed as a uri (e.g. urn:oid:1.2.3.4). A branch, “.1” is appended to create a unique namespace for the Patient ID.

...  value 1..1stringExample' 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
     (jurisdictionalHealthNumber)
0..1Shared Health Person IdentifierDefinition:
A technical identifier - identifies some entity uniquely and unambiguously.


Comments:
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..*ExtensionSlice: Unordered, Open by value:url
Definition:
An Extension

...  extension
       (phn-version)
0..1Patient PHN versionDefinition:
Indicates the version number associated with a provincial health numner

...  type 1..1Shared Health CodeableConcept CodeBinding: SharedIdentifierType (20190415) (extensible)
Definition:
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.


Comments:


....  coding 1..1CodingDefinition:
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..1uriFixed Value: http://hl7.org/fhir/v2/0203
Definition:
The identification of the code system that defines the meaning of the symbol in the code.


Comments:
Fixed value: http://hl7.org/fhir/v2/0203

.....  code 1..1codeFixed Value: JHN
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).


Comments:
Fixed value: JHN

....  text 0..1stringDefinition:
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..1uriBinding: 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..1stringExample' 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..3Shared Health HumanNameSlice: 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 in Shared Health HumanName profile.

..  name
     (legalName)
1..1Shared Health HumanNameDefinition:
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..1codeBinding: SharedNameUse (20190415) (required)
Fixed Value: official
Definition:
Identifies the purpose for this name.


Comments:
Fixed value: official

...  family 1..1stringDefinition:
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..2stringDefinition:
Given name.


Comments:
Conformance Rule: Given name(s) is not to include profession designations

...  prefix 0..1stringDefinition:
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..1stringDefinition:
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 ContactPointcpt-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..1codeBinding: Gender (20190415) (required)
Definition:
Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes.


Comments:
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..1dateDefinition:
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..1Shared Health AddressDefinition:
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: 12 elements (5 nested mandatory elements)
Must-Support: 24 elements
Fixed Value: 5 elements

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element Patient.identifier is sliced based on the values of value:type.coding.code, value:type.coding.system
  • The element Patient.name is sliced based on the value of value:use

This structure is derived from Patient

NameFlagsCard.TypeDescription & Constraintsdoco
.. Patient S0..*PatientInformation about an individual or animal receiving health care services
... id S1..1idLogical id of this artifact
... identifier S1..2(Slice Definition)Local medical record number
Slice: Unordered, Open by value:type.coding.code, value:type.coding.system
.... identifier:senderPatientIdentifier S1..1Shared Health Person IdentifierAn identifier intended for computation
..... type S1..1Shared Health CodeableConcept CodeConcept - reference to a terminology or just text
...... coding S1..1CodingCode defined by a terminology system
....... system S1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/v2/0203
....... code S1..1codeSymbol in syntax defined by the system
Fixed Value: MR
..... system SI1..1uriThe namespace for the identifier
senderPatientIdentifier-branch-1: This must be an OID ending in .1
.... identifier:jurisdictionalHealthNumber S0..1Shared Health Person IdentifierAn identifier intended for computation
..... extension S0..*ExtensionExtension
Slice: Unordered, Open by value:url
..... ext-patient-phn-version S0..1stringPatient PHN version
URL: http://sharedhealth.exchange/fhir/StructureDefinition/ext-patient-phn-version
..... type S1..1Shared Health CodeableConcept CodeConcept - reference to a terminology or just text
...... coding S1..1CodingCode defined by a terminology system
....... system S1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/v2/0203
....... code S1..1codeSymbol in syntax defined by the system
Fixed Value: JHN
..... system S1..1uriThe namespace for the identifier
Binding: SharedPatientJurisdictionalHealthIdentifierType (required)
..... value S1..1stringThe value that is unique
... name S1..3(Slice Definition)Name of a human - parts and usage
Slice: Unordered, Open by value:use
.... name:legalName S1..1Shared Health HumanNameName of a human - parts and usage
..... use S1..1codeLegal name
Fixed Value: official
... telecom S0..*Shared Health ContactPointDetails of a Technology mediated contact point (phone, fax, email, etc.)
... gender S1..1codemale | female | other | unknown
Binding: Gender (20190415) (required)
... birthDate S1..1dateThe date of birth for the individual
... address S0..1Shared Health AddressAn address expressed using postal conventions (as opposed to GPS or other location definition formats)

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Patient S0..*PatientInformation about an individual or animal receiving health care services
... id SΣ1..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: http://tools.ietf.org/html/bcp47 (required): A human language.


... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional Content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier SΣ1..2(Slice Definition)Local medical record number
Slice: Unordered, Open by value:type.coding.code, value:type.coding.system
.... identifier:senderPatientIdentifier S1..1Shared Health Person IdentifierAn identifier intended for computation
..... id 0..1idxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
..... use ?!Σ0..1codeusual | official | temp | secondary (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... type S1..1Shared Health CodeableConcept CodeConcept - reference to a terminology or just text
Binding: SharedIdentifierType (20190415) (extensible)
...... id 0..1idxml:id (or equivalent in JSON)
...... extension 0..*ExtensionAdditional Content defined by implementations
...... coding SΣ1..1CodingCode defined by a terminology system
....... id 0..1idxml:id (or equivalent in JSON)
....... extension 0..*ExtensionAdditional Content defined by implementations
....... system SΣ1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/v2/0203
....... version Σ0..1stringVersion of the system - if relevant
....... code SΣ1..1codeSymbol in syntax defined by the system
Fixed Value: MR
....... display Σ0..1stringRepresentation defined by the system
....... userSelected Σ0..1booleanIf this coding was chosen directly by the user
...... text SΣ0..1stringPlain text representation of the concept
..... system SΣI1..1uriThe namespace for the identifier
senderPatientIdentifier-branch-1: This must be an OID ending in .1
Example General: http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri
..... value SΣ1..1stringThe value that is unique
Example General: 123456
Example ???: 123456
..... period Σ0..1PeriodTime period when id is/was valid for use
..... assigner Σ0..1Reference(Organization)Organization that issued id (may be just text)
.... identifier:jurisdictionalHealthNumber S0..1Shared Health Person IdentifierAn identifier intended for computation
..... id 0..1idxml:id (or equivalent in JSON)
..... extension S0..*ExtensionExtension
Slice: Unordered, Open by value:url
..... ext-patient-phn-version S0..1stringPatient PHN version
URL: http://sharedhealth.exchange/fhir/StructureDefinition/ext-patient-phn-version
..... use ?!Σ0..1codeusual | official | temp | secondary (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... type S1..1Shared Health CodeableConcept CodeConcept - reference to a terminology or just text
Binding: SharedIdentifierType (20190415) (extensible)
...... id 0..1idxml:id (or equivalent in JSON)
...... extension 0..*ExtensionAdditional Content defined by implementations
...... coding SΣ1..1CodingCode defined by a terminology system
....... id 0..1idxml:id (or equivalent in JSON)
....... extension 0..*ExtensionAdditional Content defined by implementations
....... system SΣ1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/v2/0203
....... version Σ0..1stringVersion of the system - if relevant
....... code SΣ1..1codeSymbol in syntax defined by the system
Fixed Value: JHN
....... display Σ0..1stringRepresentation defined by the system
....... userSelected Σ0..1booleanIf this coding was chosen directly by the user
...... text SΣ0..1stringPlain text representation of the concept
..... system SΣ1..1uriThe 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 SΣ1..1stringThe value that is unique
Example General: 123456
Example ???: 123456
..... period Σ0..1PeriodTime period when id is/was valid for use
..... assigner Σ0..1Reference(Organization)Organization that issued id (may be just text)
... active ?!Σ0..1booleanWhether this patient's record is in active use
... name SΣ1..3(Slice Definition)Name of a human - parts and usage
Slice: Unordered, Open by value:use
.... name:legalName S1..1Shared Health HumanNameName of a human - parts and usage
..... id 0..1idxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
..... use ?!SΣ1..1codeLegal name
Binding: SharedNameUse (20190415) (required)
Fixed Value: official
..... text Σ0..1stringText representation of the full name
..... family SΣ1..1stringFamily name (often called 'Surname')
..... given SΣ1..2stringGiven names (not always 'first'). Includes middle names
..... prefix SΣ0..1stringParts that come before the name
..... suffix SΣ0..1stringParts that come after the name
..... period Σ0..1PeriodTime period when name was/is in use
... telecom SI0..*Shared Health ContactPointDetails of a Technology mediated contact point (phone, fax, email, etc.)
... gender SΣ1..1codemale | female | other | unknown
Binding: Gender (20190415) (required)
... birthDate SΣ1..1dateThe date of birth for the individual
... deceased[x] ?!Σ0..1Indicates if the individual is deceased or not
.... deceasedBooleanboolean
.... deceasedDateTimedateTime
... address S0..1Shared Health AddressAn address expressed using postal conventions (as opposed to GPS or other location definition formats)
... maritalStatus 0..1CodeableConceptMarital (civil) status of a patient
Binding: Marital Status Codes (required): The domestic partnership status of a person.

