PackagesCanonicalsLogsProblems
    Packages
    basisprofil.de@0.2.30
    http://fhir.de/StructureDefinition/patient-de-vsdm/0.2
{
  "description": "Basisprofil für die Verwendung der Patient Ressource im Kontext des deutschen VSDM (Versichertenstammdatenmanagement, \\\"eGK-Datensatz\\\").\\r\\nElemente, die als \\\"must-support\\\" gekennzeichnet sind, repräsentieren die optionalen Informationen aus der der VSDM-Spezifikation.",
  "_filename": "Profile-patient-de-vsdm-0.2.json",
  "package_name": "basisprofil.de",
  "date": "2019-03-15",
  "derivation": "constraint",
  "meta": {
    "lastUpdated": "2017-12-05T18:56:56.374+01:00"
  },
  "publisher": "HL7 Deutschland e.V. (Technisches Komitee FHIR)",
  "fhirVersion": "3.0.1",
  "name": "patient-de-vsdm-0.2",
  "mapping": [ {
    "name": "KVDT Mapping",
    "identity": "KVDT"
  }, {
    "name": "BDT Mapping",
    "identity": "BDT"
  } ],
  "abstract": false,
  "copyright": "HL7 Deutschland e.V.",
  "type": "Patient",
  "experimental": null,
  "resourceType": "StructureDefinition",
  "title": "Patient, deutsches VSDM-Profil (Version 0.2)",
  "package_version": "0.2.30",
  "snapshot": {
    "element": [ {
      "constraint": [ {
        "key": "dom-2",
        "human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
        "xpath": "not(parent::f:contained and f:contained)",
        "severity": "error",
        "expression": "contained.contained.empty()"
      }, {
        "key": "dom-1",
        "human": "If the resource is contained in another resource, it SHALL NOT contain any narrative",
        "xpath": "not(parent::f:contained and f:text)",
        "severity": "error",
        "expression": "contained.text.empty()"
      }, {
        "key": "dom-4",
        "human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
        "xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
        "severity": "error",
        "expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"
      }, {
        "key": "dom-3",
        "human": "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource",
        "xpath": "not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))",
        "severity": "error",
        "expression": "contained.where(('#'+id in %resource.descendants().reference).not()).empty()"
      }, {
        "key": "pat-de-1",
        "human": "Die amtliche Differenzierung der Geschlechtsangabe 'other' darf nur gefüllt sein, wenn das Geschlecht 'other' angegeben ist",
        "severity": "error",
        "expression": "gender='other' or gender.extension('http://fhir.de/StructureDefinition/gender-amtlich-de/0.2').empty()",
        "requirements": "Die amtliche Differenzierung der Geschlechtsangabe 'other' darf nur gefüllt sein, wenn das Geschlecht 'other' angegeben ist"
      } ],
      "path": "Patient",
      "min": 0,
      "definition": "Patient Ressource im Kontext des deutschen VSDM (Versichertenstammdatenmanagement, \"eGK-Datensatz\").\r\nElemente, die als \"must-support\" gekennzeichnet sind, repräsentieren die optionalen Informationen aus der der VSDM-Spezifikation.",
      "short": "Patient im Kontext des deutschen VSDM",
      "mapping": [ {
        "map": "Entity. Role, or Act",
        "identity": "rim"
      }, {
        "map": "Patient[classCode=PAT]",
        "identity": "rim"
      }, {
        "map": "ClinicalDocument.recordTarget.patientRole",
        "identity": "cda"
      }, {
        "map": "administrative.individual",
        "identity": "w5"
      } ],
      "alias": [ "SubjectOfCare Client Resident" ],
      "max": "*",
      "id": "Patient",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Resource"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.id",
      "min": 0,
      "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
      "short": "Logical id of this artifact",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "id"
      } ],
      "max": "1",
      "id": "Patient.id",
      "condition": [ "ele-1" ],
      "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Resource.id"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.meta",
      "min": 0,
      "definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.",
      "short": "Metadata about the resource",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Meta"
      } ],
      "max": "1",
      "id": "Patient.meta",
      "condition": [ "ele-1" ],
      "base": {
        "max": "1",
        "min": 0,
        "path": "Resource.meta"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.implicitRules",
      "min": 0,
      "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
      "isModifier": true,
      "short": "A set of rules under which this content was created",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "max": "1",
      "id": "Patient.implicitRules",
      "condition": [ "ele-1" ],
      "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Resource.implicitRules"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.language",
      "min": 0,
      "definition": "The base language in which the resource is written.",
      "short": "Language of the resource content",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "binding": {
        "strength": "extensible",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
          "valueReference": {
            "reference": "http://hl7.org/fhir/ValueSet/all-languages"
          }
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "Language"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
          "valueBoolean": true
        } ],
        "description": "A human language.",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/languages"
        }
      },
      "max": "1",
      "id": "Patient.language",
      "condition": [ "ele-1" ],
      "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Resource.language"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.text",
      "min": 0,
      "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
      "short": "Text summary of the resource, for human interpretation",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      }, {
        "map": "Act.text?",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Narrative"
      } ],
      "alias": [ "narrative", "html", "xhtml", "display" ],
      "max": "1",
      "id": "Patient.text",
      "condition": [ "ele-1", "dom-1" ],
      "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "DomainResource.text"
      }
    }, {
      "path": "Patient.contained",
      "min": 0,
      "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
      "short": "Contained, inline Resources",
      "mapping": [ {
        "map": "Entity. Role, or Act",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Resource"
      } ],
      "alias": [ "inline resources", "anonymous resources", "contained resources" ],
      "max": "*",
      "id": "Patient.contained",
      "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "DomainResource.contained"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Patient.extension",
      "condition": [ "ele-1" ],
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "DomainResource.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
      "isModifier": true,
      "short": "Extensions that cannot be ignored",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Patient.modifierExtension",
      "condition": [ "ele-1" ],
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "DomainResource.modifierExtension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.identifier",
      "requirements": "Patients are almost always assigned specific numerical identifiers.",
      "min": 0,
      "definition": "Identifikator für diesen Patienten",
      "short": "Identifikator für diesen Patienten",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)",
        "identity": "v2"
      }, {
        "map": "II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]",
        "identity": "rim"
      }, {
        "map": "Identifier",
        "identity": "servd"
      }, {
        "map": "PID-3",
        "identity": "v2"
      }, {
        "map": "id",
        "identity": "rim"
      }, {
        "map": ".id",
        "identity": "cda"
      }, {
        "map": "id",
        "identity": "w5"
      } ],
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "system",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Identifier"
      } ],
      "mustSupport": true,
      "max": "*",
      "id": "Patient.identifier",
      "condition": [ "ele-1" ],
      "base": {
        "max": "*",
        "min": 0,
        "path": "Patient.identifier"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.identifier",
      "requirements": "Die gesetzliche Krankenversichertennummer ist ein zentrales Identififaktionsmerkmal im deutschen Gesundheitswesen.",
      "min": 1,
      "definition": "Die Krankenversichertennummer wie auf der eGK abgebildet (10-stellige, unveränderliche Nummer).\r\nFür dieses Profil muss diese Nummer angegeben werden.",
      "short": "Die Krankenversichertennummer wie auf der eGK abgebildet.",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)",
        "identity": "v2"
      }, {
        "map": "II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]",
        "identity": "rim"
      }, {
        "map": "Identifier",
        "identity": "servd"
      }, {
        "map": "PID-3",
        "identity": "v2"
      }, {
        "map": "id",
        "identity": "rim"
      }, {
        "map": ".id",
        "identity": "cda"
      }, {
        "map": "id",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "Identifier"
      } ],
      "mustSupport": true,
      "sliceName": "VersichertenID_GKV",
      "max": "1",
      "id": "Patient.identifier:VersichertenID_GKV",
      "condition": [ "ele-1" ],
      "base": {
        "max": "*",
        "min": 0,
        "path": "Patient.identifier"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.identifier.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Patient.identifier:VersichertenID_GKV.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.identifier.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Patient.identifier:VersichertenID_GKV.extension",
      "condition": [ "ele-1" ],
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.identifier.use",
      "requirements": "Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.",
      "min": 0,
      "definition": "The purpose of this identifier.",
      "isModifier": true,
      "short": "usual | official | temp | secondary (If known)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "v2"
      }, {
        "map": "Role.code or implied by context",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "binding": {
        "strength": "required",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "IdentifierUse"
        } ],
        "description": "Identifies the purpose for this identifier, if known .",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/identifier-use"
        }
      },
      "max": "1",
      "id": "Patient.identifier:VersichertenID_GKV.use",
      "condition": [ "ele-1" ],
      "comment": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Identifier.use"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.identifier.type",
      "requirements": "Allows users to make use of identifiers when the identifier system is not known.",
      "min": 0,
      "definition": "A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.",
      "short": "Description of identifier",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE",
        "identity": "v2"
      }, {
        "map": "CD",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
        "identity": "orim"
      }, {
        "map": "CX.5",
        "identity": "v2"
      }, {
        "map": "Role.code or implied by context",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "extensible",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "IdentifierType"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
          "valueBoolean": true
        } ],
        "description": "A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/identifier-type"
        }
      },
      "max": "1",
      "id": "Patient.identifier:VersichertenID_GKV.type",
      "condition": [ "ele-1" ],
      "comment": "This element deals only with general categories of identifiers.  It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. \n\nWhere the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Identifier.type"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.identifier.type.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Patient.identifier:VersichertenID_GKV.type.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.identifier.type.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Patient.identifier:VersichertenID_GKV.type.extension",
      "condition": [ "ele-1" ],
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.identifier.type.coding",
      "requirements": "Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings.",
      "min": 1,
      "definition": "A reference to a code defined by a terminology system.",
      "short": "Code defined by a terminology system",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6",
        "identity": "v2"
      }, {
        "map": "CV",
        "identity": "rim"
      }, {
        "map": "fhir:Coding rdfs:subClassOf dt:CDCoding",
        "identity": "orim"
      }, {
        "map": "C*E.1-8, C*E.10-22",
        "identity": "v2"
      }, {
        "map": "union(., ./translation)",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "Coding"
      } ],
      "max": "1",
      "id": "Patient.identifier:VersichertenID_GKV.type.coding",
      "condition": [ "ele-1" ],
      "comment": "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 labeled as UserSelected = true.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "CodeableConcept.coding"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.identifier.type.coding.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Patient.identifier:VersichertenID_GKV.type.coding.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.identifier.type.coding.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Patient.identifier:VersichertenID_GKV.type.coding.extension",
      "condition": [ "ele-1" ],
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.identifier.type.coding.system",
      "requirements": "Need to be unambiguous about the source of the definition of the symbol.",
      "min": 1,
      "definition": "The identification of the code system that defines the meaning of the symbol in the code.",
      "short": "Identity of the terminology system",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.3",
        "identity": "v2"
      }, {
        "map": "./codeSystem",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "max": "1",
      "id": "Patient.identifier:VersichertenID_GKV.type.coding.system",
      "condition": [ "ele-1" ],
      "comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.system"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.identifier.type.coding.version",
      "min": 0,
      "definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
      "short": "Version of the system - if relevant",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.7",
        "identity": "v2"
      }, {
        "map": "./codeSystemVersion",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "id": "Patient.identifier:VersichertenID_GKV.type.coding.version",
      "condition": [ "ele-1" ],
      "comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.version"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.identifier.type.coding.code",
      "requirements": "Need to refer to a particular code in the system.",
      "min": 1,
      "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).",
      "short": "Symbol in syntax defined by the system",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.1",
        "identity": "v2"
      }, {
        "map": "./code",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "max": "1",
      "id": "Patient.identifier:VersichertenID_GKV.type.coding.code",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.code"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.identifier.type.coding.display",
      "requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.",
      "min": 0,
      "definition": "A representation of the meaning of the code in the system, following the rules of the system.",
      "short": "Representation defined by the system",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.2 - but note this is not well followed",
        "identity": "v2"
      }, {
        "map": "CV.displayName",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
        "valueBoolean": true
