{
"description": null,
"_filename": "DwPatient.StructureDefinition.json",
"package_name": "telus.dw.emr.extract",
"date": "2024-05-03T22:11:40.4165223+00:00",
"derivation": "constraint",
"meta": {
"lastUpdated": "2024-05-03T21:24:24.5432219+00:00"
},
"publisher": null,
"fhirVersion": "4.0.1",
"name": "DwPatient",
"mapping": [ {
"uri": "http://hl7.org/v3",
"name": "RIM Mapping",
"identity": "rim"
}, {
"uri": "http://hl7.org/v3/cda",
"name": "CDA (R2)",
"identity": "cda"
}, {
"uri": "http://hl7.org/fhir/fivews",
"name": "FiveWs Pattern Mapping",
"identity": "w5"
}, {
"uri": "http://hl7.org/v2",
"name": "HL7 v2 Mapping",
"identity": "v2"
}, {
"uri": "http://loinc.org",
"name": "LOINC code for the element",
"identity": "loinc"
} ],
"abstract": false,
"type": "Patient",
"experimental": null,
"resourceType": "StructureDefinition",
"title": null,
"package_version": "1.0.0",
"status": "draft",
"id": "435023b7-da31-4427-bd58-fd1bf293bd03",
"kind": "resource",
"url": "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwPatient",
"version": null,
"differential": {
"element": [ {
"id": "Patient.id",
"min": 1,
"path": "Patient.id"
}, {
"id": "Patient.meta",
"path": "Patient.meta"
}, {
"id": "Patient.meta.lastUpdated",
"path": "Patient.meta.lastUpdated",
"mustSupport": true
}, {
"id": "Patient.meta.source",
"path": "Patient.meta.source",
"mustSupport": true
}, {
"id": "Patient.extension:genderIdentity",
"path": "Patient.extension",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/patient-genderIdentity" ]
} ],
"sliceName": "genderIdentity",
"isModifier": false,
"mustSupport": true
}, {
"id": "Patient.extension:genderIdentity.value[x].coding",
"path": "Patient.extension.value[x].coding",
"binding": {
"strength": "preferred",
"valueSet": "http://hl7.org/fhir/ValueSet/gender-identity"
}
}, {
"id": "Patient.extension:pronouns",
"max": "1",
"path": "Patient.extension",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/individual-pronouns" ]
} ],
"sliceName": "pronouns",
"isModifier": false,
"mustSupport": true
}, {
"id": "Patient.extension:patientReligion",
"path": "Patient.extension",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/patient-religion" ]
} ],
"sliceName": "patientReligion",
"isModifier": false,
"mustSupport": true
}, {
"id": "Patient.extension:patientReligion.value[x].coding",
"path": "Patient.extension.value[x].coding",
"binding": {
"strength": "preferred",
"valueSet": "http://terminology.hl7.org/ValueSet/v3-ReligiousAffiliation"
}
}, {
"id": "Patient.extension:patientReligion.value[x].coding.system",
"min": 1,
"path": "Patient.extension.value[x].coding.system",
"binding": {
"strength": "preferred",
"valueSet": "http://terminology.hl7.org/ValueSet/v3-ReligiousAffiliation"
},
"mustSupport": true
}, {
"id": "Patient.extension:patientReligion.value[x].coding.code",
"min": 1,
"path": "Patient.extension.value[x].coding.code",
"mustSupport": true
}, {
"id": "Patient.extension:patientReligion.value[x].coding.display",
"min": 1,
"path": "Patient.extension.value[x].coding.display",
"mustSupport": true
}, {
"id": "Patient.extension:patientReligion.value[x].coding.userSelected",
"path": "Patient.extension.value[x].coding.userSelected",
"mustSupport": true
}, {
"id": "Patient.extension:patientReligion.value[x].text",
"path": "Patient.extension.value[x].text",
"mustSupport": true
}, {
"id": "Patient.extension:ethnicity",
"max": "1",
"path": "Patient.extension",
"type": [ {
"code": "Extension",
"profile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/ext-Ethnicity" ]
} ],
"sliceName": "ethnicity",
"isModifier": false,
"mustSupport": true
}, {
"id": "Patient.extension:ethnicity.value[x].text",
"path": "Patient.extension.value[x].text",
"mustSupport": true
}, {
"id": "Patient.extension:rosterStatus",
"path": "Patient.extension",
"type": [ {
"code": "Extension",
"profile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/ext-RosterStatus" ]
} ],
"sliceName": "rosterStatus",
"isModifier": false,
"mustSupport": true
}, {
"id": "Patient.extension:rosterPeriod",
"path": "Patient.extension",
"type": [ {
"code": "Extension",
"profile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/ext-RosterPeriod" ]
} ],
"sliceName": "rosterPeriod",
"isModifier": false,
"mustSupport": true
}, {
"id": "Patient.extension:rosterTerminationReason",
"path": "Patient.extension",
"type": [ {
"code": "Extension",
"profile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/ext-RosterTerminationReason" ]
} ],
"sliceName": "rosterTerminationReason",
"isModifier": false,
"mustSupport": true
}, {
"id": "Patient.extension:patientStatus",
"path": "Patient.extension",
"type": [ {
"code": "Extension",
"profile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/ext-PatientStatus" ]
} ],
"sliceName": "patientStatus",
