{
  "description": "Dieses Profil beschreibt die Nutzung von administrativen Patientendaten in ISiK-Szenarien.",
  "_filename": "StructureDefinition-ISiKPatient.json",
  "package_name": "de.gematik.isik-basismodul",
  "date": "2025-12-01",
  "derivation": "constraint",
  "publisher": "gematik GmbH",
  "fhirVersion": "4.0.1",
  "name": "ISiKPatient",
  "abstract": false,
  "type": "Patient",
  "experimental": "false",
  "resourceType": "StructureDefinition",
  "title": null,
  "package_version": "3.1.1",
  "status": "active",
  "id": "2c708bfd-a609-4672-93a0-1291757931ab",
  "kind": "resource",
  "url": "https://gematik.de/fhir/isik/v3/Basismodul/StructureDefinition/ISiKPatient",
  "version": "3.1.1",
  "differential": {
    "element": [ {
      "id": "Patient",
      "path": "Patient",
      "constraint": [ {
        "key": "isik-pat-1",
        "human": "Falls die Geschlechtsangabe 'other' gewählt wird, muss die amtliche Differenzierung per Extension angegeben werden",
        "source": "https://gematik.de/fhir/isik/v3/Basismodul/StructureDefinition/ISiKPatient",
        "severity": "error",
        "expression": "gender.exists() and gender='other' implies gender.extension('http://fhir.de/StructureDefinition/gender-amtlich-de').exists()"
      } ]
    }, {
      "id": "Patient.identifier",
      "min": 1,
      "path": "Patient.identifier",
      "comment": "**Hinweis:** Wenn eine pre-Adoption des neuen Identifier Typs 'VersichertenId' gewünscht ist, bitte die Spezifikation aus [Stufe 5](https://simplifier.net/guide/isik-basis-stufe-5/Einfuehrung/Artefakte/Datenobjekte_Patient) übernehmen. Die Änderung auf die neue Struktur ist in ISiK Stufe \n  3 nicht möglich, da das Codesystem 'identifier-type-de-basis' aus den deutschen Basisprofilen in Version 1.4.0 den Code KVZ10 noch nicht enthält.",
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "$this",
          "type": "pattern"
        } ]
      },
      "mustSupport": true
    }, {
      "path": "Patient.identifier",
      "min": 0,
      "type": [ {
        "code": "Identifier",
        "profile": [ "http://fhir.de/StructureDefinition/identifier-kvid-10" ]
      } ],
      "mustSupport": true,
      "sliceName": "VersichertenId-GKV",
      "patternIdentifier": {
        "type": {
          "coding": [ {
            "code": "GKV",
            "system": "http://fhir.de/CodeSystem/identifier-type-de-basis"
          } ]
        }
      },
      "max": "1",
      "id": "Patient.identifier:VersichertenId-GKV",
      "comment": "Achtung: Bitte allgemeinen Hinweis zum Element identifier beachten."
