description: Base StructureDefinition for Patient Resource
package_name: hl7.fhir.r2b.core
derivation: specialization
name: Patient
type: null
elements:
  multipleBirthBoolean:
    isModifier: false
    short: Whether patient is part of a multiple birth
    index: 14
    comments: Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in tripplets would be valueInteger=2 and the third born would have valueInteger=3 If a bool value was provided for this tripplets examle, then all 3 patient records would have valueBool=true (the ordering is not indicated).
    type: boolean
    mustSupport: false
    maxLength: 0
    base: {max: '1', min: 0, path: 'Patient.multipleBirth[x]'}
    choiceOf: multipleBirth
    isSummary: false
  address:
    isModifier: false
    short: Addresses for the individual
    index: 10
    comments: Patient may have multiple addresses with different uses or applicable periods.
    type: Address
    mustSupport: false
    array: true
    maxLength: 0
    base: {max: '*', min: 0, path: Patient.address}
    isSummary: true
  deceasedDateTime:
    isModifier: true
    short: Indicates if the individual is deceased or not
    index: 9
    comments: 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.
    type: dateTime
    mustSupport: false
    maxLength: 0
    base: {max: '1', min: 0, path: 'Patient.deceased[x]'}
    choiceOf: deceased
    isSummary: true
  managingOrganization:
    isModifier: false
    short: Organization that is the custodian of the patient record
    index: 33
    comments: 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).
    type: Reference
    mustSupport: false
    maxLength: 0
    base: {max: '1', min: 0, path: Patient.managingOrganization}
    isSummary: true
  deceasedBoolean:
    isModifier: true
    short: Indicates if the individual is deceased or not
    index: 8
    comments: 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.
    type: boolean
    mustSupport: false
    maxLength: 0
    base: {max: '1', min: 0, path: 'Patient.deceased[x]'}
    choiceOf: deceased
    isSummary: true
  name:
    isModifier: false
    short: A name associated with the patient
    index: 2
    comments: A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.
    type: HumanName
    mustSupport: false
    array: true
    maxLength: 0
    base: {max: '*', min: 0, path: Patient.name}
    isSummary: true
  birthDate:
    isModifier: false
    short: The date of birth for the individual
    index: 5
    comments: 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).
    type: date
    mustSupport: false
    maxLength: 0
    base: {max: '1', min: 0, path: Patient.birthDate}
    isSummary: true
  multipleBirthInteger:
    isModifier: false
    short: Whether patient is part of a multiple birth
    index: 15
    comments: Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in tripplets would be valueInteger=2 and the third born would have valueInteger=3 If a bool value was provided for this tripplets examle, then all 3 patient records would have valueBool=true (the ordering is not indicated).
    type: integer
    mustSupport: false
    maxLength: 0
    base: {max: '1', min: 0, path: 'Patient.multipleBirth[x]'}
    choiceOf: multipleBirth
    isSummary: false
  careProvider:
    isModifier: false
    short: Patient's nominated primary care provider
    index: 32
    comments: 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.  This is not to be used to record Care Teams, these should be recorded on either the CarePlan or EpisodeOfCare resources.
    type: Reference
    mustSupport: false
    array: true
    maxLength: 0
    base: {max: '*', min: 0, path: Patient.careProvider}
    isSummary: false
  multipleBirth:
    isModifier: false
    short: Whether patient is part of a multiple birth
    index: 13
    comments: Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in tripplets would be valueInteger=2 and the third born would have valueInteger=3 If a bool value was provided for this tripplets examle, then all 3 patient records would have valueBool=true (the ordering is not indicated).
    mustSupport: false
    choices: [multipleBirthBoolean, multipleBirthInteger]
    maxLength: 0
    base: {max: '1', min: 0, path: 'Patient.multipleBirth[x]'}
    isSummary: false
  deceased:
    isModifier: true
    short: Indicates if the individual is deceased or not
    index: 7
    comments: 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.
    mustSupport: false
    choices: [deceasedBoolean, deceasedDateTime]
    maxLength: 0
    base: {max: '1', min: 0, path: 'Patient.deceased[x]'}
    isSummary: true
  photo:
    isModifier: false
    short: Image of the patient
    index: 16
    type: Attachment
    mustSupport: false
    array: true
    maxLength: 0
    base: {max: '*', min: 0, path: Patient.photo}
    isSummary: false
  link:
    isModifier: true
    short: Link to another patient resource that concerns the same actual person
    index: 34
    comments: There is no assumption that linked patient records have mutual links.
    type: BackboneElement
    mustSupport: false
    array: true
    elements:
      other:
        isModifier: true
        short: The other patient resource that the link refers to
        index: 35
        type: Reference
        mustSupport: false
        maxLength: 0
        base: {max: '1', min: 0, path: Patient.link.other}
        isSummary: false
      type:
        isModifier: true
        short: replace | refer | seealso - type of link
        index: 36
        type: code
        mustSupport: false
        maxLength: 0
        base: {max: '1', min: 0, path: Patient.link.type}
        isSummary: false
    maxLength: 0
    base: {max: '*', min: 0, path: Patient.link}
    required: [type, other]
    isSummary: false
  active:
    isModifier: true
    short: Whether this patient's record is in active use
    index: 1
    comments: 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.
    type: boolean
    defaultValueBoolean: true
    mustSupport: false
    maxLength: 0
    base: {max: '1', min: 0, path: Patient.active}
    isSummary: true
  communication:
    isModifier: false
    short: A list of Languages which may be used to communicate with the patient about his or her health
    index: 29
    comments: 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.
