My Health Record FHIR IG - Local Development build (v1.4.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: MHRPatientEmergencyContact - Detailed Descriptions

Active as of 2024-01-22

Definitions for the dh-patient-emergency-contact-mhr-1 resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. Patient
Definition

Demographics and other administrative information about an individual receiving care or other health-related services.


Demographics and other administrative information about an individual or animal receiving care or other health-related services.

ShortA patient in the context of electronic exchange of health informationInformation about an individual or animal receiving health care services
Control0..*
Is Modifierfalse
Summaryfalse
Alternate NamesSubjectOfCare Client Resident
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
inv-pat-0: If present, birth time's date shall be the birth date (birthDate.extension('http://hl7.org/fhir/StructureDefinition/patient-birthTime').exists() implies birthDate.extension('http://hl7.org/fhir/StructureDefinition/patient-birthTime').value.toString().substring(0,10) = birthDate.toString())
inv-pat-1: Individual gender identity shall be a member of the Gender Identity Response value set if any codes within that value set can apply (extension('http://hl7.org/fhir/StructureDefinition/individual-genderIdentity').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-genderIdentity').all(extension('value').value.memberOf('https://healthterminologies.gov.au/fhir/ValueSet/gender-identity-response-1')))
inv-pat-2: Individual pronouns shall be a member of the Australian Pronouns value set if any codes within that value set can apply (extension('http://hl7.org/fhir/StructureDefinition/individual-pronouns').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-pronouns').all(extension('value').value.memberOf('https://healthterminologies.gov.au/fhir/ValueSet/australian-pronouns-1')))
inv-pat-3: Recorded sex or gender type shall be a member of the AU Recorded Sex or Gender Type value set if any codes within that value set can apply (extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('type').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').all(extension('type').value.memberOf('http://terminology.hl7.org.au/ValueSet/rsg-type')))
inv-pat-4: Recorded sex or gender source document type shall be a member of the AU Recorded Sex or Gender (RSG) Source Document Type value set if any codes within that value set can apply (extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('sourceDocument').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').all(extension('sourceDocument').value.memberOf('http://terminology.hl7.org.au/ValueSet/rsg-source-document-type')))
inv-pat-5: Recorded sex or gender jurisdiction shall be a member of the Jurisdiction ValueSet - AU Extended value set if any codes within that value set can apply (extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('jurisdiction').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').all(extension('jurisdiction').value.memberOf('http://terminology.hl7.org.au/ValueSet/jurisdiction-extended')))
au-core-pat-01: At least one patient identifier shall be valid, or if not available, the Data Absent Reason extension shall be present ((identifier.where(system.count() + value.count() >1)).exists() xor identifier.extension('http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists())
au-core-pat-02: At least one patient name shall have a family name, or if not available, the Data Absent Reason extension shall be present (name.family.exists() xor name.extension('http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists())
2. Patient.implicitRules
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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Patient.extension:birthPlace
Slice NamebirthPlace
Definition

The registered place of birth of the patient. A sytem may use the address.text if they don't store the birthPlace address in discrete elements.

ShortPlace of Birth for patient
Control0..1
TypeExtension(Patient Birth Place) (Extension Type: Address)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. Patient.extension:indigenousStatus
Slice NameindigenousStatus
Definition

National Health Data Dictionary (NHDD) based indigenous status for a person.

ShortIndigenous status
Comments

This concept is equivalent to Australian Institute of Health and Welfare data element 602543 Person—Indigenous status, code N.

Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(Australian Indigenous Status) (Extension Type: Coding)
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. Patient.extension:veteranStatus
Slice NameveteranStatus
Definition

Veteran / Australian Defence Force (ADF) status for a person.

ShortVeteran / Australian Defence Force (ADF) status
Comments

This concept is equivalent to Australian Institute of Health and Welfare data element 737931 Person—ADF veteran status, code N.

Control0..*
This element is affected by the following invariants: ele-1
TypeExtension(Australian Veteran Status) (Extension Type: Coding)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
10. Patient.extension:closingTheGapRegistration
Slice NameclosingTheGapRegistration
Definition

Indication of eligibility for the Closing the Gap co-payment.

ShortClosing the Gap co-payment eligibility indicator
Comments

This concept is equivalent to Australian Institute of Health and Welfare data element 603671 Patient—Closing the Gap co-payment eligibility indicator.

Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(Closing the Gap Registration) (Extension Type: boolean)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
12. Patient.extension:mothersMaidenName
Slice NamemothersMaidenName
Definition

Mother's maiden (unmarried) name, commonly collected to help verify patient identity.

ShortMother's Maiden name
Control0..1
TypeExtension(Patient Mother's Maiden Name) (Extension Type: string)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
14. Patient.extension:interpreterRequired
Slice NameinterpreterRequired
Definition

Indicates whether an interpreter is required to facilitate communication in a healthcare setting. While this extension is named patient-interpreterRequired for backwards compatibility, it may also be used on RelatedPerson, Practitioner, and Encounter.

ShortWhether an interpreter is required
Comments

The individual does not speak the default language of the organization, and hence requires an interpreter. If other languages are in the Communications list, then that would be the type of interpreter required.

While this extension is named patient-interpreterRequired for backwards compatibility, it may also be used on RelatedPerson, Practitioner, and Encounter.

When used on Patient, RelatedPerson, or Practitioner, it indicates a default or assumed need for an interpreter. When used on Encounter, it indicates that an interpreter is needed to facilitate communication between some participants in that Encounter. The encounter-level evaluation of whether an interpreter is needed might involve evaluating the language proficiencies of the participants.

Control0..1
TypeExtension(Interpreter Required) (Extension Type: boolean)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
16. Patient.extension:dateOfArrival
Slice NamedateOfArrival
Definition

The date a person first arrived in Australia, from another country, with the intention of living in Australia for one year or more. This date is captured once for a person and is not subsequently updated with subsequent arrivals.

ShortThe date a person first arrived in Australia, from another country, with the intention of living in Australia for one year or more
Comments

See Australian Bureau of Statics (ABS) 1200.0.55.007 - Year of Arrival Standard, 2014, Version 1.5 for further information. This concept is equivalent to Australian Institute of Health and Welfare data element 269447 Person—year of first arrival in Australia.

Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(Date of Arrival in Australia) (Extension Type: date)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
18. Patient.extension:genderIdentity
Slice NamegenderIdentity
Definition

An individual's personal sense of being a man, woman, boy, girl, nonbinary, or something else.

ShortGender identity shall be a member of the Gender Identity Response value set if any codes within that value set can apply
Comments

This represents an individual’s identity, ascertained by asking them what that identity is.

Control0..*
This element is affected by the following invariants: inv-pat-1
TypeExtension(Individual Gender Identity) (Complex Extension)
Is Modifierfalse
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
20. Patient.extension:individualPronouns
Slice NameindividualPronouns
Definition

The pronouns to use when referring to an individual in verbal or written communication.

ShortPronouns shall be a member of the Australian Pronouns value set if any codes within that value set can apply
Control0..*
This element is affected by the following invariants: inv-pat-2
TypeExtension(Individual Pronouns) (Complex Extension)
Is Modifierfalse
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
22. Patient.extension:recordedSexOrGender
Slice NamerecordedSexOrGender
Definition

A sex or gender property for the individual from a document or other record

ShortRecorded sex or gender type shall be a member of the AU Recorded Sex or Gender Type value set if any codes within that value set can apply. Recorded sex or gender source document type shall be a member of the AU Recorded Sex or Gender (RSG) Source Document Type value set if any codes within that value set can apply. Recorded sex or gender jurisdiction shall be a member of the Jurisdiction - ValueSet AU Extended value set if any codes within that value set can apply
Comments

The type of recorded sex or gender is populated in the extension:type.value[x] of the Person Recorded Sex or Gender extension and shall contain one of the codes from the AU Recorded Sex or Gender Type value set if any of the codes within the value set can apply.

The document from which the sex or gender property was acquired is populated in the extension:sourceDocument.value[x] of the Person Recorded Sex or Gender extension and shall contain one of the codes from the AU Recorded Sex or Gender (RSG) Source Document Type value set if any of the codes within the value set can apply.

The jurisdiction that issued the document where the sex or gender was acquired is populated in the extension:jurisdiction.value[x] of the Person Recorded Sex or Gender extension and shall contain one of the codes from the Jurisdiction ValueSet - AU Extended value set if any of the codes within the value set can apply.

Control0..*
This element is affected by the following invariants: inv-pat-3, inv-pat-4, inv-pat-5
TypeExtension(Person Recorded Sex Or Gender) (Complex Extension)
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
24. Patient.modifierExtension
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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
Comments

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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
26. Patient.identifier
Definition

An identifier for this patient.