      } ],
      "max": "1",
      "id": "Patient.identifier:VersichertenID_GKV.type.coding.display",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.display"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.identifier.type.coding.userSelected",
      "requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
      "min": 0,
      "definition": "Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).",
      "short": "If this coding was chosen directly by the user",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "Sometimes implied by being first",
        "identity": "v2"
      }, {
        "map": "CD.codingRationale",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [     fhir:source \"true\";     fhir:target dt:CDCoding.codingRationale\\#O   ]",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "boolean"
      } ],
      "max": "1",
      "id": "Patient.identifier:VersichertenID_GKV.type.coding.userSelected",
      "condition": [ "ele-1" ],
      "comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.userSelected"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.identifier.type.text",
      "requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
      "min": 0,
      "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.",
      "short": "Plain text representation of the concept",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.9. But note many systems use C*E.2 for this",
        "identity": "v2"
      }, {
        "map": "./originalText[mediaType/code=\"text/plain\"]/data",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
        "valueBoolean": true
      } ],
      "max": "1",
      "id": "Patient.identifier:VersichertenID_GKV.type.text",
      "condition": [ "ele-1" ],
      "comment": "Very often the text is the same as a displayName of one of the codings.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "CodeableConcept.text"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.identifier.system",
      "requirements": "There are many sets  of identifiers.  To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.",
      "min": 1,
      "definition": "Establishes the namespace for the value - that is, a URL that describes a set values that are unique.",
      "short": "The namespace for the identifier value",
      "fixedUri": "http://fhir.de/NamingSystem/gkv/kvid-10",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CX.4 / EI-2-4",
        "identity": "v2"
      }, {
        "map": "II.root or Role.id.root",
        "identity": "rim"
      }, {
        "map": "./IdentifierType",
        "identity": "servd"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "max": "1",
      "id": "Patient.identifier:VersichertenID_GKV.system",
      "condition": [ "ele-1" ],
      "comment": "Die Versicherten-ID ist der 10-stellige unveränderliche Teil der 30-stelligen Krankenversichertennummer.",
      "example": [ {
        "label": "General",
        "valueUri": "http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri"
      } ],
      "base": {
        "max": "1",
        "min": 0,
        "path": "Identifier.system"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.identifier.value",
      "min": 1,
      "definition": "The portion of the identifier typically relevant to the user and which is unique within the context of the system.",
      "short": "The value that is unique",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CX.1 / EI.1",
        "identity": "v2"
      }, {
        "map": "II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)",
        "identity": "rim"
      }, {
        "map": "./Value",
        "identity": "servd"
      }, {
        "map": "3119",
        "identity": "KVDT"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "id": "Patient.identifier:VersichertenID_GKV.value",
      "condition": [ "ele-1" ],
      "comment": "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](extension-rendered-value.html).",
      "example": [ {
        "label": "General",
        "valueString": "123456"
      } ],
      "base": {
        "max": "1",
        "min": 0,
        "path": "Identifier.value"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "per-1",
        "human": "If present, start SHALL have a lower value than end",
        "xpath": "not(exists(f:start)) or not(exists(f:end)) or (f:start/@value <= f:end/@value)",
        "severity": "error",
        "expression": "start.empty() or end.empty() or (start <= end)"
      } ],
      "path": "Patient.identifier.period",
      "min": 0,
      "definition": "Time period during which identifier is/was valid for use.",
      "short": "Time period when id is/was valid for use",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "DR",
        "identity": "v2"
      }, {
        "map": "IVL[lowClosed=\"true\" and highClosed=\"true\"] or URG[lowClosed=\"true\" and highClosed=\"true\"]",
        "identity": "rim"
      }, {
        "map": "CX.7 + CX.8",
        "identity": "v2"
      }, {
        "map": "Role.effectiveTime or implied by context",
        "identity": "rim"
      }, {
        "map": "./StartDate and ./EndDate",
        "identity": "servd"
      } ],
      "type": [ {
        "code": "Period"
      } ],
      "max": "1",
      "id": "Patient.identifier:VersichertenID_GKV.period",
      "condition": [ "ele-1" ],
      "comment": "This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. \"the patient was an inpatient of the hospital for this time range\") or one value from the range applies (e.g. \"give to the patient between these two times\"). If duration is required, specify the type as Interval|Duration.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Identifier.period"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ref-1",
        "human": "SHALL have a contained resource if a local reference is provided",
        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
        "severity": "error",
        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))"
      } ],
      "path": "Patient.identifier.assigner",
      "min": 0,
      "definition": "Organization that issued/manages the identifier.",
      "short": "Organization that issued id (may be just text)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
        "identity": "rim"
      }, {
        "map": "CX.4 / (CX.4,CX.9,CX.10)",
        "identity": "v2"
      }, {
        "map": "II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper",
        "identity": "rim"
      }, {
        "map": "./IdentifierIssuingAuthority",
        "identity": "servd"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
      } ],
      "max": "1",
      "id": "Patient.identifier:VersichertenID_GKV.assigner",
      "condition": [ "ele-1" ],
      "comment": "The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Identifier.assigner"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.active",
      "requirements": "Need to be able to mark a patient record as not to be used because it was created in error.",
      "min": 0,
      "definition": "Whether this patient record is in active use.",
      "isModifier": true,
      "short": "Whether this patient's record is in active use",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "statusCode",
        "identity": "rim"
      }, {
        "map": "n/a",
        "identity": "cda"
      }, {
        "map": "status",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "boolean"
      } ],
      "defaultValueBoolean": true,
      "max": "1",
      "id": "Patient.active",
      "condition": [ "ele-1" ],
      "comment": "Default is true. If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient\n\nThis element is labeled as a modifier because when the patient record is marked as not active it is not expected to be used/referenced without being changed back to active.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Patient.active"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "hum-1",
        "human": "Wenn die Extension 'namenszusatz' verwendet wird, dann muss der vollständige Name im Attribut 'family' angegeben werden",
        "severity": "error",
        "expression": "family.extension('http://fhir.de/StructureDefinition/humanname-namenszusatz').empty() or family.hasValue()"
      }, {
        "key": "hum-2",
        "human": "Wenn die Extension 'nachname' verwendet wird, dann muss der vollständige Name im Attribut 'family' angegeben werden",
        "severity": "error",
        "expression": "family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-name').empty() or family.hasValue()"
      }, {
        "key": "hum-3",
        "human": "Wenn die Extension 'vorsatzwort' verwendet wird, dann muss der vollständige Name im Attribut 'family' angegeben werden",
        "severity": "error",
        "expression": "family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-prefix').empty() or family.hasValue()"
      }, {
        "key": "hum-4",
        "human": "Wenn die Extension 'prefix-qualifier' verwendet wird, dann muss ein Namenspräfix im Attribut 'prefix' angegeben werden",
        "severity": "error",
        "expression": "prefix.all($this.extension('http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier').empty() or $this.hasValue())"
      } ],
      "path": "Patient.name",
      "requirements": "Need to be able to track the patient by multiple names. Examples are your official name and a partner name.",
      "min": 1,
      "definition": "Personenname nach deutschem Profil.\r\nDieser enthält bestimmte Extensions, die in Deutschland Verwendung finden.\r\nIn diesem Profil sind die Kardinalitäten gemäß VSDM-Spezifikation berücksichtigt.",
      "short": "Personenname nach deutschem Profil",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "XPN",
        "identity": "v2"
      }, {
        "map": "EN (actually, PN)",
        "identity": "rim"
      }, {
        "map": "ProviderName",
        "identity": "servd"
      }, {
        "map": "PID-5, PID-9",
        "identity": "v2"
      }, {
        "map": "name",
        "identity": "rim"
      }, {
        "map": ".patient.name",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "HumanName",
        "profile": "http://fhir.de/StructureDefinition/humanname-de-basis/0.2"
      } ],
      "mustSupport": true,
      "max": "*",
      "id": "Patient.name",
      "condition": [ "ele-1" ],
      "comment": "Hinweis zur Repräsentation von Anreden: Diese sollten, sofern erforderlich, ausschließlich in HumanName.text erscheinen (z.B. \"Frsu Dr. Martha Musterfrau\").\r\nNach Möglichkeit sollte die Anrede aus dem Geschlecht der Person abgeleitet werden.\r\nDas Element prefix wird nur für akademische Titel und andere Namensbestandteile verwendet.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Patient.name"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.name.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Patient.name.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.name.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Patient.name.extension",
      "condition": [ "ele-1" ],
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.name.use",
      "requirements": "Allows the appropriate name for a particular context of use to be selected from among a set of names.",
      "min": 0,
      "definition": "Identifies the purpose for this name.",
      "isModifier": true,
      "short": "usual | official | temp | nickname | anonymous | old | maiden",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "XPN.7, but often indicated by which field contains the name",
        "identity": "v2"
      }, {
        "map": "unique(./use)",
        "identity": "rim"
      }, {
        "map": "./NamePurpose",
        "identity": "servd"
      }, {
        "map": "1211 (in BDT als Freitext!)",
        "identity": "BDT"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "binding": {
        "strength": "required",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "NameUse"
        } ],
        "description": "The use of a human name",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/name-use"
        }
      },
      "max": "1",
      "id": "Patient.name.use",
      "condition": [ "ele-1" ],
      "comment": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old name etc.for a current/permanent one. Applications can assume that a name is current unless it explicitly says that it is temporary or old.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "HumanName.use"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.name.text",
      "requirements": "A renderable, unencoded form.",
      "min": 0,
      "definition": "A full text representation of the name.",
      "short": "Text representation of the full name",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "implied by XPN.11",
        "identity": "v2"
      }, {
        "map": "./formatted",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "id": "Patient.name.text",
      "condition": [ "ele-1" ],
      "comment": "Can provide both a text representation and structured parts.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "HumanName.text"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.name.family",
      "min": 1,
      "definition": "Der vollständige Familienname, einschließlich aller Vorsatz- und Zusatzwörter, mit Leerzeichen getrennt.",
      "short": "Familienname",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "XPN.1/FN.1",
        "identity": "v2"
      }, {
        "map": "./part[partType = FAM]",
        "identity": "rim"
      }, {
        "map": "./FamilyName",
        "identity": "servd"
      }, {
        "map": "3120 + 3100 + 3101",
        "identity": "BDT"
      }, {
        "map": "3120 + 3100 + 3101",
        "identity": "KVDT"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "mustSupport": true,
      "alias": [ "surname" ],
      "max": "1",
      "id": "Patient.name.family",
      "condition": [ "ele-1", "hum-1", "hum-2", "hum-3" ],
      "comment": "Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).",
      "base": {
        "max": "1",
        "min": 0,
        "path": "HumanName.family"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.name.family.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Patient.name.family.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.name.family.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Patient.name.family.extension",
      "condition": [ "ele-1" ],
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.name.family.extension",
      "min": 0,
      "definition": "Namenszusatz, z.B. Adelstitel als Bestandteil das Nachnamens, z.B. Gräfin, Prinz oder Fürst.\r\nIm Kontext von VSDM sind ausschließlich die Namenszusätze aus DEÜV Anlage 7 zulässig.",
      "short": "Namenszusatz gemäß VSDM (Versichertenstammdatenmanagement, \"eGK\")",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      }, {
        "map": "3100",
        "identity": "KVDT"
      }, {
        "map": "3100",
        "identity": "BDT"
      } ],
      "type": [ {
        "code": "Extension",
        "profile": "http://fhir.de/StructureDefinition/humanname-namenszusatz/0.2"
      } ],
      "mustSupport": true,
      "sliceName": "namenszusatz",
      "alias": [ "extensions", "user content" ],
      "max": "1",
      "id": "Patient.name.family.extension:namenszusatz",
      "condition": [ "ele-1", "hum-1" ],
      "comment": "Die Extension wurde erstellt aufgrund der Anforderung, die auf der eGK vorhandenen Patientenstammdaten in FHIR abbilden zu können. Auf der eGK werden die Namensbestandteile \"Namenszusatz\" und \"Vorsatzwort\" getrennt vom Nachnamen gespeichert. Anhand der Liste der zulässigen Namenszusätze ist deutlich erkennbar, dass es sich hierbei sinngemäß um Adelstitel handelt.\r\nDas Vorsatzwort kann durch die Core-Extension http://build.fhir.org/extension-humanname-own-name.html abgebildet werden, für den Namenszusatz ergibt sich jedoch die Notwendikeit einer nationalen Extension, da in andern Ländern Adelstitel entweder gar nicht oder als reguläres Namenspräfix erfasst werden.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.name.family.extension",
      "min": 0,
      "definition": "Nachname ohne Vor- und Zusätze.\r\nDient z.B. der alphabetischen Einordnung des Namens.",
      "short": "Nachname ohne Vor- und Zusätze",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      }, {
        "map": "FN.3",
        "identity": "v2"
      }, {
        "map": "ENXP where Qualifiers = (BR)",
        "identity": "rim"
      }, {
        "map": "3101",
        "identity": "KVDT"
      }, {
        "map": "3101",
        "identity": "BDT"
      } ],
      "type": [ {
        "code": "Extension",
        "profile": "http://hl7.org/fhir/StructureDefinition/humanname-own-name"