    }, {
      "id": "Patient.identifier:VersichertenId-GKV.type",
      "min": 1,
      "path": "Patient.identifier.type",
      "mustSupport": true
    }, {
      "id": "Patient.identifier:VersichertenId-GKV.system",
      "path": "Patient.identifier.system",
      "mustSupport": true
    }, {
      "id": "Patient.identifier:VersichertenId-GKV.value",
      "path": "Patient.identifier.value",
      "mustSupport": true
    }, {
      "id": "Patient.identifier:Patientennummer",
      "max": "*",
      "min": 1,
      "path": "Patient.identifier",
      "type": [ {
        "code": "Identifier",
        "profile": [ "http://fhir.de/StructureDefinition/identifier-pid" ]
      } ],
      "sliceName": "Patientennummer",
      "mustSupport": true,
      "patternIdentifier": {
        "type": {
          "coding": [ {
            "code": "MR",
            "system": "http://terminology.hl7.org/CodeSystem/v2-0203"
          } ]
        }
      }
    }, {
      "id": "Patient.identifier:Patientennummer.type",
      "path": "Patient.identifier.type",
      "mustSupport": true
    }, {
      "id": "Patient.identifier:Patientennummer.system",
      "path": "Patient.identifier.system",
      "mustSupport": true
    }, {
      "id": "Patient.identifier:Patientennummer.value",
      "path": "Patient.identifier.value",
      "mustSupport": true
    }, {
      "path": "Patient.identifier",
      "min": 0,
      "short": "Private Krankenversichertennummer",
      "type": [ {
        "code": "Identifier",
        "profile": [ "http://fhir.de/StructureDefinition/identifier-pkv" ]
      } ],
      "mustSupport": false,
      "sliceName": "Versichertennummer_PKV",
      "patternIdentifier": {
        "type": {
          "coding": [ {
            "code": "PKV",
            "system": "http://fhir.de/CodeSystem/identifier-type-de-basis"
          } ]
        }
      },
      "max": "1",
      "id": "Patient.identifier:Versichertennummer_PKV",
      "comment": "Für Privatpatienten, die noch nicht über eine lebenslange, unveränderliche Krankenversichertennummer (KVNR) verfügen,\n  können bis auf weiteres noch die versicherungsspezifischen PKV-Nummern angegeben werden. \n  Da bei diesen der Bezeichner des vom Kostenträger verwendeten Namensraums meist nicht ermittelt werden kann,\n  ist statt dessen der Name des Kostenträgers in `assigner` anzugeben.\n  **Achtung:**  Dieser Slice dient NICHT zur Abbildung einer 10-stelligen PKV-VersichertenId nach § 362 SGB V. Diese sind durch den Slice 'VersichertenId' abzubilden, da die Nummernkreise dieser Identifier identisch sind.\n  **Weitere Hinweise:** siehe [Deutsche Basisprofile](https://simplifier.net/guide/leitfaden-de-basis-r4/ig-markdown-PrivateKrankenversichertennummer-Identifier?version=current)\n  Der Identifier kann jedoch zusätzlich zur KVNR verwendet werden, wenn für eine Zusatzversicherung eine separate, versicherungsspezifische PKV-Nummer vorliegt."
    }, {
      "id": "Patient.identifier:Versichertennummer_PKV.use",
      "path": "Patient.identifier.use",
      "mustSupport": true
    }, {
      "id": "Patient.identifier:Versichertennummer_PKV.type",
      "min": 1,
      "path": "Patient.identifier.type",
      "mustSupport": true
    }, {
      "id": "Patient.identifier:Versichertennummer_PKV.value",
      "path": "Patient.identifier.value",
      "mustSupport": true
    }, {
      "id": "Patient.identifier:Versichertennummer_PKV.assigner",
      "path": "Patient.identifier.assigner",
      "mustSupport": true
    }, {
      "id": "Patient.identifier:Versichertennummer_PKV.assigner.identifier.system",
      "path": "Patient.identifier.assigner.identifier.system",
      "mustSupport": true
    }, {
      "id": "Patient.identifier:Versichertennummer_PKV.assigner.identifier.value",
      "path": "Patient.identifier.assigner.identifier.value",
      "mustSupport": true
    }, {