ShortIdentifies this patient across multiple systemsAn identifier for this patient
NoteThis is a business identifier, not a resource identifier (see discussion)
Control10..*
This element is affected by the following invariants: au-core-pat-01
TypeIdentifier(Identifier, AU IHI, AU Medicare Card Number, AU DVA Number, AU Health Care Card Number, AU Pensioner Concession Card Number, AU Commonwealth Seniors Health Card Number, AU Medical Record Number, AU Insurance Member Number, AU Patient Internal Identifier)
Is Modifierfalse
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Summarytrue
Requirements

Patients are almost always assigned specific numerical identifiers.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Patient.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • pattern @ type
  • 28. Patient.identifier:ihi
    Slice Nameihi
    Definition

    An identifier for this patient.

    ShortIdentifies this patient across multiple systemsAn identifier for this patient
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..1*
    TypeIdentifier(AU IHI)
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    Patients are almost always assigned specific numerical identifiers.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    30. Patient.identifier:medicare
    Slice Namemedicare
    Definition

    An identifier for this patient.

    ShortIdentifies this patient across multiple systemsAn identifier for this patient
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..*
    TypeIdentifier(AU Medicare Card Number)
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    Patients are almost always assigned specific numerical identifiers.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    32. Patient.identifier:dva
    Slice Namedva
    Definition

    An identifier for this patient.

    ShortIdentifies this patient across multiple systemsAn identifier for this patient
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..1*
    TypeIdentifier(AU DVA Number)
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    Patients are almost always assigned specific numerical identifiers.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    34. Patient.active
    Definition

    Whether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules.

    It is often used to filter patient lists to exclude inactive patients

    Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death.

    ShortWhether this patient's record is in active use
    Comments

    If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient.

    Control0..1
    Typeboolean
    Is Modifiertrue because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

    Need to be able to mark a patient record as not to be used because it was created in error.

    Meaning if MissingThis resource is generally assumed to be active if no value is provided for the active element
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    36. Patient.name
    Definition

    A name associated with the individual.

    ShortA name associated with the patient
    Comments

    A patient may have multiple names with different uses or applicable periods. At least one name SHOULD be the name the patient is considered to have for administrative and record keeping purposes - family name is used to enable matching against patient records.


    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.

    Control10..*
    This element is affected by the following invariants: au-core-pat-02
    TypeHumanName
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    Need to be able to track the patient by multiple names. Examples are your official name and a partner name.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    au-core-pat-03: At least text, family name, or given name shall be present, or if neither is available, the Data Absent Reason extension shall be present ((text.exists() or family.exists() or given.exists()) xor extension('http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists())
    38. Patient.name.use
    Definition

    Identifies the purpose for this name.

    Shortusual | official | temp | nickname | anonymous | old | maiden
    Comments

    Applications can assume that a name is current unless it explicitly says that it is temporary or old.

    Control0..1
    BindingThe codes SHALL be taken from NameUsehttp://hl7.org/fhir/ValueSet/name-use|4.0.1
    (required to http://hl7.org/fhir/ValueSet/name-use|4.0.1)

    The use of a human name.

    Typecode
    Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Requirements

    Allows the appropriate name for a particular context of use to be selected from among a set of names.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    40. Patient.name.text
    Definition

    Specifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts.

    ShortText representation of the full name
    Comments

    Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

    Control0..1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Requirements

    A renderable, unencoded form.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    42. Patient.name.family
    Definition

    The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.

    ShortFamily name (often called 'Surname')
    Comments

    Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).

    Control0..1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Alternate Namessurname
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    44. Patient.name.given
    Definition

    Given name.

    ShortGiven names (not always 'first'). Includes middle names
    Comments

    If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first.

    Control0..*
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Alternate Namesfirst name, middle name
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    46. Patient.telecom
    Definition

    A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted.

    ShortA contact detail for the individual
    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 might 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).

    Control0..*
    TypeContactPoint
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    People have (primary) ways to contact them in some way such as phone, email.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    48. Patient.telecom.system
    Definition

    Telecommunications form for contact point - what communications system is required to make use of the contact.

    Shortphone | fax | email | pager | url | sms | other
    Control0..1
    This element is affected by the following invariants: cpt-2
    BindingThe codes SHALL be taken from ContactPointSystemhttp://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
    (required to http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1)

    Telecommunications form for contact point.

    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    50. Patient.telecom.value
    Definition

    The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

    ShortThe actual contact point details
    Comments

    Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

    Control0..1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Requirements

    Need to support legacy numbers that are not in a tightly controlled format.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    52. Patient.telecom.use
    Definition

    Identifies the purpose for the contact point.