      } ],
      "mustSupport": true,
      "sliceName": "nachname",
      "alias": [ "extensions", "user content" ],
      "max": "1",
      "id": "Patient.name.family.extension:nachname",
      "condition": [ "ele-1", "hum-2" ],
      "comment": "If the person's surname has legally changed to become (or incorporate) the surname of the person's partner or spouse, this is the person's surname immediately prior to such change. Often this is the person's \"maiden name\".",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.name.family.extension.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Patient.name.family.extension:nachname.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.name.family.extension.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "0",
      "id": "Patient.name.family.extension:nachname.extension",
      "condition": [ "ele-1" ],
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.name.family.extension.url",
      "min": 1,
      "definition": "Source of the definition for the extension code - a logical name or a URL.",
      "short": "identifies the meaning of the extension",
      "fixedUri": "http://hl7.org/fhir/StructureDefinition/humanname-own-name",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Patient.name.family.extension:nachname.url",
      "condition": [ "ele-1" ],
      "comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Extension.url"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.name.family.extension.valueString",
      "min": 0,
      "definition": "Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).",
      "short": "Value of extension",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "sliceName": "valueString",
      "max": "1",
      "id": "Patient.name.family.extension:nachname.value[x]:valueString",
      "condition": [ "ele-1" ],
      "comment": "A stream of bytes, base64 encoded",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Extension.value[x]"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.name.family.extension",
      "min": 0,
      "definition": "Vorsatzwort zum Nachnamen, z.B. \"von\" \"van der\", \"zu\" usw.\r\nIm Kontext von VSDM sind ausschließlich die Vorsatzwörter aus DEÜV Anlage 6 zulässig.",
      "short": "Vorsatzwort",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      }, {
        "map": "FN.2",
        "identity": "v2"
      }, {
        "map": "ENXP where Qualifiers = (VV, R)",
        "identity": "rim"
      }, {
        "map": "3120",
        "identity": "BDT"
      }, {
        "map": "3120",
        "identity": "KVDT"
      } ],
      "type": [ {
        "code": "Extension",
        "profile": "http://hl7.org/fhir/StructureDefinition/humanname-own-prefix"
      } ],
      "mustSupport": true,
      "sliceName": "vorsatzwort",
      "alias": [ "extensions", "user content" ],
      "max": "1",
      "id": "Patient.name.family.extension:vorsatzwort",
      "condition": [ "ele-1", "hum-3" ],
      "comment": "An example of a voorvoegsel is the \"van\" in \"Ludwig van Beethoven\". Since the voorvoegsel doesn't sort completely alphabetically, it is reasonable to specify it as a separate sub-component.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.name.family.extension.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Patient.name.family.extension:vorsatzwort.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.name.family.extension.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "0",
      "id": "Patient.name.family.extension:vorsatzwort.extension",
      "condition": [ "ele-1" ],
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.name.family.extension.url",
      "min": 1,
      "definition": "Source of the definition for the extension code - a logical name or a URL.",
      "short": "identifies the meaning of the extension",
      "fixedUri": "http://hl7.org/fhir/StructureDefinition/humanname-own-prefix",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Patient.name.family.extension:vorsatzwort.url",
      "condition": [ "ele-1" ],
      "comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Extension.url"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.name.family.extension.valueString",
      "min": 0,
      "definition": "Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).",
      "short": "Value of extension",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "sliceName": "valueString",
      "max": "1",
      "id": "Patient.name.family.extension:vorsatzwort.value[x]:valueString",
      "condition": [ "ele-1" ],
      "comment": "A stream of bytes, base64 encoded",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Extension.value[x]"
      }
    }, {
      "path": "Patient.name.family.value",
      "min": 0,
      "definition": "Primitive value for string",
      "short": "Primitive value for string",
      "type": [ {
        "_code": {
          "extension": [ {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-json-type",
            "valueString": "string"
          }, {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-xml-type",
            "valueString": "xsd:string"
          }, {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-rdf-type",
            "valueString": "xsd:string"
          } ]
        }
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Patient.name.family.value",
      "maxLength": 1048576,
      "base": {
        "max": "1",
        "min": 0,
        "path": "string.value"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.name.given",
      "min": 1,
      "definition": "Vorname der Person",
      "short": "Vorname",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "XPN.2 + XPN.3",
        "identity": "v2"
      }, {
        "map": "./part[partType = GIV]",
        "identity": "rim"
      }, {
        "map": "./GivenNames",
        "identity": "servd"
      }, {
        "map": "3102",
        "identity": "KVDT"
      }, {
        "map": "3102",
        "identity": "BDT"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "mustSupport": true,
      "alias": [ "first name", "middle name" ],
      "max": "*",
      "id": "Patient.name.given",
      "condition": [ "ele-1" ],
      "comment": "If only initials are recorded, they may be used in place of the full name.  Not called \"first name\" since given names do not always come first.",
      "orderMeaning": "Given Names appear in the correct order for presenting the name",
      "base": {
        "max": "*",
        "min": 0,
        "path": "HumanName.given"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.name.prefix",
      "min": 0,
      "definition": "Namensteile vor dem Vornamen, z.B. akademischer Titel.",
      "short": "Namensteile vor dem Vornamen",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "XPN.5",
        "identity": "v2"
      }, {
        "map": "./part[partType = PFX]",
        "identity": "rim"
      }, {
        "map": "./TitleCode",
        "identity": "servd"
      }, {
        "map": "3104",
        "identity": "KVDT"
      }, {
        "map": "3104",
        "identity": "BDT"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "mustSupport": true,
      "max": "*",
      "id": "Patient.name.prefix",
      "condition": [ "ele-1", "hum-4" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "orderMeaning": "Prefixes appear in the correct order for presenting the name",
      "base": {
        "max": "*",
        "min": 0,
        "path": "HumanName.prefix"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.name.prefix.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Patient.name.prefix.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.name.prefix.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Patient.name.prefix.extension",
      "condition": [ "ele-1" ],
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.name.prefix.extension",
      "min": 0,
      "definition": "Spezialisierung der Art des Präfixes, z.B. \"AC\" für Akademische Titel",
      "isModifier": false,
      "short": "LS | AC | NB | PR | HON | BR | AD | SP | MID | CL | IN | VV",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      }, {
        "map": "ENXP.qualifier",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension",
        "profile": "http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier"
      } ],
      "mustSupport": true,
      "sliceName": "prefix-qualifier",
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Patient.name.prefix.extension:prefix-qualifier",
      "condition": [ "ele-1", "hum-4" ],
      "comment": "Used to indicate additional information about the name part and how it should be used.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.name.prefix.extension.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Patient.name.prefix.extension:prefix-qualifier.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.name.prefix.extension.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "0",
      "id": "Patient.name.prefix.extension:prefix-qualifier.extension",
      "condition": [ "ele-1" ],
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.name.prefix.extension.url",
      "min": 1,
      "definition": "Source of the definition for the extension code - a logical name or a URL.",
      "short": "identifies the meaning of the extension",
      "fixedUri": "http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Patient.name.prefix.extension:prefix-qualifier.url",
      "condition": [ "ele-1" ],
      "comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Extension.url"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.name.prefix.extension.valueCode",
      "min": 0,
      "definition": "Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).",
      "short": "Value of extension",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "sliceName": "valueCode",
      "binding": {
        "strength": "required",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "EntityNamePartQualifier"
        } ],
        "description": "A set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/name-part-qualifier"
        }
      },
      "max": "1",
      "id": "Patient.name.prefix.extension:prefix-qualifier.value[x]:valueCode",
      "condition": [ "ele-1" ],
      "comment": "A stream of bytes, base64 encoded",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Extension.value[x]"
      }
    }, {
      "path": "Patient.name.prefix.value",
      "min": 0,
      "definition": "Primitive value for string",
      "short": "Primitive value for string",
      "type": [ {
        "_code": {
          "extension": [ {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-json-type",
            "valueString": "string"
          }, {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-xml-type",
            "valueString": "xsd:string"
          }, {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-rdf-type",
            "valueString": "xsd:string"
          } ]
        }
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Patient.name.prefix.value",
      "maxLength": 1048576,
      "base": {
        "max": "1",
        "min": 0,
        "path": "string.value"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.name.suffix",
      "min": 0,
      "definition": "Namensteile nach dem Nachnamen",
      "short": "Namensteile nach dem Nachnamen",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "XPN/4",
        "identity": "v2"
      }, {
        "map": "./part[partType = SFX]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "*",
      "id": "Patient.name.suffix",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "orderMeaning": "Suffixes appear in the correct order for presenting the name",
      "base": {
        "max": "*",
        "min": 0,
        "path": "HumanName.suffix"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "per-1",
        "human": "If present, start SHALL have a lower value than end",
        "xpath": "not(exists(f:start)) or not(exists(f:end)) or (f:start/@value <= f:end/@value)",
        "severity": "error",
        "expression": "start.empty() or end.empty() or (start <= end)"
      } ],
      "path": "Patient.name.period",
      "requirements": "Allows names to be placed in historical context.",
      "min": 0,
      "definition": "Indicates the period of time when this name was valid for the named person.",
      "short": "Time period when name was/is in use",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "DR",
        "identity": "v2"
      }, {
        "map": "IVL[lowClosed=\"true\" and highClosed=\"true\"] or URG[lowClosed=\"true\" and highClosed=\"true\"]",
        "identity": "rim"
      }, {
        "map": "XPN.13 + XPN.14",
        "identity": "v2"
      }, {
        "map": "./usablePeriod[type=\"IVL\"]",
        "identity": "rim"
      }, {
        "map": "./StartDate and ./EndDate",
        "identity": "servd"
      } ],
      "type": [ {
        "code": "Period"
      } ],
      "max": "1",
      "id": "Patient.name.period",
      "condition": [ "ele-1" ],
      "comment": "This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. \"the patient was an inpatient of the hospital for this time range\") or one value from the range applies (e.g. \"give to the patient between these two times\"). If duration is required, specify the type as Interval|Duration.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "HumanName.period"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "cpt-2",
        "human": "A system is required if a value is provided.",
        "xpath": "not(exists(f:value)) or exists(f:system)",
        "severity": "error",
        "expression": "value.empty() or system.exists()"
      } ],
      "path": "Patient.telecom",
      "requirements": "People have (primary) ways to contact them in some way such as phone, email.",
      "min": 0,
      "definition": "A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted.",
      "short": "A contact detail for the individual",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "XTN",
        "identity": "v2"
      }, {
        "map": "TEL",
        "identity": "rim"
      }, {
        "map": "ContactPoint",
        "identity": "servd"
      }, {
        "map": "PID-13, PID-14, PID-40",
        "identity": "v2"
      }, {
        "map": "telecom",
        "identity": "rim"
      }, {
        "map": ".telecom",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "ContactPoint"
      } ],
      "max": "*",
      "id": "Patient.telecom",
      "condition": [ "ele-1" ],
      "comment": "A Patient may have multiple ways to be contacted with different uses or applicable periods.  May need to have options for contacting the person urgently and also to help with identification. The address may not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Patient.telecom"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.telecom.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Patient.telecom.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.telecom.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Patient.telecom.extension",
      "condition": [ "ele-1" ],
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.telecom.system",
      "min": 0,
      "definition": "Telecommunications form for contact point - what communications system is required to make use of the contact.",
      "short": "phone | fax | email | pager | url | sms | other",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "XTN.3",
        "identity": "v2"
      }, {
        "map": "./scheme",
        "identity": "rim"
      }, {
        "map": "./ContactPointType",
        "identity": "servd"
      }, {
        "map": "1291 (abweichendes CodeSystem)",
        "identity": "BDT"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "binding": {
        "strength": "required",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ContactPointSystem"
        } ],
        "description": "Telecommunications form for contact point",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/contact-point-system"
        }
      },
      "max": "1",
      "id": "Patient.telecom.system",
      "condition": [ "ele-1", "cpt-2" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ContactPoint.system"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.telecom.value",
      "requirements": "Need to support legacy numbers that are not in a tightly controlled format.",
      "min": 0,
      "definition": "The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).",
      "short": "The actual contact point details",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "XTN.1 (or XTN.12)",
        "identity": "v2"
      }, {
        "map": "./url",
        "identity": "rim"
      }, {
        "map": "./Value",
        "identity": "servd"
      }, {