    type: BackboneElement
    mustSupport: false
    array: true
    elements:
      language:
        isModifier: false
        short: The language which can be used to communicate with the patient about his or her health
        index: 30
        comments: 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.
        type: CodeableConcept
        mustSupport: false
        maxLength: 0
        base: {max: '1', min: 0, path: Patient.communication.language}
        isSummary: false
      preferred:
        isModifier: false
        short: Language preference indicator
        index: 31
        comments: This language is specifically identified for communicating healthcare information.
        type: boolean
        mustSupport: false
        maxLength: 0
        base: {max: '1', min: 0, path: Patient.communication.preferred}
        isSummary: false
    maxLength: 0
    base: {max: '*', min: 0, path: Patient.communication}
    required: [language]
    isSummary: false
  animal:
    isModifier: true
    short: This patient is known to be an animal (non-human)
    index: 25
    comments: The animal element is labeled "Is Modifier" since patients may be non-human. Systems SHALL either handle patient details appropriately (e.g. inform users patient is not human) or reject declared animal records.   The absense of the animal element does not imply that the patient is a human. If a system requires such a positive assertion that the patient is human, an extension will be required.  (Do not use a species of homo-sapiens in animal species, as this would incorrectly infer that the patient is an animal).
    type: BackboneElement
    mustSupport: false
    elements:
      species:
        isModifier: false
        short: E.g. Dog, Cow
        index: 26
        comments: 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.).
        type: CodeableConcept
        mustSupport: false
        maxLength: 0
        base: {max: '1', min: 0, path: Patient.animal.species}
        isSummary: true
      breed:
        isModifier: false
        short: E.g. Poodle, Angus
        index: 27
        comments: 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.
        type: CodeableConcept
        mustSupport: false
        maxLength: 0
        base: {max: '1', min: 0, path: Patient.animal.breed}
        isSummary: true
      genderStatus:
        isModifier: false
        short: E.g. Neutered, Intact
        type: CodeableConcept
        mustSupport: false
        maxLength: 0
        base: {max: '1', min: 0, path: Patient.animal.genderStatus}
        isSummary: true
        index: 28
    maxLength: 0
    base: {max: '1', min: 0, path: Patient.animal}
    required: [species]
    isSummary: true
  identifier:
    isModifier: false
    short: An identifier for this patient
    index: 0
    type: Identifier
    mustSupport: false
    array: true
    maxLength: 0
    base: {max: '*', min: 0, path: Patient.identifier}
    isSummary: true
  telecom:
    isModifier: false
    short: A contact detail for the individual
    index: 3
    comments: 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).
    type: ContactPoint
    mustSupport: false
    array: true
    maxLength: 0
    base: {max: '*', min: 0, path: Patient.telecom}
    isSummary: true
  gender:
    isModifier: false
    short: male | female | other | unknown
    index: 4
    comments: 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.
    type: code
    mustSupport: false
    maxLength: 0
    base: {max: '1', min: 0, path: Patient.gender}
    isSummary: true
  maritalStatus:
    isModifier: false
    short: Marital (civil) status of a patient
    type: CodeableConcept
    mustSupport: false
    maxLength: 0
    base: {max: '1', min: 0, path: Patient.maritalStatus}
    isSummary: false
    index: 11
  contact:
    constraint:
      pat-1: {human: SHALL at least contain a contact's details or a reference to an organization, severity: error, expression: name.exists() or telecom.exists() or address.exists() or organization.exists()}
    isModifier: false
    short: A contact party (e.g. guardian, partner, friend) for the patient
    index: 17
    comments: '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.'
    type: BackboneElement
    mustSupport: false
    array: true
    elements:
      relationship:
        isModifier: false
        short: The kind of relationship
        index: 18
        type: CodeableConcept
        mustSupport: false
        array: true
        maxLength: 0
        base: {max: '*', min: 0, path: Patient.contact.relationship}
        isSummary: false
      name:
        isModifier: false
        short: A name associated with the contact person
        type: HumanName
        mustSupport: false
        maxLength: 0
        base: {max: '1', min: 0, path: Patient.contact.name}
        isSummary: false
        index: 19
      telecom:
        isModifier: false
        short: A contact detail for the person
        index: 20
        comments: 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.
        type: ContactPoint
        mustSupport: false
        array: true
        maxLength: 0
        base: {max: '*', min: 0, path: Patient.contact.telecom}
        isSummary: false
      address:
        isModifier: false
        short: Address for the contact person
        type: Address
        mustSupport: false
        maxLength: 0
        base: {max: '1', min: 0, path: Patient.contact.address}
        isSummary: false
        index: 21
      gender:
        isModifier: false
        short: male | female | other | unknown
        type: code
        mustSupport: false
        maxLength: 0
        base: {max: '1', min: 0, path: Patient.contact.gender}
        isSummary: false
        index: 22
      organization:
        isModifier: false
        short: Organization that is associated with the contact
        type: Reference
        mustSupport: false
        maxLength: 0
        base: {max: '1', min: 0, path: Patient.contact.organization}
        isSummary: false
        index: 23
      period:
        isModifier: false
        short: The period during which this contact person or organization is valid to be contacted relating to this patient
        type: Period
        mustSupport: false
        maxLength: 0
        base: {max: '1', min: 0, path: Patient.contact.period}
        isSummary: false
        index: 24
    maxLength: 0
    base: {max: '*', min: 0, path: Patient.contact}
    isSummary: false
package_version: 1.4.0
class: resource
kind: resource
url: http://hl7.org/fhir/StructureDefinition/Patient
base: http://hl7.org/fhir/StructureDefinition/DomainResource
version: null