    Shorthome | work | temp | old | mobile - purpose of this contact point
    Comments

    Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

    Control0..1
    BindingThe codes SHALL be taken from ContactPointUsehttp://hl7.org/fhir/ValueSet/contact-point-use|4.0.1
    (required to http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1)

    Use of contact point.

    Typecode
    Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Requirements

    Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    54. Patient.gender
    Definition

    Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes.

    Shortmale | female | other | unknown
    Comments

    The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex.

    Control10..1
    BindingThe codes SHALL be taken from AdministrativeGenderhttp://hl7.org/fhir/ValueSet/administrative-gender|4.0.1
    (required to http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1)

    The gender of a person used for administrative purposes.

    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Requirements

    Needed for identification of the individual, in combination with (at least) name and birth date.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    56. Patient.birthDate
    Definition

    The date of birth for the individual.

    ShortDate of birth extended for time and accuracy indicatorThe date of birth for the individual
    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 maternity/infant care systems).

    Control10..1
    This element is affected by the following invariants: inv-pat-0
    Typedate
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Requirements

    Age of the individual drives many clinical processes. May include accuracy indicator and specific birth time.


    Age of the individual drives many clinical processes.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    LOINC Code21112-8
    58. Patient.birthDate.extension:accuracyIndicator
    Slice NameaccuracyIndicator
    Definition

    General date accuracy indicator coding.

    ShortBirth date accuracy indicator
    Comments

    In some circumstances, systems may only have date or datetime data that has unknown or estimated parts. This coding establishes the accuracy of the day, month and year parts.

    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Date Accuracy Indicator) (Extension Type: Coding)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    60. Patient.birthDate.extension:birthTime
    Slice NamebirthTime
    Definition

    The time of day that the patient was born. This includes the date to ensure that the timezone information can be communicated effectively.

    ShortBirth time
    Comments

    The patient prefix on the extension was retained to ensure backward compatibility with existing data (the content itself is provided to assist in sharing data across patient resources effectively)

    Control0..1
    This element is affected by the following invariants: inv-pat-0
    TypeExtension(Patient/Person/RelatedPerson/Practitioner Birth Time) (Extension Type: dateTime)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    62. Patient.deceased[x]
    Definition

    Indicates if the individual is deceased or not. Deceased date accuracy indicator is optional.


    Indicates if the individual is deceased or not.

    ShortIndicates if the individual is deceased or not
    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.

    Control0..1
    TypeChoice of: boolean, dateTime
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifiertrue because This 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.
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    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.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    SlicingThis element introduces a set of slices on Patient.deceased[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
    • type @ $this
    • 64. Patient.deceased[x]:deceasedBoolean
      Slice NamedeceasedBoolean
      Definition

      Boolean indicator if the individual is deceased or not.


      Indicates if the individual is deceased or not.

      ShortDeceased indicatorIndicates if the individual is deceased or not
      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.

      Control0..1
      Typeboolean, dateTime
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifiertrue because This 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.
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      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.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      66. Patient.deceased[x]:deceasedDateTime
      Slice NamedeceasedDateTime
      Definition

      Individual deceased date-time with optional accuracy indicator.


      Indicates if the individual is deceased or not.

      ShortDeceased date timeIndicates if the individual is deceased or not
      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.

      Control0..1
      TypedateTime, boolean
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifiertrue because This 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.
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      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.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      68. Patient.deceased[x]:deceasedDateTime.extension:accuracyIndicator
      Slice NameaccuracyIndicator
      Definition

      General date accuracy indicator coding.

      ShortDeceased date accuracy indicator
      Comments

      In some circumstances, systems may only have date or datetime data that has unknown or estimated parts. This coding establishes the accuracy of the day, month and year parts.

      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(Date Accuracy Indicator) (Extension Type: Coding)
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      70. Patient.address
      Definition

      An address for the individual.

      ShortAn address for the individual
      Comments

      The address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource).


      Patient may have multiple addresses with different uses or applicable periods.

      Control0..*
      TypeAddress(Australian Address, Address)
      Is Modifierfalse
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summarytrue
      Requirements

      May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      72. Patient.contact
      Definition

      A contact party (e.g. guardian, partner, friend) for the patient.

      ShortA contact party (e.g. guardian, partner, friend) for the patient
      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.