        "map": "1290, 7330, 7331, 7332, 7349, 7333, 7335, 7334",
        "identity": "BDT"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "id": "Patient.telecom.value",
      "condition": [ "ele-1" ],
      "comment": "Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ContactPoint.value"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.telecom.use",
      "requirements": "Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.",
      "min": 0,
      "definition": "Identifies the purpose for the contact point.",
      "isModifier": true,
      "short": "home | work | temp | old | mobile - purpose of this contact point",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "XTN.2 - but often indicated by field",
        "identity": "v2"
      }, {
        "map": "unique(./use)",
        "identity": "rim"
      }, {
        "map": "./ContactPointPurpose",
        "identity": "servd"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "binding": {
        "strength": "required",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ContactPointUse"
        } ],
        "description": "Use of contact point",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/contact-point-use"
        }
      },
      "max": "1",
      "id": "Patient.telecom.use",
      "condition": [ "ele-1" ],
      "comment": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old contact etc.for a current/permanent one. Applications can assume that a contact is current unless it explicitly says that it is temporary or old.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ContactPoint.use"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.telecom.rank",
      "min": 0,
      "definition": "Specifies a preferred order in which to use a set of contacts. Contacts are ranked with lower values coming before higher values.",
      "short": "Specify preferred order of use (1 = highest)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "n/a",
        "identity": "v2"
      } ],
      "type": [ {
        "code": "positiveInt"
      } ],
      "max": "1",
      "id": "Patient.telecom.rank",
      "condition": [ "ele-1" ],
      "comment": "Note that rank does not necessarily follow the order in which the contacts are represented in the instance.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ContactPoint.rank"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "per-1",
        "human": "If present, start SHALL have a lower value than end",
        "xpath": "not(exists(f:start)) or not(exists(f:end)) or (f:start/@value <= f:end/@value)",
        "severity": "error",
        "expression": "start.empty() or end.empty() or (start <= end)"
      } ],
      "path": "Patient.telecom.period",
      "min": 0,
      "definition": "Time period when the contact point was/is in use.",
      "short": "Time period when the contact point was/is in use",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "DR",
        "identity": "v2"
      }, {
        "map": "IVL[lowClosed=\"true\" and highClosed=\"true\"] or URG[lowClosed=\"true\" and highClosed=\"true\"]",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "v2"
      }, {
        "map": "./usablePeriod[type=\"IVL\"]",
        "identity": "rim"
      }, {
        "map": "./StartDate and ./EndDate",
        "identity": "servd"
      } ],
      "type": [ {
        "code": "Period"
      } ],
      "max": "1",
      "id": "Patient.telecom.period",
      "condition": [ "ele-1" ],
      "comment": "This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. \"the patient was an inpatient of the hospital for this time range\") or one value from the range applies (e.g. \"give to the patient between these two times\"). If duration is required, specify the type as Interval|Duration.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ContactPoint.period"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.gender",
      "requirements": "Needed for identification of the individual, in combination with (at least) name and birth date. Gender of individual drives many clinical processes.",
      "min": 1,
      "definition": "Geschlecht.\r\nIn diesem Profil sind die Kardinalitäten gemäß VSDM-Spezifikation berücksichtigt.",
      "short": "male | female | other | unknown",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "PID-8",
        "identity": "v2"
      }, {
        "map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender",
        "identity": "rim"
      }, {
        "map": ".patient.administrativeGenderCode",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "mustSupport": true,
      "binding": {
        "strength": "required",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "AdministrativeGender"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
          "valueBoolean": true
        } ],
        "description": "The gender of a person used for administrative purposes.",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/administrative-gender"
        }
      },
      "max": "1",
      "id": "Patient.gender",
      "condition": [ "ele-1" ],
      "comment": "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.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Patient.gender"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.gender.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Patient.gender.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.gender.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Patient.gender.extension",
      "condition": [ "ele-1" ],
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.gender.extension",
      "min": 0,
      "definition": "Optional Extension Element - found in all resources.",
      "short": "Optional Extensions Element",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension",
        "profile": "http://fhir.de/StructureDefinition/gender-amtlich-de/0.2"
      } ],
      "mustSupport": true,
      "sliceName": "other-amtlich",
      "alias": [ "extensions", "user content" ],
      "max": "1",
      "id": "Patient.gender.extension:other-amtlich",
      "condition": [ "ele-1" ],
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.gender.extension.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Patient.gender.extension:other-amtlich.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.gender.extension.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Patient.gender.extension:other-amtlich.extension",
      "condition": [ "ele-1" ],
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.gender.extension.url",
      "min": 1,
      "definition": "Source of the definition for the extension code - a logical name or a URL.",
      "short": "identifies the meaning of the extension",
      "fixedUri": "http://fhir.de/StructureDefinition/gender-amtlich-de/0.2",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Patient.gender.extension:other-amtlich.url",
      "condition": [ "ele-1" ],
      "comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Extension.url"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.gender.extension.valueCoding",
      "min": 1,
      "definition": "Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).",
      "short": "Value of extension",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Coding"
      } ],
      "mustSupport": true,
      "sliceName": "valueCoding",
      "binding": {
        "strength": "required",
        "valueSetUri": "http://fhir.de/ValueSet/gender-amtlich-de"
      },
      "max": "1",
      "id": "Patient.gender.extension:other-amtlich.valueCoding:valueCoding",
      "condition": [ "ele-1" ],
      "comment": "A stream of bytes, base64 encoded",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Extension.value[x]"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.gender.extension.valueCoding.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Patient.gender.extension:other-amtlich.value[x]:valueCoding.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.gender.extension.valueCoding.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Patient.gender.extension:other-amtlich.value[x]:valueCoding.extension",
      "condition": [ "ele-1" ],
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.gender.extension.valueCoding.system",
      "requirements": "Need to be unambiguous about the source of the definition of the symbol.",
      "min": 1,
      "definition": "The identification of the code system that defines the meaning of the symbol in the code.",
      "short": "Identity of the terminology system",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.3",
        "identity": "v2"
      }, {
        "map": "./codeSystem",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Patient.gender.extension:other-amtlich.valueCoding:valueCoding.system",
      "condition": [ "ele-1" ],
      "comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.system"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.gender.extension.valueCoding.version",
      "min": 0,
      "definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
      "short": "Version of the system - if relevant",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.7",
        "identity": "v2"
      }, {
        "map": "./codeSystemVersion",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "id": "Patient.gender.extension:other-amtlich.value[x]:valueCoding.version",
      "condition": [ "ele-1" ],
      "comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.version"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.gender.extension.valueCoding.code",
      "requirements": "Need to refer to a particular code in the system.",
      "min": 1,
      "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).",
      "short": "Symbol in syntax defined by the system",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.1",
        "identity": "v2"
      }, {
        "map": "./code",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Patient.gender.extension:other-amtlich.valueCoding:valueCoding.code",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.code"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.gender.extension.valueCoding.display",
      "requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.",
      "min": 0,
      "definition": "A representation of the meaning of the code in the system, following the rules of the system.",
      "short": "Representation defined by the system",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.2 - but note this is not well followed",
        "identity": "v2"
      }, {
        "map": "CV.displayName",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
        "valueBoolean": true
      } ],
      "max": "1",
      "id": "Patient.gender.extension:other-amtlich.value[x]:valueCoding.display",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.display"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.gender.extension.valueCoding.userSelected",
      "requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
      "min": 0,
      "definition": "Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).",
      "short": "If this coding was chosen directly by the user",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "Sometimes implied by being first",
        "identity": "v2"
      }, {
        "map": "CD.codingRationale",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [     fhir:source \"true\";     fhir:target dt:CDCoding.codingRationale\\#O   ]",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "boolean"
      } ],
      "max": "1",
      "id": "Patient.gender.extension:other-amtlich.value[x]:valueCoding.userSelected",
      "condition": [ "ele-1" ],
      "comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.userSelected"
      },
      "isSummary": true
    }, {
      "path": "Patient.gender.value",
      "min": 0,
      "definition": "Primitive value for code",
      "short": "Primitive value for code",
      "type": [ {
        "_code": {
          "extension": [ {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-json-type",
            "valueString": "string"
          }, {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-xml-type",
            "valueString": "xsd:token"
          }, {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-rdf-type",
            "valueString": "xsd:token"
          } ]
        },
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-regex",
          "valueString": "[^\\s]+([\\s]?[^\\s]+)*"
        } ]
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Patient.gender.value",
      "maxLength": 1048576,
      "base": {
        "max": "1",
        "min": 0,
        "path": "string.value"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.birthDate",
      "requirements": "Age of the individual drives many clinical processes.",
      "min": 1,
      "definition": "Geburtsdatum\r\nIn diesem Profil sind die Kardinalitäten gemäß VSDM-Spezifikation berücksichtigt.",
      "short": "Geburtsdatum",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "PID-7",
        "identity": "v2"
      }, {
        "map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/birthTime",
        "identity": "rim"
      }, {
        "map": ".patient.birthTime",
        "identity": "cda"
      }, {
        "map": "21112-8",
        "identity": "loinc"
      } ],
      "type": [ {
        "code": "date"
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Patient.birthDate",
      "condition": [ "ele-1" ],
      "comment": "At least an estimated year should be provided as a guess if the real DOB is unknown  There is a standard extension \"patient-birthTime\" available that should be used where Time is required (such as in maternaty/infant care systems).",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Patient.birthDate"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.deceased[x]",
      "requirements": "The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.",
      "min": 0,
      "definition": "Indicates if the individual is deceased or not.",
      "isModifier": true,
      "short": "Indicates if the individual is deceased or not",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "PID-30  (bool) and PID-29 (datetime)",
        "identity": "v2"
      }, {
        "map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedTime",
        "identity": "rim"
      }, {
        "map": "n/a",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "boolean"
      }, {
        "code": "dateTime"
      } ],
      "max": "1",
      "id": "Patient.deceased[x]",
      "condition": [ "ele-1" ],
      "comment": "If there's no value in the instance it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.\n\nThis element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Patient.deceased[x]"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "add-1",
        "human": "Wenn die Extension 'Hausnummer' verwendet wird, muss auch Address.line gefüllt werden",
        "severity": "error",
        "expression": "line.all($this.extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber').empty() or $this.hasValue())"
      }, {
        "key": "add-2",
        "human": "Wenn die Extension 'Strasse' verwendet wird, muss auch Address.line gefüllt werden",
        "severity": "error",
        "expression": "line.all($this.extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName').empty() or $this.hasValue())"
      }, {
        "key": "add-3",
        "human": "Wenn die Extension 'Postfach' verwendet wird, muss auch Address.line gefüllt werden",
        "severity": "error",
        "expression": "line.all($this.extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-postBox').empty() or $this.hasValue())"
      }, {
        "key": "add-4",
        "human": "Eine Postfach-Adresse darf nicht vom Type \"physical\" oder \"both\" sein.",
        "severity": "warning",
        "expression": "line.all($this.extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-postBox').empty() or $this.hasValue()) or type='postal' or type.empty()"
      }, {
        "key": "add-5",
        "human": "Wenn die Extension 'Adresszusatz' verwendet wird, muss auch Address.line gefüllt werden",
        "severity": "error",
        "expression": "line.all($this.extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator').empty() or $this.hasValue())"
      }, {
        "key": "add-6",
        "human": "Wenn die Extension 'Postfach' verwendet wird, dürfen die Extensions 'Strasse' und 'Hausnummer' nicht verwendet werden",
        "severity": "warning",
        "expression": "line.all($this.extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-postBox').empty() or ($this.extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName').empty() and $this.extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber').empty()))"
      } ],