      "id": "Patient.identifier:Versichertennummer_PKV.assigner.display",
      "path": "Patient.identifier.assigner.display",
      "mustSupport": true
    }, {
      "id": "Patient.active",
      "path": "Patient.active",
      "comment": "Einschränkung der Übergreifenden MS-Definition: Verfügt ein bestätigungsrelevantes System nicht über die Datenstruktur zur Hinterlegung des Aktivitätsstatus einer Patienten-Ressource, so MUSS dieses System die Information NICHT abbilden. Das System SOLL jedoch den Aktivitätsstatus hart kodieren in der Patienteninstanz (Patient.active auf 'true'), sodass Clients nicht missverständlich mit einer inaktiven Patient-Ressource interagieren.",
      "mustSupport": true
    }, {
      "id": "Patient.name",
      "min": 1,
      "path": "Patient.name",
      "comment": "In order to maintain the differntiations of name parts as given in the VSDM dataset or qualify prefixes as academic titles, vendors can opt to support the extensions specified in the German HumanName Base Profile https://simplifier.net/basisprofil-de-r4/humannamedebasis\r\nThis is however not required within the scope of this specification.",
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "$this",
          "type": "pattern"
        } ]
      },
      "mustSupport": true
    }, {
      "id": "Patient.name:Name",
      "max": "1",
      "min": 1,
      "path": "Patient.name",
      "type": [ {
        "code": "HumanName",
        "profile": [ "http://fhir.de/StructureDefinition/humanname-de-basis" ]
      } ],
      "sliceName": "Name",
      "mustSupport": true,
      "patternHumanName": {
        "use": "official"
      }
    }, {
      "id": "Patient.name:Name.use",
      "min": 1,
      "path": "Patient.name.use",
      "mustSupport": true
    }, {
      "id": "Patient.name:Name.family",
      "min": 1,
      "path": "Patient.name.family",
      "mustSupport": true
    }, {
      "id": "Patient.name:Name.family.extension:namenszusatz",
      "path": "Patient.name.family.extension",
      "sliceName": "namenszusatz",
      "mustSupport": true
    }, {
      "id": "Patient.name:Name.family.extension:nachname",
      "path": "Patient.name.family.extension",
      "sliceName": "nachname",
      "mustSupport": true
    }, {
      "id": "Patient.name:Name.family.extension:vorsatzwort",
      "path": "Patient.name.family.extension",
      "sliceName": "vorsatzwort",
      "mustSupport": true
    }, {
      "id": "Patient.name:Name.given",
      "min": 1,
      "path": "Patient.name.given",
      "mustSupport": true
    }, {
      "id": "Patient.name:Name.prefix",
      "path": "Patient.name.prefix",
      "mustSupport": true
    }, {
      "id": "Patient.name:Name.prefix.extension:prefix-qualifier",
      "max": "1",
      "path": "Patient.name.prefix.extension",
      "sliceName": "prefix-qualifier",
      "mustSupport": true
    }, {
      "id": "Patient.name:Name.prefix.extension:prefix-qualifier.value[x]",
      "path": "Patient.name.prefix.extension.value[x]",
      "fixedCode": "AC"
    }, {
      "id": "Patient.name:Geburtsname",
      "max": "1",
      "min": 0,
      "path": "Patient.name",
      "type": [ {
        "code": "HumanName",
        "profile": [ "http://fhir.de/StructureDefinition/humanname-de-basis" ]
      } ],
      "sliceName": "Geburtsname",
      "mustSupport": true,
      "patternHumanName": {
        "use": "maiden"
      }
    }, {
      "id": "Patient.name:Geburtsname.use",
      "min": 1,
      "path": "Patient.name.use",
      "mustSupport": true
    }, {
      "id": "Patient.name:Geburtsname.family",
      "min": 1,
      "path": "Patient.name.family",
      "mustSupport": true
    }, {
      "id": "Patient.name:Geburtsname.family.extension:namenszusatz",
      "path": "Patient.name.family.extension",
      "sliceName": "namenszusatz",
      "mustSupport": true
    }, {
      "id": "Patient.name:Geburtsname.family.extension:nachname",