... multipleBirth[x] 0..1Whether patient is part of a multiple birth
.... multipleBirthBooleanboolean
.... multipleBirthIntegerinteger
... photo 0..*AttachmentImage of the patient
... contact I0..*BackboneElementA 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..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... relationship 0..*CodeableConceptThe kind of relationship
Binding: PatientContactRelationship (extensible): The nature of the relationship between a patient and a contact person for that patient.


.... name 0..1HumanNameA name associated with the contact person
.... telecom 0..*ContactPointA contact detail for the person
.... address 0..1AddressAddress for the contact person
.... gender 0..1codemale | female | other | unknown
Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.

.... organization I0..1Reference(Organization)Organization that is associated with the contact
.... period 0..1PeriodThe period during which this contact person or organization is valid to be contacted relating to this patient
... animal ?!Σ0..1BackboneElementThis patient is known to be an animal (non-human)
.... id 0..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... species Σ1..1CodeableConceptE.g. Dog, Cow
Binding: AnimalSpecies (example): The species of an animal.

.... breed Σ0..1CodeableConceptE.g. Poodle, Angus
Binding: AnimalBreeds (example): The breed of an animal.

.... genderStatus Σ0..1CodeableConceptE.g. Neutered, Intact
Binding: GenderStatus (example): The state of the animal's reproductive organs.

... communication 0..*BackboneElementA list of Languages which may be used to communicate with the patient about his or her health
.... id 0..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... language 1..1CodeableConceptThe language which can be used to communicate with the patient about his or her health
Binding: http://tools.ietf.org/html/bcp47 (required): A human language.

.... preferred 0..1booleanLanguage preference indicator
... careProvider 0..*Reference(Organization | Practitioner)Patient's nominated primary care provider
... managingOrganization Σ0..1Reference(Organization)Organization that is the custodian of the patient record
... link ?!0..*BackboneElementLink to another patient resource that concerns the same actual person
.... id 0..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... other ?!1..1Reference(Patient)The other patient resource that the link refers to
.... type ?!1..1codereplace | refer | seealso - type of link
Binding: LinkType (required): The type of link between this patient resource and another patient resource.


doco Documentation for this format

Grid View

This structure is derived from Patient

NameCard.TypeConstraints and Usage
.  Patient 0..*PatientDefinition:
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..1idDefinition:
The logical id of the resource, as used in the URL for the resource.


Comments:
Usage Note: This will usually be a GUID and is assigned by the sending application.

..  identifier 1..2IdentifierSlice: Unordered, Open by value:type.coding.code, value:type.coding.system
Definition:
The identifier for the patient as known to the sending application.

..  identifier
     (senderPatientIdentifier)
1..1Shared Health Person IdentifierDefinition:
A technical identifier - identifies some entity uniquely and unambiguously.


Comments:
Conformance Rule: Patient.identifier(senderPatientIdentifier) 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. Renewal Request, 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.

...  type 1..1Shared Health CodeableConcept CodeBinding: SharedIdentifierType (20190415) (extensible)
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 1..1CodingDefinition:
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..1uriFixed Value: http://hl7.org/fhir/v2/0203
Definition:
The identification of the code system that defines the meaning of the symbol in the code.


Comments:
Fixed value: http://hl7.org/fhir/v2/0203

.....  code 1..1codeFixed Value: MR
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).


Comments:
Fixed value: MR

....  text 0..1stringDefinition:
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..1urisenderPatientIdentifier-branch-1: This must be an OID ending in .1
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 must be an OID of the form [Vendor OID].[Application Instance node].1 expressed as a uri (e.g. urn:oid:1.2.3.4). A branch, “.1” is appended to create a unique namespace for the Patient ID.