      "path": "Patient.address",
      "requirements": "May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.",
      "min": 1,
      "definition": "Adresse nach deutschem Profil.\r\nDie in diesem Profil verwendeten Extensions bilden die Struktur der Adresse ab, wie sie im VSDM-Format der elektronischen Versichertenkarte verwendet wird.",
      "short": "Adresse nach deutschem Profil",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "XAD",
        "identity": "v2"
      }, {
        "map": "AD",
        "identity": "rim"
      }, {
        "map": "Address",
        "identity": "servd"
      }, {
        "map": "PID-11",
        "identity": "v2"
      }, {
        "map": "addr",
        "identity": "rim"
      }, {
        "map": ".addr",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "Address",
        "profile": "http://fhir.de/StructureDefinition/address-de-basis/0.2"
      } ],
      "max": "*",
      "id": "Patient.address",
      "condition": [ "ele-1" ],
      "comment": "Note: address is for postal addresses, not physical locations.",
      "example": [ {
        "label": "Beispiel für einfache Adresse",
        "valueAddress": {
          "use": "home",
          "city": "Musterhausen",
          "line": [ "Musterweg 42" ],
          "type": "postal",
          "postalCode": "99999"
        }
      } ],
      "base": {
        "max": "*",
        "min": 0,
        "path": "Patient.address"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.address.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Patient.address.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.address.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Patient.address.extension",
      "condition": [ "ele-1" ],
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.address.use",
      "requirements": "Allows an appropriate address to be chosen from a list of many.",
      "min": 0,
      "definition": "The purpose of this address.",
      "isModifier": true,
      "short": "home | work | temp | old - purpose of this address",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "XAD.7",
        "identity": "v2"
      }, {
        "map": "unique(./use)",
        "identity": "rim"
      }, {
        "map": "./AddressPurpose",
        "identity": "servd"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "binding": {
        "strength": "required",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "AddressUse"
        } ],
        "description": "The use of an address",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/address-use"
        }
      },
      "max": "1",
      "id": "Patient.address.use",
      "condition": [ "ele-1" ],
      "comment": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old address etc.for a current/permanent one. Applications can assume that an address is current unless it explicitly says that it is temporary or old.",
      "example": [ {
        "label": "General",
        "valueCode": "home"
      } ],
      "base": {
        "max": "1",
        "min": 0,
        "path": "Address.use"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.address.type",
      "min": 0,
      "definition": "Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both.",
      "short": "postal | physical | both",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "XAD.18",
        "identity": "v2"
      }, {
        "map": "unique(./use)",
        "identity": "rim"
      }, {
        "map": "address type parameter",
        "identity": "vcard"
      }, {
        "map": "1202 (1=physical, 2=postal)",
        "identity": "BDT"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "binding": {
        "strength": "required",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "AddressType"
        } ],
        "description": "The type of an address (physical / postal)",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/address-type"
        }
      },
      "max": "1",
      "id": "Patient.address.type",
      "condition": [ "ele-1", "add-4" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "example": [ {
        "label": "General",
        "valueCode": "both"
      } ],
      "base": {
        "max": "1",
        "min": 0,
        "path": "Address.type"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.address.text",
      "requirements": "A renderable, unencoded form.",
      "min": 0,
      "definition": "A full text representation of the address.",
      "short": "Text representation of the address",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "XAD.1 + XAD.2 + XAD.3 + XAD.4 + XAD.5 + XAD.6",
        "identity": "v2"
      }, {
        "map": "./formatted",
        "identity": "rim"
      }, {
        "map": "address label parameter",
        "identity": "vcard"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "id": "Patient.address.text",
      "condition": [ "ele-1" ],
      "comment": "Can provide both a text representation and parts.",
      "example": [ {
        "label": "General",
        "valueString": "137 Nowhere Street, Erewhon 9132"
      } ],
      "base": {
        "max": "1",
        "min": 0,
        "path": "Address.text"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.address.line",
      "requirements": "home | work | temp | old - purpose of this address.",
      "min": 0,
      "definition": "Diese Komponente kann Straßennamen, Hausnummer, Appartmentnummer, Postfach, c/o sowie weitere Zustellungshinweise enthalten. Die Informationen können in mehrere line-Komponenten aufgeteilt werden.\r\nBei Verwendung der Extensions, um Straße, Hausnnummer und Postleitzahl strukturiert zu übermitteln, müssen diese Informationen stets vollständig auch in der line-Komponente, die sie erweitern, enthalten sein, um es Systemen, die diese Extensions nicht verwenden zu ermöglichen, auf diese Informationen zugreifen zu können.",
      "short": "Straßenname mit Hausnummer oder Postfach sowie weitere Angaben zur Zustellung",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "XAD.1 + XAD.2 (note: XAD.1 and XAD.2 have different meanings for a company address than for a person address)",
        "identity": "v2"
      }, {
        "map": "AD.part[parttype = AL]",
        "identity": "rim"
      }, {
        "map": "street",
        "identity": "vcard"
      }, {
        "map": "./StreetAddress (newline delimitted)",
        "identity": "servd"
      }, {
        "map": "3107 + 3109 + 3115 oder 3123",
        "identity": "KVDT"
      }, {
        "map": "3107 + 3109 + 3115 oder 3123",
        "identity": "BDT"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "mustSupport": true,
      "max": "*",
      "id": "Patient.address.line",
      "condition": [ "ele-1", "add-1", "add-2", "add-3", "add-4", "add-5", "add-6" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "example": [ {
        "label": "General",
        "valueString": "137 Nowhere Street"
      }, {
        "label": "Beipiel für Adresszeile mit Extensions für Straße und Hausnummer",
        "valueString": "Musterweg 42",
        "_valueString": {
          "extension": [ {
            "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName",
            "valueString": "Musterweg 42"
          }, {
            "url": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber",
            "valueString": "42"
          } ]
        }
      } ],
      "orderMeaning": "The order in which lines should appear in an address label",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Address.line"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.address.line.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Patient.address.line.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.address.line.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Patient.address.line.extension",
      "condition": [ "ele-1" ],
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.address.line.extension",
      "min": 0,
      "definition": "Strassenname (ohne Hausnummer)\r\nBei Angabe einer Strasse in dieser Extension muss diese auch in Address.line angegeben werden um die Interoperabilität mit Systemen zu gewährleisten, die diese Extension nicht verwenden.",
      "short": "Strassenname (ohne Hausnummer)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      }, {
        "map": "ADXP[partType=STR]",
        "identity": "rim"
      }, {
        "map": "3107",
        "identity": "KVDT"
      }, {
        "map": "3107",
        "identity": "BDT"
      } ],
      "type": [ {
        "code": "Extension",
        "profile": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName"
      } ],
      "mustSupport": true,
      "sliceName": "Strasse",
      "alias": [ "extensions", "user content" ],
      "max": "1",
      "id": "Patient.address.line.extension:Strasse",
      "condition": [ "ele-1", "add-2", "add-6" ],
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.address.line.extension.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Patient.address.line.extension:Strasse.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.address.line.extension.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "0",
      "id": "Patient.address.line.extension:Strasse.extension",
      "condition": [ "ele-1" ],
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.address.line.extension.url",
      "min": 1,
      "definition": "Source of the definition for the extension code - a logical name or a URL.",
      "short": "identifies the meaning of the extension",
      "fixedUri": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Patient.address.line.extension:Strasse.url",
      "condition": [ "ele-1" ],
      "comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Extension.url"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.address.line.extension.valueString",
      "min": 0,
      "definition": "Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).",
      "short": "Value of extension",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "sliceName": "valueString",
      "max": "1",
      "id": "Patient.address.line.extension:Strasse.value[x]:valueString",
      "condition": [ "ele-1" ],
      "comment": "A stream of bytes, base64 encoded",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Extension.value[x]"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.address.line.extension",
      "min": 0,
      "definition": "Hausnummer, sowie Zusätze (Appartmentnummer, Etage...)\r\nBei Angabe einer Hausnummer in dieser Extension muss diese auch in Address.line angegeben werden um die Interoperabilität mit Systemen zu gewährleisten, die diese Extension nicht verwenden.",
      "short": "Hausnummer",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      }, {
        "map": "ADXP[partType=BNR]",
        "identity": "rim"
      }, {
        "map": "3109",
        "identity": "KVDT"
      }, {
        "map": "3109",
        "identity": "BDT"
      } ],
      "type": [ {
        "code": "Extension",
        "profile": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber"
      } ],
      "mustSupport": true,
      "sliceName": "Hausnummer",
      "alias": [ "extensions", "user content" ],
      "max": "1",
      "id": "Patient.address.line.extension:Hausnummer",
      "condition": [ "ele-1", "add-1", "add-6" ],
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.address.line.extension.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Patient.address.line.extension:Hausnummer.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.address.line.extension.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "0",
      "id": "Patient.address.line.extension:Hausnummer.extension",
      "condition": [ "ele-1" ],
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.address.line.extension.url",
      "min": 1,
      "definition": "Source of the definition for the extension code - a logical name or a URL.",
      "short": "identifies the meaning of the extension",
      "fixedUri": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Patient.address.line.extension:Hausnummer.url",
      "condition": [ "ele-1" ],
      "comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Extension.url"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.address.line.extension.valueString",
      "min": 0,
      "definition": "Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).",
      "short": "Value of extension",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "sliceName": "valueString",
      "max": "1",
      "id": "Patient.address.line.extension:Hausnummer.value[x]:valueString",
      "condition": [ "ele-1" ],
      "comment": "A stream of bytes, base64 encoded",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Extension.value[x]"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.address.line.extension",
      "min": 0,
      "definition": "Zusätzliche Informationen, wie z.B. \"3. Etage\", \"Appartment C\"\r\nBei Angabe einer Zusatzinformation in dieser Extension muss diese auch in Address.line angegeben werden um die Interoperabilität mit Systemen zu gewährleisten, die diese Extension nicht verwenden.",
      "short": "Adresszusatz",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      }, {
        "map": "ADXP[partType=ADL]",
        "identity": "rim"
      }, {
        "map": "3115",
        "identity": "KVDT"
      }, {
        "map": "3115",
        "identity": "BDT"
      } ],
      "type": [ {
        "code": "Extension",
        "profile": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator"
      } ],
      "mustSupport": true,
      "sliceName": "Adresszusatz",
      "alias": [ "extensions", "user content" ],
      "max": "1",
      "id": "Patient.address.line.extension:Adresszusatz",
      "condition": [ "ele-1", "add-5" ],
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.address.line.extension.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Patient.address.line.extension:Adresszusatz.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.address.line.extension.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "0",
      "id": "Patient.address.line.extension:Adresszusatz.extension",
      "condition": [ "ele-1" ],
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.address.line.extension.url",
      "min": 1,
      "definition": "Source of the definition for the extension code - a logical name or a URL.",
      "short": "identifies the meaning of the extension",
      "fixedUri": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Patient.address.line.extension:Adresszusatz.url",
      "condition": [ "ele-1" ],
      "comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Extension.url"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.address.line.extension.valueString",
      "min": 0,
      "definition": "Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).",
      "short": "Value of extension",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "sliceName": "valueString",
      "max": "1",
      "id": "Patient.address.line.extension:Adresszusatz.value[x]:valueString",
      "condition": [ "ele-1" ],
      "comment": "A stream of bytes, base64 encoded",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Extension.value[x]"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.address.line.extension",
      "min": 0,
      "definition": "Postfach-Adresse.\r\nBei Angabe eines Postfaches in dieser Extension muss das Postfach auch in Address.line angegeben werden um die Interoperabilität mit Systemen zu gewährleisten, die diese Extension nicht verwenden.\r\nEine Postfach-Adresse darf nicht in Verbindung mit Address.type \"physical\" oder \"both\" verwendet werden.",
      "short": "Postfach",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      }, {
        "map": "ADXP[partType=POB]",
        "identity": "rim"
      }, {
        "map": "3123",
        "identity": "KVDT"
      }, {
        "map": "3123",
        "identity": "BDT"
      } ],
      "type": [ {
        "code": "Extension",
        "profile": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-postBox"
      } ],
      "mustSupport": true,
      "sliceName": "Postfach",
      "alias": [ "extensions", "user content" ],
      "max": "1",
      "id": "Patient.address.line.extension:Postfach",
      "condition": [ "ele-1", "add-3", "add-4", "add-6" ],
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.address.line.extension.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Patient.address.line.extension:Postfach.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.address.line.extension.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "0",
      "id": "Patient.address.line.extension:Postfach.extension",
      "condition": [ "ele-1" ],
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.address.line.extension.url",