"isModifier": false,
"mustSupport": true
}, {
"id": "Patient.extension:patientStatusDate",
"path": "Patient.extension",
"type": [ {
"code": "Extension",
"profile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/ext-PatientStatusDate" ]
} ],
"sliceName": "patientStatusDate",
"isModifier": false,
"mustSupport": true
}, {
"id": "Patient.identifier",
"min": 1,
"path": "Patient.identifier",
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "type.coding.code",
"type": "type"
} ]
},
"definition": "A patient resource may have multiple identifier namely Patient number assigned by the EMR and Health Card number \r\nUse slicing here",
"mustSupport": true
}, {
"id": "Patient.identifier:MRN",
"max": "1",
"min": 1,
"path": "Patient.identifier",
"short": "Medical record number in sender system",
"comment": "Patient id in the EMR",
"sliceName": "MRN",
"mustSupport": true
}, {
"id": "Patient.identifier:MRN.type",
"min": 1,
"path": "Patient.identifier.type"
}, {
"id": "Patient.identifier:MRN.type.coding.system",
"path": "Patient.identifier.type.coding.system",
"fixedUri": "http://terminology.hl7.org/CodeSystem/v2-0203",
"mustSupport": true
}, {
"id": "Patient.identifier:MRN.type.coding.code",
"path": "Patient.identifier.type.coding.code",
"comment": "UsageNote: MR -Medical Record Number\r\n\r\nNote that FHIR strings SHALL NOT exceed 1MB in size",
"mustSupport": true
}, {
"id": "Patient.identifier:MRN.system",
"min": 1,
"path": "Patient.identifier.system",
"comment": "urn:telus:emr:pss:9988:patientId\r\nIdentifier.system is always case sensitive.",
"patternUri": "urn:telus:emr:::PatientId"
}, {
"id": "Patient.identifier:MRN.value",
"min": 1,
"path": "Patient.identifier.value",
"mustSupport": false
}, {
"id": "Patient.identifier:JHN",
"path": "Patient.identifier",
"short": "Jursidictional Health Number",
"comment": "Federal or provincial Health number",
"sliceName": "JHN",
"mustSupport": true
}, {
"id": "Patient.identifier:JHN.extension:versionCode",
"path": "Patient.identifier.extension",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-identifierversion" ]
} ],
"sliceName": "versionCode",
"isModifier": false,
"mustSupport": true
}, {
"id": "Patient.identifier:JHN.type",
"min": 1,
"path": "Patient.identifier.type",
"mustSupport": true
}, {
"id": "Patient.identifier:JHN.type.coding.system",
"path": "Patient.identifier.type.coding.system",
"fixedUri": "http://terminology.hl7.org/CodeSystem/v2-0203"
}, {
"id": "Patient.identifier:JHN.system",
"min": 1,
"path": "Patient.identifier.system",
"mustSupport": true
}, {
"id": "Patient.identifier:JHN.value",
"min": 1,
"path": "Patient.identifier.value",
"mustSupport": true
}, {
"id": "Patient.active",
"min": 1,
"path": "Patient.active",
"mustSupport": true
}, {
"id": "Patient.name",
"path": "Patient.name",
"mustSupport": true
}, {
"id": "Patient.name.use",
"path": "Patient.name.use",
"mustSupport": true
}, {
"id": "Patient.name.text",
"path": "Patient.name.text",
"mustSupport": true
}, {
"id": "Patient.name.family",
"path": "Patient.name.family",
"mustSupport": true
}, {
"id": "Patient.name.given",
"path": "Patient.name.given",
"mustSupport": true
}, {
"id": "Patient.name.prefix",
"max": "1",
"path": "Patient.name.prefix",
"mustSupport": true
}, {
"id": "Patient.name.suffix",
"max": "1",
"path": "Patient.name.suffix",
"mustSupport": true
}, {
"id": "Patient.telecom",
"path": "Patient.telecom",
"mustSupport": true
}, {
"id": "Patient.gender",
"min": 1,
"path": "Patient.gender",
"comment": "EMR --> FHIR \r\nMale/M = male\r\nFemale/F = female\r\nblank = unknown\r\nunknown/U = unknown\r\nother/O = other\r\n\r\n\r\nThe gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a \"hard\" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex.",
"mustSupport": true
}, {
"id": "Patient.birthDate",
"min": 1,
"path": "Patient.birthDate",
"mustSupport": true
}, {
"id": "Patient.deceased[x]",
"path": "Patient.deceased[x]",
"comment": "Deceased date will be provided where it approrpiately documented in the EMR. \r\nPSS - Only deceased status will be provided as PSS does not capture deceased date discreetly, it is documented in the status date field which is not always reliable. \r\nMA - Deceased status and date can be provided. Date will only be included for the patient whose status is deceased.\r\n\r\nIf there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.",
"mustSupport": true
}, {
"id": "Patient.address",
"path": "Patient.address",
"mustSupport": true
}, {
"id": "Patient.maritalStatus",
"path": "Patient.maritalStatus",
"comment": "Provide as text if available\r\n\r\nNot all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
"mustSupport": true
}, {
"id": "Patient.communication",
"path": "Patient.communication",