...  value 1..1stringExample' 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
     (jurisdictionalHealthNumber)
0..1Shared Health Person IdentifierDefinition:
A technical identifier - identifies some entity uniquely and unambiguously.


Comments:
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..*ExtensionSlice: Unordered, Open by value:url
Definition:
An Extension

...  extension
       (phn-version)
0..1Patient PHN versionDefinition:
Indicates the version number associated with a provincial health numner

...  type 1..1Shared Health CodeableConcept CodeBinding: SharedIdentifierType (20190415) (extensible)
Definition:
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.


Comments:


....  coding 1..1CodingDefinition:
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..1uriFixed Value: http://hl7.org/fhir/v2/0203
Definition:
The identification of the code system that defines the meaning of the symbol in the code.


Comments:
Fixed value: http://hl7.org/fhir/v2/0203

.....  code 1..1codeFixed Value: JHN
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).


Comments:
Fixed value: JHN

....  text 0..1stringDefinition:
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..1uriBinding: 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..1stringExample' 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..3Shared Health HumanNameSlice: 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 in Shared Health HumanName profile.

..  name
     (legalName)
1..1Shared Health HumanNameDefinition:
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..1codeBinding: SharedNameUse (20190415) (required)
Fixed Value: official
Definition:
Identifies the purpose for this name.


Comments:
Fixed value: official

...  family 1..1stringDefinition:
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..2stringDefinition:
Given name.


Comments:
Conformance Rule: Given name(s) is not to include profession designations

...  prefix 0..1stringDefinition:
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..1stringDefinition:
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 ContactPointcpt-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..1codeBinding: Gender (20190415) (required)
Definition:
Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes.


Comments:
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..1dateDefinition:
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..1Shared Health AddressDefinition:
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: 12 elements (5 nested mandatory elements)
Must-Support: 24 elements
Fixed Value: 5 elements

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element Patient.identifier is sliced based on the values of value:type.coding.code, value:type.coding.system
  • The element Patient.name is sliced based on the value of value:use

Differential View

This structure is derived from Patient

NameFlagsCard.TypeDescription & Constraintsdoco
.. Patient S0..*PatientInformation about an individual or animal receiving health care services
... id S1..1idLogical id of this artifact
... identifier S1..2(Slice Definition)Local medical record number
Slice: Unordered, Open by value:type.coding.code, value:type.coding.system
.... identifier:senderPatientIdentifier S1..1Shared Health Person IdentifierAn identifier intended for computation
..... type S1..1Shared Health CodeableConcept CodeConcept - reference to a terminology or just text
...... coding S1..1CodingCode defined by a terminology system
....... system S1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/v2/0203
....... code S1..1codeSymbol in syntax defined by the system
Fixed Value: MR
..... system SI1..1uriThe namespace for the identifier
senderPatientIdentifier-branch-1: This must be an OID ending in .1
.... identifier:jurisdictionalHealthNumber S0..1Shared Health Person IdentifierAn identifier intended for computation
..... extension S0..*ExtensionExtension
Slice: Unordered, Open by value:url
..... ext-patient-phn-version S0..1stringPatient PHN version
URL: http://sharedhealth.exchange/fhir/StructureDefinition/ext-patient-phn-version
..... type S1..1Shared Health CodeableConcept CodeConcept - reference to a terminology or just text
...... coding S1..1CodingCode defined by a terminology system
....... system S1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/v2/0203
....... code S1..1codeSymbol in syntax defined by the system
Fixed Value: JHN
..... system S1..1uriThe namespace for the identifier
Binding: SharedPatientJurisdictionalHealthIdentifierType (required)
..... value S1..1stringThe value that is unique
... name S1..3(Slice Definition)Name of a human - parts and usage
Slice: Unordered, Open by value:use
.... name:legalName S1..1Shared Health HumanNameName of a human - parts and usage
..... use S1..1codeLegal name
Fixed Value: official
... telecom S0..*Shared Health ContactPointDetails of a Technology mediated contact point (phone, fax, email, etc.)
... gender S1..1codemale | female | other | unknown
Binding: Gender (20190415) (required)
... birthDate S1..1dateThe date of birth for the individual
... address S0..1Shared Health AddressAn address expressed using postal conventions (as opposed to GPS or other location definition formats)

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Patient S0..*PatientInformation about an individual or animal receiving health care services
... id SΣ1..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: http://tools.ietf.org/html/bcp47 (required): A human language.


... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional Content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier SΣ1..2(Slice Definition)Local medical record number
Slice: Unordered, Open by value:type.coding.code, value:type.coding.system
.... identifier:senderPatientIdentifier S1..1Shared Health Person IdentifierAn identifier intended for computation
..... id 0..1idxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
..... use ?!Σ0..1codeusual | official | temp | secondary (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... type S1..1Shared Health CodeableConcept CodeConcept - reference to a terminology or just text
Binding: SharedIdentifierType (20190415) (extensible)
...... id 0..1idxml:id (or equivalent in JSON)
...... extension 0..*ExtensionAdditional Content defined by implementations
...... coding SΣ1..1CodingCode defined by a terminology system
....... id 0..1idxml:id (or equivalent in JSON)
....... extension 0..*ExtensionAdditional Content defined by implementations
....... system SΣ1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/v2/0203
....... version Σ0..1stringVersion of the system - if relevant
....... code SΣ1..1codeSymbol in syntax defined by the system
Fixed Value: MR
....... display Σ0..1stringRepresentation defined by the system
....... userSelected Σ0..1booleanIf this coding was chosen directly by the user
...... text SΣ0..1stringPlain text representation of the concept
..... system SΣI1..1uriThe namespace for the identifier
senderPatientIdentifier-branch-1: This must be an OID ending in .1
Example General: http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri
..... value SΣ1..1stringThe value that is unique
Example General: 123456
Example ???: 123456
..... period Σ0..1PeriodTime period when id is/was valid for use
..... assigner Σ0..1Reference(Organization)Organization that issued id (may be just text)
.... identifier:jurisdictionalHealthNumber S0..1Shared Health Person IdentifierAn identifier intended for computation
..... id 0..1idxml:id (or equivalent in JSON)
..... extension S0..*ExtensionExtension
Slice: Unordered, Open by value:url
..... ext-patient-phn-version S0..1stringPatient PHN version
URL: http://sharedhealth.exchange/fhir/StructureDefinition/ext-patient-phn-version
..... use ?!Σ0..1codeusual | official | temp | secondary (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... type S1..1Shared Health CodeableConcept CodeConcept - reference to a terminology or just text
Binding: SharedIdentifierType (20190415) (extensible)
...... id 0..1idxml:id (or equivalent in JSON)
...... extension 0..*ExtensionAdditional Content defined by implementations
...... coding SΣ1..1CodingCode defined by a terminology system
....... id 0..1idxml:id (or equivalent in JSON)
....... extension 0..*ExtensionAdditional Content defined by implementations
....... system SΣ1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/v2/0203
....... version Σ0..1stringVersion of the system - if relevant
....... code SΣ1..1codeSymbol in syntax defined by the system
Fixed Value: JHN
....... display Σ0..1stringRepresentation defined by the system
....... userSelected Σ0..1booleanIf this coding was chosen directly by the user
...... text SΣ0..1stringPlain text representation of the concept
..... system SΣ1..1uriThe 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 SΣ1..1stringThe value that is unique
Example General: 123456
Example ???: 123456
..... period Σ0..1PeriodTime period when id is/was valid for use
..... assigner Σ0..1Reference(Organization)Organization that issued id (may be just text)
... active ?!Σ0..1booleanWhether this patient's record is in active use
... name SΣ1..3(Slice Definition)Name of a human - parts and usage
Slice: Unordered, Open by value:use
.... name:legalName S1..1Shared Health HumanNameName of a human - parts and usage
..... id 0..1idxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
..... use ?!SΣ1..1codeLegal name
Binding: SharedNameUse (20190415) (required)
Fixed Value: official
..... text Σ0..1stringText representation of the full name
..... family SΣ1..1stringFamily name (often called 'Surname')
..... given SΣ1..2stringGiven names (not always 'first'). Includes middle names
..... prefix SΣ0..1stringParts that come before the name
..... suffix SΣ0..1stringParts that come after the name
..... period Σ0..1PeriodTime period when name was/is in use
... telecom SI0..*Shared Health ContactPointDetails of a Technology mediated contact point (phone, fax, email, etc.)
... gender SΣ1..1codemale | female | other | unknown
Binding: Gender (20190415) (required)
... birthDate SΣ1..1dateThe date of birth for the individual
... deceased[x] ?!Σ0..1Indicates if the individual is deceased or not
.... deceasedBooleanboolean
.... deceasedDateTimedateTime
... address S0..1Shared Health AddressAn address expressed using postal conventions (as opposed to GPS or other location definition formats)
... maritalStatus 0..1CodeableConceptMarital (civil) status of a patient
Binding: Marital Status Codes (required): The domestic partnership status of a person.