      "min": 1,
      "definition": "Source of the definition for the extension code - a logical name or a URL.",
      "short": "identifies the meaning of the extension",
      "fixedUri": "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-postBox",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Patient.address.line.extension:Postfach.url",
      "condition": [ "ele-1" ],
      "comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Extension.url"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.address.line.extension.valueString",
      "min": 0,
      "definition": "Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).",
      "short": "Value of extension",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "sliceName": "valueString",
      "max": "1",
      "id": "Patient.address.line.extension:Postfach.value[x]:valueString",
      "condition": [ "ele-1" ],
      "comment": "A stream of bytes, base64 encoded",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Extension.value[x]"
      }
    }, {
      "path": "Patient.address.line.value",
      "min": 0,
      "definition": "Primitive value for string",
      "short": "Primitive value for string",
      "type": [ {
        "_code": {
          "extension": [ {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-json-type",
            "valueString": "string"
          }, {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-xml-type",
            "valueString": "xsd:string"
          }, {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-rdf-type",
            "valueString": "xsd:string"
          } ]
        }
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Patient.address.line.value",
      "maxLength": 1048576,
      "base": {
        "max": "1",
        "min": 0,
        "path": "string.value"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.address.city",
      "min": 1,
      "definition": "The name of the city, town, village or other community or delivery center.",
      "short": "Name of city, town etc.",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "XAD.3",
        "identity": "v2"
      }, {
        "map": "AD.part[parttype = CTY]",
        "identity": "rim"
      }, {
        "map": "locality",
        "identity": "vcard"
      }, {
        "map": "./Jurisdiction",
        "identity": "servd"
      }, {
        "map": "3113 oder 3122 (Postfach)",
        "identity": "BDT"
      }, {
        "map": "3113 oder 3122 (Postfach)",
        "identity": "KVDT"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "mustSupport": true,
      "alias": [ "Municpality" ],
      "max": "1",
      "id": "Patient.address.city",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "example": [ {
        "label": "General",
        "valueString": "Erewhon"
      } ],
      "base": {
        "max": "1",
        "min": 0,
        "path": "Address.city"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.address.district",
      "min": 0,
      "definition": "The name of the administrative area (county).",
      "short": "District name (aka county)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "XAD.9",
        "identity": "v2"
      }, {
        "map": "AD.part[parttype = CNT | CPA]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "alias": [ "County" ],
      "max": "0",
      "id": "Patient.address.district",
      "condition": [ "ele-1" ],
      "comment": "District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.",
      "example": [ {
        "label": "General",
        "valueString": "Madison"
      } ],
      "base": {
        "max": "1",
        "min": 0,
        "path": "Address.district"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.address.state",
      "min": 0,
      "definition": "Name (oder Kürzel) des Bundeslandes.",
      "short": "Bundesland",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "XAD.4",
        "identity": "v2"
      }, {
        "map": "AD.part[parttype = STA]",
        "identity": "rim"
      }, {
        "map": "region",
        "identity": "vcard"
      }, {
        "map": "./Region",
        "identity": "servd"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "binding": {
        "strength": "preferred",
        "valueSetUri": "http://fhir.de/ValueSet/iso/bundeslaender"
      },
      "alias": [ "Province", "Territory" ],
      "max": "1",
      "id": "Patient.address.state",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Address.state"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.address.postalCode",
      "min": 1,
      "definition": "Postleitzahl gemäß der im jeweiligen Land gültigen Konventionen",
      "short": "Postleitzahl",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "XAD.5",
        "identity": "v2"
      }, {
        "map": "AD.part[parttype = ZIP]",
        "identity": "rim"
      }, {
        "map": "code",
        "identity": "vcard"
      }, {
        "map": "./PostalIdentificationCode",
        "identity": "servd"
      }, {
        "map": "3112 oder 3121 (Postfach)",
        "identity": "BDT"
      }, {
        "map": "3112 oder 3121 (Postfach)",
        "identity": "KVDT"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "mustSupport": true,
      "alias": [ "Zip" ],
      "max": "1",
      "id": "Patient.address.postalCode",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "example": [ {
        "label": "General",
        "valueString": "9132"
      } ],
      "base": {
        "max": "1",
        "min": 0,
        "path": "Address.postalCode"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.address.country",
      "min": 1,
      "definition": "Staat (vorzugsweise als 2-Stelliger ISO-Ländercode).\r\nEs obliegt abgeleiteten Profilen, hier die Verwendung der ISO-Ländercodes verbindlich vorzuschreiben",
      "short": "Staat",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "XAD.6",
        "identity": "v2"
      }, {
        "map": "AD.part[parttype = CNT]",
        "identity": "rim"
      }, {
        "map": "country",
        "identity": "vcard"
      }, {
        "map": "./Country",
        "identity": "servd"
      }, {
        "map": "3114 oder 3124 (Postfach), abweichendes CodeSystem",
        "identity": "BDT"
      }, {
        "map": "3114 oder 3124 (Postfach), abweichendes CodeSystem",
        "identity": "KVDT"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "mustSupport": true,
      "binding": {
        "strength": "preferred",
        "valueSetUri": "http://hl7.org/fhir/ValueSet/jurisdiction"
      },
      "max": "1",
      "id": "Patient.address.country",
      "condition": [ "ele-1" ],
      "comment": "ISO 3166 3 letter codes can be used in place of a full country name.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Address.country"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "per-1",
        "human": "If present, start SHALL have a lower value than end",
        "xpath": "not(exists(f:start)) or not(exists(f:end)) or (f:start/@value <= f:end/@value)",
        "severity": "error",
        "expression": "start.empty() or end.empty() or (start <= end)"
      } ],
      "path": "Patient.address.period",
      "requirements": "Allows addresses to be placed in historical context.",
      "min": 0,
      "definition": "Time period when address was/is in use.",
      "short": "Time period when address was/is in use",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "DR",
        "identity": "v2"
      }, {
        "map": "IVL[lowClosed=\"true\" and highClosed=\"true\"] or URG[lowClosed=\"true\" and highClosed=\"true\"]",
        "identity": "rim"
      }, {
        "map": "XAD.12 / XAD.13 + XAD.14",
        "identity": "v2"
      }, {
        "map": "./usablePeriod[type=\"IVL\"]",
        "identity": "rim"
      }, {
        "map": "./StartDate and ./EndDate",
        "identity": "servd"
      } ],
      "type": [ {
        "code": "Period"
      } ],
      "max": "1",
      "id": "Patient.address.period",
      "condition": [ "ele-1" ],
      "comment": "This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. \"the patient was an inpatient of the hospital for this time range\") or one value from the range applies (e.g. \"give to the patient between these two times\"). If duration is required, specify the type as Interval|Duration.",
      "example": [ {
        "label": "General",
        "valuePeriod": {
          "end": "2010-07-01",
          "start": "2010-03-23"
        }
      } ],
      "base": {
        "max": "1",
        "min": 0,
        "path": "Address.period"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.address.period.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Patient.address.period.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.address.period.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Patient.address.period.extension",
      "condition": [ "ele-1" ],
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.address.period.start",
      "min": 0,
      "definition": "The start of the period. The boundary is inclusive.",
      "short": "Starting time with inclusive boundary",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "DR.1",
        "identity": "v2"
      }, {
        "map": "./low",
        "identity": "rim"
      }, {
        "map": "8226",
        "identity": "BDT"
      } ],
      "type": [ {
        "code": "dateTime"
      } ],
      "max": "1",
      "id": "Patient.address.period.start",
      "condition": [ "ele-1", "per-1" ],
      "comment": "If the low element is missing, the meaning is that the low boundary is not known.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Period.start"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.address.period.end",
      "min": 0,
      "definition": "The end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.",
      "short": "End time with inclusive boundary, if not ongoing",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "DR.2",
        "identity": "v2"
      }, {
        "map": "./high",
        "identity": "rim"
      }, {
        "map": "8227",
        "identity": "BDT"
      } ],
      "type": [ {
        "code": "dateTime"
      } ],
      "meaningWhenMissing": "If the end of the period is missing, it means that the period is ongoing",
      "max": "1",
      "id": "Patient.address.period.end",
      "condition": [ "ele-1", "per-1" ],
      "comment": "The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Period.end"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.maritalStatus",
      "requirements": "Most, if not all systems capture it.",
      "min": 0,
      "definition": "This field contains a patient's most recent marital (civil) status.",
      "short": "Marital (civil) status of a patient",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE",
        "identity": "v2"
      }, {
        "map": "CD",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
        "identity": "orim"
      }, {
        "map": "PID-16",
        "identity": "v2"
      }, {
        "map": "player[classCode=PSN]/maritalStatusCode",
        "identity": "rim"
      }, {
        "map": ".patient.maritalStatusCode",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "extensible",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "MaritalStatus"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
          "valueBoolean": true
        } ],
        "description": "The domestic partnership status of a person.",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/marital-status"
        }
      },
      "max": "1",
      "id": "Patient.maritalStatus",
      "condition": [ "ele-1" ],
      "comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Patient.maritalStatus"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.multipleBirth[x]",
      "requirements": "For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs.",
      "min": 0,
      "definition": "Indicates whether the patient is part of a multiple (bool) or indicates the actual birth order (integer).",
      "short": "Whether patient is part of a multiple birth",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "PID-24 (bool), PID-25 (integer)",
        "identity": "v2"
      }, {
        "map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthInd,  player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber",
        "identity": "rim"
      }, {
        "map": "n/a",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "boolean"
      }, {
        "code": "integer"
      } ],
      "max": "1",
      "id": "Patient.multipleBirth[x]",
      "condition": [ "ele-1" ],
      "comment": "Where the valueInteger is provided, the number is the birth number in the sequence.\nE.g. The middle birth in tripplets would be valueInteger=2 and the third born would have valueInteger=3\nIf a bool value was provided for this tripplets examle, then all 3 patient records would have valueBool=true (the ordering is not indicated).",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Patient.multipleBirth[x]"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "att-1",
        "human": "It the Attachment has data, it SHALL have a contentType",
        "xpath": "not(exists(f:data)) or exists(f:contentType)",
        "severity": "error",
        "expression": "data.empty() or contentType.exists()"
      } ],
      "path": "Patient.photo",
      "requirements": "Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too.",
      "min": 0,
      "definition": "Image of the patient.",
      "short": "Image of the patient",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "ED/RP",
        "identity": "v2"
      }, {
        "map": "ED",
        "identity": "rim"
      }, {
        "map": "OBX-5 - needs a profile",
        "identity": "v2"
      }, {
        "map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/desc",
        "identity": "rim"
      }, {
        "map": "n/a",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "Attachment"
      } ],
      "max": "*",
      "id": "Patient.photo",
      "condition": [ "ele-1" ],
      "comment": "When providing a summary view (for example with Observation.value[x]) Attachment should be represented with a brief display text such as \"Attachment\".",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Patient.photo"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "pat-1",
        "human": "SHALL at least contain a contact's details or a reference to an organization",
        "xpath": "exists(f:name) or exists(f:telecom) or exists(f:address) or exists(f:organization)",
        "severity": "error",
        "expression": "name.exists() or telecom.exists() or address.exists() or organization.exists()"
      } ],
      "path": "Patient.contact",
      "requirements": "Need to track people you can contact about the patient.",
      "min": 0,
      "definition": "A contact party (e.g. guardian, partner, friend) for the patient.",
      "short": "A contact party (e.g. guardian, partner, friend) for the patient",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON]",
        "identity": "rim"
      }, {
        "map": "n/a",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString": "Contact"
      } ],
      "max": "*",
      "id": "Patient.contact",
      "condition": [ "ele-1" ],
      "comment": "Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Patient.contact"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.contact.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Patient.contact.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.contact.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Patient.contact.extension",
      "condition": [ "ele-1" ],
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.contact.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
      "isModifier": true,
      "short": "Extensions that cannot be ignored",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "Patient.contact.modifierExtension",
      "condition": [ "ele-1" ],
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.contact.relationship",
      "requirements": "Used to determine which contact person is the most relevant to approach, depending on circumstances.",
      "min": 0,
      "definition": "The nature of the relationship between the patient and the contact person.",
      "short": "The kind of relationship",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE",
        "identity": "v2"
      }, {
        "map": "CD",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
        "identity": "orim"
      }, {
        "map": "NK1-7, NK1-3",
        "identity": "v2"
      }, {
        "map": "code",
        "identity": "rim"
      }, {
        "map": "n/a",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "extensible",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ContactRelationship"