      "path": "Patient.name.family.extension",
      "sliceName": "nachname",
      "mustSupport": true
    }, {
      "id": "Patient.name:Geburtsname.family.extension:vorsatzwort",
      "path": "Patient.name.family.extension",
      "sliceName": "vorsatzwort",
      "mustSupport": true
    }, {
      "id": "Patient.name:Geburtsname.given",
      "max": "0",
      "path": "Patient.name.given"
    }, {
      "id": "Patient.name:Geburtsname.prefix",
      "max": "0",
      "path": "Patient.name.prefix"
    }, {
      "id": "Patient.telecom.system",
      "min": 1,
      "path": "Patient.telecom.system"
    }, {
      "id": "Patient.telecom.value",
      "min": 1,
      "path": "Patient.telecom.value"
    }, {
      "id": "Patient.gender",
      "min": 1,
      "path": "Patient.gender",
      "mustSupport": true
    }, {
      "id": "Patient.gender.extension:Geschlecht-Administrativ",
      "max": "1",
      "min": 0,
      "path": "Patient.gender.extension",
      "type": [ {
        "code": "Extension",
        "profile": [ "http://fhir.de/StructureDefinition/gender-amtlich-de" ]
      } ],
      "sliceName": "Geschlecht-Administrativ",
      "mustSupport": true
    }, {
      "id": "Patient.birthDate",
      "min": 1,
      "path": "Patient.birthDate",
      "mustSupport": true
    }, {
      "id": "Patient.birthDate.extension:Data-Absent-Reason",
      "max": "1",
      "min": 0,
      "path": "Patient.birthDate.extension",
      "type": [ {
        "code": "Extension",
        "profile": [ "http://hl7.org/fhir/StructureDefinition/data-absent-reason" ]
      } ],
      "sliceName": "Data-Absent-Reason",
      "mustSupport": true
    }, {
      "id": "Patient.birthDate.extension:Data-Absent-Reason.value[x]",
      "path": "Patient.birthDate.extension.value[x]",
      "fixedCode": "unknown",
      "mustSupport": true
    }, {
      "id": "Patient.address",
      "path": "Patient.address",
      "comment": "In order to differentiate between post box addresses and physical addresses, street names and house numbers, and to add city district names, vendors can opt to support the extensions as suggested in the German Address Base Profile http://fhir.de/StructureDefinition/address-de-basis.\r\nSuch differentiations are however not required within the scope of this specification.",
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "$this",
          "type": "pattern"
        } ]
      },
      "mustSupport": true
    }, {
      "constraint": [ {
        "key": "address-cnt-2or3-char",
        "human": "The content of the country element (if present) SHALL be selected EITHER from ValueSet ISO Country Alpha-2 http://hl7.org/fhir/ValueSet/iso3166-1-2 OR MAY be selected from ISO Country Alpha-3 Value Set http://hl7.org/fhir/ValueSet/iso3166-1-3, IF the country is not specified in value Set ISO Country Alpha-2 http://hl7.org/fhir/ValueSet/iso3166-1-2.",
        "source": "https://gematik.de/fhir/isik/v3/Basismodul/StructureDefinition/ISiKPatient",
        "severity": "warning",
        "expression": "country.empty() or (country.memberOf('http://hl7.org/fhir/ValueSet/iso3166-1-2') or country.memberOf('http://hl7.org/fhir/ValueSet/iso3166-1-3'))"
      } ],
      "path": "Patient.address",
      "min": 0,
      "type": [ {
        "code": "Address",
        "profile": [ "http://fhir.de/StructureDefinition/address-de-basis" ]
      } ],
      "mustSupport": true,
      "sliceName": "Strassenanschrift",
      "max": "*",
      "id": "Patient.address:Strassenanschrift",
      "patternAddress": {
        "type": "both"
      }
    }, {
      "id": "Patient.address:Strassenanschrift.extension:Stadtteil",
      "path": "Patient.address.extension",
      "sliceName": "Stadtteil",
      "mustSupport": true
    }, {
      "id": "Patient.address:Strassenanschrift.type",
      "min": 1,
      "path": "Patient.address.type",
      "mustSupport": true