... multipleBirth[x] 0..1Whether patient is part of a multiple birth
.... multipleBirthBooleanboolean
.... multipleBirthIntegerinteger
... photo 0..*AttachmentImage of the patient
... contact I0..*BackboneElementA 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..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... relationship 0..*CodeableConceptThe kind of relationship
Binding: PatientContactRelationship (extensible): The nature of the relationship between a patient and a contact person for that patient.


.... name 0..1HumanNameA name associated with the contact person
.... telecom 0..*ContactPointA contact detail for the person
.... address 0..1AddressAddress for the contact person
.... gender 0..1codemale | female | other | unknown
Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.

.... organization I0..1Reference(Organization)Organization that is associated with the contact
.... period 0..1PeriodThe period during which this contact person or organization is valid to be contacted relating to this patient
... animal ?!Σ0..1BackboneElementThis patient is known to be an animal (non-human)
.... id 0..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... species Σ1..1CodeableConceptE.g. Dog, Cow
Binding: AnimalSpecies (example): The species of an animal.

.... breed Σ0..1CodeableConceptE.g. Poodle, Angus
Binding: AnimalBreeds (example): The breed of an animal.

.... genderStatus Σ0..1CodeableConceptE.g. Neutered, Intact
Binding: GenderStatus (example): The state of the animal's reproductive organs.

... communication 0..*BackboneElementA list of Languages which may be used to communicate with the patient about his or her health
.... id 0..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... language 1..1CodeableConceptThe language which can be used to communicate with the patient about his or her health
Binding: http://tools.ietf.org/html/bcp47 (required): A human language.

.... preferred 0..1booleanLanguage preference indicator
... careProvider 0..*Reference(Organization | Practitioner)Patient's nominated primary care provider
... managingOrganization Σ0..1Reference(Organization)Organization that is the custodian of the patient record
... link ?!0..*BackboneElementLink to another patient resource that concerns the same actual person
.... id 0..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... other ?!1..1Reference(Patient)The other patient resource that the link refers to
.... type ?!1..1codereplace | refer | seealso - type of link
Binding: LinkType (required): The type of link between this patient resource and another patient resource.


doco Documentation for this format

 

Other representations of profile: Schematron

Terminology Bindings

PathConformanceValueSet / Code
Patient.languagerequiredhttp://tools.ietf.org/html/bcp47
Patient.identifier:senderPatientIdentifier.userequiredIdentifierUse
Patient.identifier:senderPatientIdentifier.typeextensibleSharedIdentifierType
Patient.identifier:jurisdictionalHealthNumber.userequiredIdentifierUse
Patient.identifier:jurisdictionalHealthNumber.typeextensibleSharedIdentifierType
Patient.identifier:jurisdictionalHealthNumber.systemrequiredSharedPatientJurisdictionalHealthIdentifierType
Patient.name:legalName.userequiredFixed Value: official
Patient.genderrequiredGender
Patient.maritalStatusrequiredMarital Status Codes
Patient.contact.relationshipextensiblePatientContactRelationship
Patient.contact.genderrequiredAdministrativeGender
Patient.animal.speciesexampleAnimalSpecies
Patient.animal.breedexampleAnimalBreeds
Patient.animal.genderStatusexampleGenderStatus
Patient.communication.languagerequiredhttp://tools.ietf.org/html/bcp47
Patient.link.typerequiredLinkType

Constraints

IdPathDetailsRequirements
senderPatientIdentifier-branch-1Patient.identifier:senderPatientIdentifier.systemThis must be an OID ending in .1
: $this.matches('^urn\\:oid\\:(\\d+\\.)+1$')
cpt-2Patient.telecomA system is required if a value is provided.
: value.empty() or system.exists()
pat-1Patient.contactSHALL at least contain a contact's details or a reference to an organization
: name.exists() or telecom.exists() or address.exists() or organization.exists()