        } ],
        "description": "The nature of the relationship between a patient and a contact person for that patient.",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/v2-0131"
        }
      },
      "max": "*",
      "id": "Patient.contact.relationship",
      "condition": [ "ele-1" ],
      "comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Patient.contact.relationship"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "hum-1",
        "human": "Wenn die Extension 'namenszusatz' verwendet wird, dann muss der vollständige Name im Attribut 'family' angegeben werden",
        "severity": "error",
        "expression": "family.extension('http://fhir.de/StructureDefinition/humanname-namenszusatz').empty() or family.hasValue()"
      }, {
        "key": "hum-2",
        "human": "Wenn die Extension 'nachname' verwendet wird, dann muss der vollständige Name im Attribut 'family' angegeben werden",
        "severity": "error",
        "expression": "family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-name').empty() or family.hasValue()"
      }, {
        "key": "hum-3",
        "human": "Wenn die Extension 'vorsatzwort' verwendet wird, dann muss der vollständige Name im Attribut 'family' angegeben werden",
        "severity": "error",
        "expression": "family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-prefix').empty() or family.hasValue()"
      }, {
        "key": "hum-4",
        "human": "Wenn die Extension 'prefix-qualifier' verwendet wird, dann muss ein Namenspräfix im Attribut 'prefix' angegeben werden",
        "severity": "error",
        "expression": "prefix.all($this.extension('http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier').empty() or $this.hasValue())"
      } ],
      "path": "Patient.contact.name",
      "requirements": "Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person.",
      "min": 0,
      "definition": "Personenname nach deutschem Profil.\r\nDieser enthält bestimmte Extensions, die in Deutschland Verwendung finden.",
      "short": "Personenname nach deutschem Profil.",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "XPN",
        "identity": "v2"
      }, {
        "map": "EN (actually, PN)",
        "identity": "rim"
      }, {
        "map": "ProviderName",
        "identity": "servd"
      }, {
        "map": "NK1-2",
        "identity": "v2"
      }, {
        "map": "name",
        "identity": "rim"
      }, {
        "map": "n/a",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "HumanName",
        "profile": "http://fhir.de/StructureDefinition/humanname-de-basis/0.2"
      } ],
      "max": "*",
      "id": "Patient.contact.name",
      "condition": [ "ele-1" ],
      "comment": "Hinweis zur Repräsentation von Anreden: Diese sollten, sofern erforderlich, ausschließlich in HumanName.text erscheinen (z.B. \"Frsu Dr. Martha Musterfrau\").\r\nNach Möglichkeit sollte die Anrede aus dem Geschlecht der Person abgeleitet werden.\r\nDas Element prefix wird nur für akademische Titel und andere Namensbestandteile verwendet.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Patient.contact.name"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "cpt-2",
        "human": "A system is required if a value is provided.",
        "xpath": "not(exists(f:value)) or exists(f:system)",
        "severity": "error",
        "expression": "value.empty() or system.exists()"
      } ],
      "path": "Patient.contact.telecom",
      "requirements": "People have (primary) ways to contact them in some way such as phone, email.",
      "min": 0,
      "definition": "A contact detail for the person, e.g. a telephone number or an email address.",
      "short": "A contact detail for the person",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "XTN",
        "identity": "v2"
      }, {
        "map": "TEL",
        "identity": "rim"
      }, {
        "map": "ContactPoint",
        "identity": "servd"
      }, {
        "map": "NK1-5, NK1-6, NK1-40",
        "identity": "v2"
      }, {
        "map": "telecom",
        "identity": "rim"
      }, {
        "map": "n/a",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "ContactPoint"
      } ],
      "max": "*",
      "id": "Patient.contact.telecom",
      "condition": [ "ele-1" ],
      "comment": "Contact may have multiple ways to be contacted with different uses or applicable periods.  May need to have options for contacting the person urgently, and also to help with identification.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Patient.contact.telecom"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "add-1",
        "human": "Wenn die Extension 'Hausnummer' verwendet wird, muss auch Address.line gefüllt werden",
        "severity": "error",
        "expression": "line.all($this.extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber').empty() or $this.hasValue())"
      }, {
        "key": "add-2",
        "human": "Wenn die Extension 'Strasse' verwendet wird, muss auch Address.line gefüllt werden",
        "severity": "error",
        "expression": "line.all($this.extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName').empty() or $this.hasValue())"
      }, {
        "key": "add-3",
        "human": "Wenn die Extension 'Postfach' verwendet wird, muss auch Address.line gefüllt werden",
        "severity": "error",
        "expression": "line.all($this.extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-postBox').empty() or $this.hasValue())"
      }, {
        "key": "add-4",
        "human": "Eine Postfach-Adresse darf nicht vom Type \"physical\" oder \"both\" sein.",
        "severity": "warning",
        "expression": "line.all($this.extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-postBox').empty() or $this.hasValue()) or type='postal' or type.empty()"
      }, {
        "key": "add-5",
        "human": "Wenn die Extension 'Adresszusatz' verwendet wird, muss auch Address.line gefüllt werden",
        "severity": "error",
        "expression": "line.all($this.extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator').empty() or $this.hasValue())"
      }, {
        "key": "add-6",
        "human": "Wenn die Extension 'Postfach' verwendet wird, dürfen die Extensions 'Strasse' und 'Hausnummer' nicht verwendet werden",
        "severity": "warning",
        "expression": "line.all($this.extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-postBox').empty() or ($this.extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName').empty() and $this.extension('http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber').empty()))"
      } ],
      "path": "Patient.contact.address",
      "requirements": "Need to keep track where the contact person can be contacted per postal mail or visited.",
      "min": 0,
      "definition": "Adresse nach deutschem Profil.\r\nDie in diesem Profil verwendeten Extensions bilden die Struktur der Adresse ab, wie sie im VSDM-Format der elektronischen Versichertenkarte verwendet wird.",
      "short": "Adresse nach deutschem Profil.",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "XAD",
        "identity": "v2"
      }, {
        "map": "AD",
        "identity": "rim"
      }, {
        "map": "Address",
        "identity": "servd"
      }, {
        "map": "NK1-4",
        "identity": "v2"
      }, {
        "map": "addr",
        "identity": "rim"
      }, {
        "map": "n/a",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "Address",
        "profile": "http://fhir.de/StructureDefinition/address-de-basis/0.2"
      } ],
      "max": "*",
      "id": "Patient.contact.address",
      "condition": [ "ele-1" ],
      "comment": "Note: address is for postal addresses, not physical locations.",
      "example": [ {
        "label": "Beispiel für einfache Adresse",
        "valueAddress": {
          "use": "home",
          "city": "Musterhausen",
          "line": [ "Musterweg 42" ],
          "type": "postal",
          "postalCode": "99999"
        }
      } ],
      "base": {
        "max": "1",
        "min": 0,
        "path": "Patient.contact.address"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.contact.gender",
      "requirements": "Needed to address the person correctly.",
      "min": 0,
      "definition": "Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes.",
      "short": "male | female | other | unknown",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "NK1-15",
        "identity": "v2"
      }, {
        "map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender",
        "identity": "rim"
      }, {
        "map": "n/a",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "binding": {
        "strength": "required",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "AdministrativeGender"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
          "valueBoolean": true
        } ],
        "description": "The gender of a person used for administrative purposes.",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/administrative-gender"
        }
      },
      "max": "1",
      "id": "Patient.contact.gender",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Patient.contact.gender"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ref-1",
        "human": "SHALL have a contained resource if a local reference is provided",
        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
        "severity": "error",
        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))"
      } ],
      "path": "Patient.contact.organization",
      "requirements": "For guardians or business related contacts, the organization is relevant.",
      "min": 0,
      "definition": "Organization on behalf of which the contact is acting or for which the contact is working.",
      "short": "Organization that is associated with the contact",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
        "identity": "rim"
      }, {
        "map": "NK1-13, NK1-30, NK1-31, NK1-32, NK1-41",
        "identity": "v2"
      }, {
        "map": "scoper",
        "identity": "rim"
      }, {
        "map": "n/a",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
      } ],
      "max": "1",
      "id": "Patient.contact.organization",
      "condition": [ "ele-1", "pat-1" ],
      "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Patient.contact.organization"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "per-1",
        "human": "If present, start SHALL have a lower value than end",
        "xpath": "not(exists(f:start)) or not(exists(f:end)) or (f:start/@value <= f:end/@value)",
        "severity": "error",
        "expression": "start.empty() or end.empty() or (start <= end)"
      } ],
      "path": "Patient.contact.period",
      "min": 0,
      "definition": "The period during which this contact person or organization is valid to be contacted relating to this patient.",
      "short": "The period during which this contact person or organization is valid to be contacted relating to this patient",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "DR",
        "identity": "v2"
      }, {
        "map": "IVL[lowClosed=\"true\" and highClosed=\"true\"] or URG[lowClosed=\"true\" and highClosed=\"true\"]",
        "identity": "rim"
      }, {
        "map": "effectiveTime",
        "identity": "rim"
      }, {
        "map": "n/a",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "Period"
      } ],
      "max": "1",
      "id": "Patient.contact.period",
      "condition": [ "ele-1" ],
      "comment": "This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. \"the patient was an inpatient of the hospital for this time range\") or one value from the range applies (e.g. \"give to the patient between these two times\"). If duration is required, specify the type as Interval|Duration.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Patient.contact.period"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.animal",
      "requirements": "Many clinical systems are extended to care for animal patients as well as human.",
      "min": 0,
      "definition": "This patient is known to be an animal.",
      "isModifier": true,
      "short": "This patient is known to be an animal (non-human)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "player[classCode=ANM]",
        "identity": "rim"
      }, {
        "map": "n/a",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString": "Animal"
      } ],
      "max": "0",
      "id": "Patient.animal",
      "condition": [ "ele-1" ],
      "comment": "Die verterinärmedizinische Profilierung von FHIR is außerhalb des Scopes der Basisprofile",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Patient.animal"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.animal.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Patient.animal.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.animal.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Patient.animal.extension",
      "condition": [ "ele-1" ],
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.animal.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
      "isModifier": true,
      "short": "Extensions that cannot be ignored",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "Patient.animal.modifierExtension",
      "condition": [ "ele-1" ],
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.animal.species",
      "requirements": "Need to know what kind of animal.",
      "min": 1,
      "definition": "Identifies the high level taxonomic categorization of the kind of animal.",
      "short": "E.g. Dog, Cow",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE",
        "identity": "v2"
      }, {
        "map": "CD",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
        "identity": "orim"
      }, {
        "map": "PID-35",
        "identity": "v2"
      }, {
        "map": "code",
        "identity": "rim"
      }, {
        "map": "n/a",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "AnimalSpecies"
        } ],
        "description": "The species of an animal.",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/animal-species"
        }
      },
      "max": "1",
      "id": "Patient.animal.species",
      "condition": [ "ele-1" ],
      "comment": "If the patient is non-human, at least a species SHALL be specified. Species SHALL be a widely recognised taxonomic classification.  It may or may not be Linnaean taxonomy and may or may not be at the level of species. If the level is finer than species--such as a breed code--the code system used SHALL allow inference of the species.  (The common example is that the word \"Hereford\" does not allow inference of the species Bos taurus, because there is a Hereford pig breed, but the SNOMED CT code for \"Hereford Cattle Breed\" does.).",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Patient.animal.species"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.animal.breed",
      "requirements": "May need to know the specific kind within the species.",
      "min": 0,
      "definition": "Identifies the detailed categorization of the kind of animal.",
      "short": "E.g. Poodle, Angus",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE",
        "identity": "v2"
      }, {
        "map": "CD",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
        "identity": "orim"
      }, {
        "map": "PID-37",
        "identity": "v2"
      }, {
        "map": "playedRole[classCode=GEN]/scoper[classCode=ANM, determinerCode=KIND]/code",
        "identity": "rim"
      }, {
        "map": "n/a",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "AnimalBreed"
        } ],
        "description": "The breed of an animal.",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/animal-breeds"
        }
      },
      "max": "1",
      "id": "Patient.animal.breed",
      "condition": [ "ele-1" ],
      "comment": "Breed MAY be used to provide further taxonomic or non-taxonomic classification.  It may involve local or proprietary designation--such as commercial strain--and/or additional information such as production type.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Patient.animal.breed"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.animal.genderStatus",
      "requirements": "Gender status can affect housing and animal behavior.",
      "min": 0,
      "definition": "Indicates the current state of the animal's reproductive organs.",
      "short": "E.g. Neutered, Intact",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE",
        "identity": "v2"
      }, {
        "map": "CD",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
        "identity": "orim"
      }, {
        "map": "N/A",
        "identity": "v2"
      }, {
        "map": "genderStatusCode",