"comment": "Usage Note - \r\nPSS provide Langauge as preferedOfficalLanguage and Spoken language as MotherTongue\r\nMA - Provide the language selected in the Preferred language drop-down as Text only \r\n\r\npreferred boolean will not be provided in PSS as it is not identified in EMR which one of the two language is preferred. \r\nMA - Preferred language relative to the doctor. There is only one language available in MA \r\n\r\nIf no language is specified, this *implies* that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.",
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "$this",
"type": "type"
} ]
},
"mustSupport": true
}, {
"id": "Patient.communication:motherTongue",
"path": "Patient.communication",
"sliceName": "motherTongue",
"mustSupport": true
}, {
"id": "Patient.communication:motherTongue.extension:languageUse",
"max": "1",
"path": "Patient.communication.extension",
"type": [ {
"code": "Extension",
"profile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/ext-LanguageUse" ]
} ],
"sliceName": "languageUse",
"isModifier": false,
"mustSupport": true
}, {
"id": "Patient.communication:motherTongue.extension:languageUse.value[x]",
"path": "Patient.communication.extension.value[x]",
"mustSupport": true
}, {
"id": "Patient.communication:motherTongue.extension:languageUse.value[x].coding",
"path": "Patient.communication.extension.value[x].coding",
"mustSupport": true
}, {
"id": "Patient.communication:motherTongue.extension:languageUse.value[x].text",
"path": "Patient.communication.extension.value[x].text",
"mustSupport": true
}, {
"id": "Patient.communication:motherTongue.language",
"path": "Patient.communication.language",
"mustSupport": true
}, {
"id": "Patient.communication:preferredOfficialLanguage",
"path": "Patient.communication",
"sliceName": "preferredOfficialLanguage",
"mustSupport": true
}, {
"id": "Patient.communication:preferredOfficialLanguage.extension:languageUse",
"max": "1",
"path": "Patient.communication.extension",
"type": [ {
"code": "Extension",
"profile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/ext-LanguageUse" ]
} ],
"sliceName": "languageUse",
"isModifier": false,
"mustSupport": true
}, {
"id": "Patient.communication:preferredOfficialLanguage.extension:languageUse.value[x]",
"path": "Patient.communication.extension.value[x]",
"mustSupport": true
}, {
"id": "Patient.communication:preferredOfficialLanguage.extension:languageUse.value[x].coding",
"path": "Patient.communication.extension.value[x].coding",
"mustSupport": true
}, {
"id": "Patient.communication:preferredOfficialLanguage.extension:languageUse.value[x].text",
"path": "Patient.communication.extension.value[x].text",
"mustSupport": true
}, {
"id": "Patient.communication:preferredOfficialLanguage.language",
"path": "Patient.communication.language",
"mustSupport": true
}, {
"id": "Patient.communication:serviceLanguage",
"path": "Patient.communication",
"sliceName": "serviceLanguage",
"mustSupport": true
}, {
"id": "Patient.communication:serviceLanguage.extension:languageUse",
"max": "1",
"path": "Patient.communication.extension",
"type": [ {
"code": "Extension",
"profile": [ "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/ext-LanguageUse" ]
} ],
"sliceName": "languageUse",
"isModifier": false,
"mustSupport": true
}, {
"id": "Patient.communication:serviceLanguage.extension:languageUse.value[x].coding",
"path": "Patient.communication.extension.value[x].coding",
"mustSupport": true
}, {
"id": "Patient.communication:serviceLanguage.extension:languageUse.value[x].text",
"path": "Patient.communication.extension.value[x].text",
"mustSupport": true
}, {
"id": "Patient.communication:serviceLanguage.language",
"path": "Patient.communication.language",
"mustSupport": true
}, {
"id": "Patient.generalPractitioner",
"path": "Patient.generalPractitioner",
"type": [ {
"code": "Reference",
"versioning": "independent",
"aggregation": [ "referenced" ]
} ],
"comment": "Usage note - Provider reference to the organization and the practitioner resource \r\nIf a patient has not been assigned a doctor at the clinic only provide reference to the organization resources (parent organization if there are more than 1)\r\nWhen a Primary MD/NP for that provider at that clinic is assigned provide reference to the sub-organization and the practitioner \r\n\r\nDiscuss further how/where to provide the referring and family providers outside of the clinic \r\n\r\n\r\nThis may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources.\nMultiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a \"fly-in/fly-out\" worker that has the onsite GP also included with his home GP to remain aware of medical issues.\n\nJurisdictions may decide that they can profile this down to 1 if desired, or 1 per type.",
"mustSupport": true
} ]
},
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Patient"
}