    }, {
      "id": "Patient.address:Strassenanschrift.line",
      "min": 1,
      "path": "Patient.address.line",
      "mustSupport": true
    }, {
      "id": "Patient.address:Strassenanschrift.line.extension:Strasse",
      "path": "Patient.address.line.extension",
      "sliceName": "Strasse",
      "mustSupport": true
    }, {
      "id": "Patient.address:Strassenanschrift.line.extension:Hausnummer",
      "path": "Patient.address.line.extension",
      "sliceName": "Hausnummer",
      "mustSupport": true
    }, {
      "id": "Patient.address:Strassenanschrift.line.extension:Adresszusatz",
      "path": "Patient.address.line.extension",
      "sliceName": "Adresszusatz",
      "mustSupport": true
    }, {
      "id": "Patient.address:Strassenanschrift.line.extension:Postfach",
      "max": "0",
      "path": "Patient.address.line.extension",
      "sliceName": "Postfach"
    }, {
      "id": "Patient.address:Strassenanschrift.city",
      "min": 1,
      "path": "Patient.address.city",
      "mustSupport": true
    }, {
      "id": "Patient.address:Strassenanschrift.postalCode",
      "min": 1,
      "path": "Patient.address.postalCode",
      "mustSupport": true
    }, {
      "id": "Patient.address:Strassenanschrift.country",
      "min": 1,
      "path": "Patient.address.country",
      "mustSupport": true
    }, {
      "constraint": [ {
        "key": "address-cnt-2or3-char",
        "human": "The content of the country element (if present) SHALL be selected EITHER from ValueSet ISO Country Alpha-2 http://hl7.org/fhir/ValueSet/iso3166-1-2 OR MAY be selected from ISO Country Alpha-3 Value Set http://hl7.org/fhir/ValueSet/iso3166-1-3, IF the country is not specified in value Set ISO Country Alpha-2 http://hl7.org/fhir/ValueSet/iso3166-1-2.",
        "source": "https://gematik.de/fhir/isik/v3/Basismodul/StructureDefinition/ISiKPatient",
        "severity": "warning",
        "expression": "country.empty() or (country.memberOf('http://hl7.org/fhir/ValueSet/iso3166-1-2') or country.memberOf('http://hl7.org/fhir/ValueSet/iso3166-1-3'))"
      } ],
      "path": "Patient.address",
      "min": 0,
      "type": [ {
        "code": "Address",
        "profile": [ "http://fhir.de/StructureDefinition/address-de-basis" ]
      } ],
      "mustSupport": true,
      "sliceName": "Postfach",
      "max": "*",
      "id": "Patient.address:Postfach",
      "patternAddress": {
        "type": "postal"
      }
    }, {
      "id": "Patient.address:Postfach.type",
      "min": 1,
      "path": "Patient.address.type",
      "mustSupport": true
    }, {
      "id": "Patient.address:Postfach.line",
      "min": 1,
      "path": "Patient.address.line",
      "mustSupport": true
    }, {
      "id": "Patient.address:Postfach.line.extension:Strasse",
      "max": "0",
      "path": "Patient.address.line.extension",
      "sliceName": "Strasse"
    }, {
      "id": "Patient.address:Postfach.line.extension:Hausnummer",
      "max": "0",
      "path": "Patient.address.line.extension",
      "sliceName": "Hausnummer"
    }, {
      "id": "Patient.address:Postfach.line.extension:Adresszusatz",
      "max": "0",
      "path": "Patient.address.line.extension",
      "sliceName": "Adresszusatz"
    }, {
      "id": "Patient.address:Postfach.line.extension:Postfach",
      "path": "Patient.address.line.extension",
      "sliceName": "Postfach",
      "mustSupport": true
    }, {
      "id": "Patient.address:Postfach.city",
      "min": 1,
      "path": "Patient.address.city",
      "mustSupport": true
    }, {
      "id": "Patient.address:Postfach.postalCode",
      "min": 1,
      "path": "Patient.address.postalCode",
      "mustSupport": true
    }, {
      "id": "Patient.address:Postfach.country",
      "min": 1,
      "path": "Patient.address.country",
      "mustSupport": true
    } ]
  },
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Patient"
}