        "identity": "rim"
      }, {
        "map": "n/a",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "AnimalGenderStatus"
        } ],
        "description": "The state of the animal's reproductive organs.",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/animal-genderstatus"
        }
      },
      "max": "1",
      "id": "Patient.animal.genderStatus",
      "condition": [ "ele-1" ],
      "comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Patient.animal.genderStatus"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.communication",
      "requirements": "If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency is an important things to keep track of both for patient and other persons of interest.",
      "min": 0,
      "definition": "Languages which may be used to communicate with the patient about his or her health.",
      "short": "A list of Languages which may be used to communicate with the patient about his or her health",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "LanguageCommunication",
        "identity": "rim"
      }, {
        "map": "patient.languageCommunication",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "max": "*",
      "id": "Patient.communication",
      "condition": [ "ele-1" ],
      "comment": "If no language is specified, this *implies* that the default local language is spoken.  If you need to convey proficiency for multiple modes then you need multiple Patient.Communication associations.   For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Patient.communication"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.communication.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Patient.communication.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.communication.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Patient.communication.extension",
      "condition": [ "ele-1" ],
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.communication.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
      "isModifier": true,
      "short": "Extensions that cannot be ignored",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "Patient.communication.modifierExtension",
      "condition": [ "ele-1" ],
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.communication.language",
      "requirements": "Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.",
      "min": 1,
      "definition": "The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. \"en\" for English, or \"en-US\" for American English versus \"en-EN\" for England English.",
      "short": "The language which can be used to communicate with the patient about his or her health",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE",
        "identity": "v2"
      }, {
        "map": "CD",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
        "identity": "orim"
      }, {
        "map": "PID-15, LAN-2",
        "identity": "v2"
      }, {
        "map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/languageCommunication/code",
        "identity": "rim"
      }, {
        "map": ".languageCode",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "extensible",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
          "valueReference": {
            "reference": "http://hl7.org/fhir/ValueSet/all-languages"
          }
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "Language"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
          "valueBoolean": true
        } ],
        "description": "A human language.",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/languages"
        }
      },
      "max": "1",
      "id": "Patient.communication.language",
      "condition": [ "ele-1" ],
      "comment": "The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Patient.communication.language"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.communication.preferred",
      "requirements": "People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method.",
      "min": 0,
      "definition": "Indicates whether or not the patient prefers this language (over other languages he masters up a certain level).",
      "short": "Language preference indicator",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "PID-15",
        "identity": "v2"
      }, {
        "map": "preferenceInd",
        "identity": "rim"
      }, {
        "map": ".preferenceInd",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "boolean"
      } ],
      "max": "1",
      "id": "Patient.communication.preferred",
      "condition": [ "ele-1" ],
      "comment": "This language is specifically identified for communicating healthcare information.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Patient.communication.preferred"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ref-1",
        "human": "SHALL have a contained resource if a local reference is provided",
        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
        "severity": "error",
        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))"
      } ],
      "path": "Patient.generalPractitioner",
      "min": 0,
      "definition": "Patient's nominated care provider.",
      "short": "Patient's nominated primary care provider",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
        "identity": "rim"
      }, {
        "map": "PD1-4",
        "identity": "v2"
      }, {
        "map": "subjectOf.CareEvent.performer.AssignedEntity",
        "identity": "rim"
      }, {
        "map": "n/a",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": "http://fhir.de/StructureDefinition/organization-de-basis/0.2"
      }, {
        "code": "Reference",
        "targetProfile": "http://fhir.de/StructureDefinition/practitioner-de-basis/0.2"
      } ],
      "alias": [ "careProvider" ],
      "max": "*",
      "id": "Patient.generalPractitioner",
      "condition": [ "ele-1" ],
      "comment": "This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disablity setting, or even organization that will provide people to perform the care provider roles.\n\nIt 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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Patient.generalPractitioner"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ref-1",
        "human": "SHALL have a contained resource if a local reference is provided",
        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
        "severity": "error",
        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))"
      } ],
      "path": "Patient.managingOrganization",
      "requirements": "Need to know who recognizes this patient record, manages and updates it.",
      "min": 0,
      "definition": "haupt-behandelnde Organisation nach deutschem Profil.\r\nDieses Profil enthält für Deutschland spezififische Besonderheiten und Extensions.",
      "short": "haupt-behandelnde Organisation nach deutschem Profil",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
        "identity": "rim"
      }, {
        "map": "scoper",
        "identity": "rim"
      }, {
        "map": ".providerOrganization",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": "http://fhir.de/StructureDefinition/organization-de-basis/0.2"
      } ],
      "max": "1",
      "id": "Patient.managingOrganization",
      "condition": [ "ele-1" ],
      "comment": "There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association).",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Patient.managingOrganization"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.link",
      "requirements": "There are multiple usecases: \n\n* Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and * Distribution of patient information across multiple servers.",
      "min": 0,
      "definition": "Link to another patient resource that concerns the same actual patient.",
      "isModifier": true,
      "short": "Link to another patient resource that concerns the same actual person",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "outboundLink",
        "identity": "rim"
      }, {
        "map": "n/a",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "max": "*",
      "id": "Patient.link",
      "condition": [ "ele-1" ],
      "comment": "There is no assumption that linked patient records have mutual links. \n\nThis element is labelled as a modifier because it may not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Patient.link"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.link.id",
      "min": 0,
      "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Patient.link.id",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.link.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Patient.link.extension",
      "condition": [ "ele-1" ],
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      }
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Patient.link.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
      "isModifier": true,
      "short": "Extensions that cannot be ignored",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "Patient.link.modifierExtension",
      "condition": [ "ele-1" ],
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ref-1",
        "human": "SHALL have a contained resource if a local reference is provided",
        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
        "severity": "error",
        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))"
      } ],
      "path": "Patient.link.other",
      "min": 1,
      "definition": "The other patient resource that the link refers to.",
      "short": "The other patient or related person resource that the link refers to",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
        "identity": "rim"
      }, {
        "map": "PID-3, MRG-1",
        "identity": "v2"
      }, {
        "map": "id",
        "identity": "rim"
      }, {
        "map": "n/a",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
      }, {
        "code": "Reference",
        "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
      } ],
      "max": "1",
      "id": "Patient.link.other",
      "condition": [ "ele-1" ],
      "comment": "Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Patient.link.other"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Patient.link.type",
      "min": 1,
      "definition": "The type of link between this patient resource and another patient resource.",
      "short": "replaced-by | replaces | refer | seealso - type of link",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "typeCode",
        "identity": "rim"
      }, {
        "map": "n/a",
        "identity": "cda"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "binding": {
        "strength": "required",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "LinkType"
        } ],
        "description": "The type of link between this patient resource and another patient resource.",
        "valueSetReference": {
          "reference": "http://hl7.org/fhir/ValueSet/link-type"
        }
      },
      "max": "1",
      "id": "Patient.link.type",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings may not exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Patient.link.type"
      },
      "isSummary": true
    } ]
  },
  "status": "draft",
  "id": "a9451ce5-d32a-4e92-b9fd-6037d9fa2d74",
  "kind": "resource",
  "url": "http://fhir.de/StructureDefinition/patient-de-vsdm/0.2",
  "version": "0.2",
  "differential": {
    "element": [ {
      "id": "Patient",
      "path": "Patient",
      "short": "Patient im Kontext des deutschen VSDM",
      "definition": "Patient Ressource im Kontext des deutschen VSDM (Versichertenstammdatenmanagement, \"eGK-Datensatz\").\r\nElemente, die als \"must-support\" gekennzeichnet sind, repräsentieren die optionalen Informationen aus der der VSDM-Spezifikation."
    }, {
      "id": "Patient.identifier",
      "path": "Patient.identifier",
      "mustSupport": true
    }, {
      "id": "Patient.identifier:VersichertenID_GKV",
      "min": 1,
      "path": "Patient.identifier",
      "sliceName": "VersichertenID_GKV",
      "definition": "Die Krankenversichertennummer wie auf der eGK abgebildet (10-stellige, unveränderliche Nummer).\r\nFür dieses Profil muss diese Nummer angegeben werden.",
      "mustSupport": true
    }, {
      "id": "Patient.name",
      "min": 1,
      "path": "Patient.name",
      "definition": "Personenname nach deutschem Profil.\r\nDieser enthält bestimmte Extensions, die in Deutschland Verwendung finden.\r\nIn diesem Profil sind die Kardinalitäten gemäß VSDM-Spezifikation berücksichtigt.",
      "mustSupport": true
    }, {
      "id": "Patient.name.family",
      "min": 1,
      "path": "Patient.name.family",
      "mustSupport": true
    }, {
      "id": "Patient.name.family.extension:namenszusatz",
      "path": "Patient.name.family.extension",
      "sliceName": "namenszusatz",
      "definition": "Namenszusatz, z.B. Adelstitel als Bestandteil das Nachnamens, z.B. Gräfin, Prinz oder Fürst.\r\nIm Kontext von VSDM sind ausschließlich die Namenszusätze aus DEÜV Anlage 7 zulässig.",
      "mustSupport": true
    }, {
      "id": "Patient.name.family.extension:nachname",
      "path": "Patient.name.family.extension",
      "sliceName": "nachname",
      "mustSupport": true
    }, {
      "id": "Patient.name.family.extension:vorsatzwort",
      "path": "Patient.name.family.extension",
      "sliceName": "vorsatzwort",
      "definition": "Vorsatzwort zum Nachnamen, z.B. \"von\" \"van der\", \"zu\" usw.\r\nIm Kontext von VSDM sind ausschließlich die Vorsatzwörter aus DEÜV Anlage 6 zulässig.",
      "mustSupport": true
    }, {
      "id": "Patient.name.given",
      "min": 1,
      "path": "Patient.name.given",
      "mustSupport": true
    }, {
      "id": "Patient.name.prefix",
      "path": "Patient.name.prefix",
      "mustSupport": true
    }, {
      "id": "Patient.name.prefix.extension:prefix-qualifier",
      "path": "Patient.name.prefix.extension",
      "sliceName": "prefix-qualifier",
      "mustSupport": true
    }, {
      "id": "Patient.gender",
      "min": 1,
      "path": "Patient.gender",
      "definition": "Geschlecht.\r\nIn diesem Profil sind die Kardinalitäten gemäß VSDM-Spezifikation berücksichtigt.",
      "mustSupport": true
    }, {
      "id": "Patient.gender.extension:other-amtlich",
      "path": "Patient.gender.extension",
      "sliceName": "other-amtlich",
      "mustSupport": true
    }, {
      "id": "Patient.gender.extension:other-amtlich.valueCoding:valueCoding",
      "path": "Patient.gender.extension.valueCoding",
      "sliceName": "valueCoding",
      "mustSupport": true
    }, {
      "id": "Patient.gender.extension:other-amtlich.valueCoding:valueCoding.system",
      "path": "Patient.gender.extension.valueCoding.system",
      "mustSupport": true
    }, {
      "id": "Patient.gender.extension:other-amtlich.valueCoding:valueCoding.code",
      "path": "Patient.gender.extension.valueCoding.code",
      "mustSupport": true
    }, {
      "id": "Patient.birthDate",
      "min": 1,
      "path": "Patient.birthDate",
      "short": "Geburtsdatum",
      "definition": "Geburtsdatum\r\nIn diesem Profil sind die Kardinalitäten gemäß VSDM-Spezifikation berücksichtigt.",
      "mustSupport": true
    }, {
      "id": "Patient.address",
      "min": 1,
      "path": "Patient.address"
    }, {
      "id": "Patient.address.line",
      "path": "Patient.address.line",
      "mustSupport": true
    }, {
      "id": "Patient.address.line.extension:Strasse",
      "path": "Patient.address.line.extension",
      "sliceName": "Strasse",
      "mustSupport": true
    }, {
      "id": "Patient.address.line.extension:Hausnummer",
      "path": "Patient.address.line.extension",
      "sliceName": "Hausnummer",
      "mustSupport": true
    }, {
      "id": "Patient.address.line.extension:Adresszusatz",
      "path": "Patient.address.line.extension",
      "sliceName": "Adresszusatz",
      "mustSupport": true
    }, {
      "id": "Patient.address.line.extension:Postfach",
      "path": "Patient.address.line.extension",
      "sliceName": "Postfach",
      "mustSupport": true
    }, {
      "id": "Patient.address.city",
      "min": 1,
      "path": "Patient.address.city",
      "mustSupport": true
    }, {
      "id": "Patient.address.postalCode",
      "min": 1,
      "path": "Patient.address.postalCode",
      "mustSupport": true
    }, {
      "id": "Patient.address.country",
      "min": 1,
      "path": "Patient.address.country",
      "mustSupport": true
    } ]
  },
  "contact": [ {
    "telecom": [ {
      "value": "http://hl7.de/technische-komitees/fhir/",
      "system": "other"
    } ]
  } ],
  "baseDefinition": "http://fhir.de/StructureDefinition/patient-de-basis/0.2"
}