      Control0..*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Need to track people you can contact about the patient.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      pat-1: SHALL at least contain a contact's details or a reference to an organization (name.exists() or telecom.exists() or address.exists() or organization.exists())
      pat-1: SHALL at least contain a contact's details or a reference to an organization (name.exists() or telecom.exists() or address.exists() or organization.exists())
      SlicingThis element introduces a set of slices on Patient.contact. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ extension('http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-mhr-special-processing-1').value.system
      • value @ extension('http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-mhr-special-processing-1').value.code
      • 74. Patient.contact.modifierExtension
        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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        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.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        76. Patient.contact:mhr-ec
        Slice Namemhr-ec
        Definition

        This contact is an emergency contact for processing by the My Health Record System.


        A contact party (e.g. guardian, partner, friend) for the patient.

        ShortThis contact is an emergency contactA contact party (e.g. guardian, partner, friend) for the patient
        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.

        Control0..*
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Requirements

        Need to track people you can contact about the patient.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        pat-1: SHALL at least contain a contact's details or a reference to an organization (name.exists() or telecom.exists() or address.exists() or organization.exists())
        inv-dh-pec-01: If a relationship is either 'Next of kin' or 'Emergency Contact', there shall be a second relationship representing additional information. (relationship.where(coding.where(system='http://terminology.hl7.org/CodeSystem/v2-0131' and code='C') or coding.where(system='http://terminology.hl7.org/CodeSystem/v2-0131' and code='N')).exists() implies relationship.text.exists())
        inv-dh-pec-02: If a relationship is 'Carer', there shall not be a second relationship representing additional information. (relationship.where(coding.where(system='http://snomed.info/sct' and code='133932002').exists()).exists() implies relationship.text.empty())
        pat-1: SHALL at least contain a contact's details or a reference to an organization (name.exists() or telecom.exists() or address.exists() or organization.exists())
        78. Patient.contact:mhr-ec.extension
        Definition

        An Extension


        May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortExtensionAdditional content defined by implementations
        Comments

        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.

        Control10..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on Patient.contact.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 80. Patient.contact:mhr-ec.extension:special-processing
          Slice Namespecial-processing
          Definition

          Used by the My Health Record system to identify elements for special processing.

          ShortMHR special processing is relevent to the element
          Control1..1
          This element is affected by the following invariants: ele-1
          TypeExtension(MHR My Health Record Special Processing) (Extension Type: Coding)
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          82. Patient.contact:mhr-ec.extension:special-processing.url
          Definition

          Source of the definition for the extension code - a logical name or a URL.

          Shortidentifies the meaning of the extension
          Comments

          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.

          Control1..1
          Typeuri
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          Fixed Valuehttp://ns.electronichealth.net.au/fhir/StructureDefinition/dh-mhr-special-processing-1
          84. Patient.contact:mhr-ec.extension:special-processing.value[x]
          Definition

          Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

          ShortValue of extension
          Control10..1
          BindingThe codes SHALL be taken from For codes, see ADHA My Health Record Special Processing
          (required to http://ns.electronichealth.net.au/fhir/ValueSet/dh-mhr-special-processing-1)
          TypeCoding, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          SlicingThis element introduces a set of slices on Patient.contact.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
          • type @ $this
          • 86. Patient.contact:mhr-ec.extension:special-processing.value[x]:valueCoding
            Slice NamevalueCoding
            Definition

            Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

            ShortValue of extension
            Control10..1
            BindingThe codes SHALL be taken from For codes, see ADHA My Health Record Special Processing
            (required to http://ns.electronichealth.net.au/fhir/ValueSet/dh-mhr-special-processing-1)
            TypeCoding, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            88. Patient.contact:mhr-ec.extension:special-processing.value[x]:valueCoding.system
            Definition

            The identification of the code system that defines the meaning of the symbol in the code.

            ShortIdentity of the terminology system
            Comments

            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 reference to some definition that establishes the system clearly and unambiguously.

            Control10..1
            Typeuri
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Need to be unambiguous about the source of the definition of the symbol.

            Fixed Valuehttp://ns.electronichealth.net.au/fhir/CodeSystem/dh-mhr-special-processing-1
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            90. Patient.contact:mhr-ec.extension:special-processing.value[x]:valueCoding.code
            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).

            ShortSymbol in syntax defined by the system
            Control10..1
            Typecode
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Need to refer to a particular code in the system.

            Fixed Valueemergency-contact
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            92. Patient.contact:mhr-ec.modifierExtension
            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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            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.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            94. Patient.contact:mhr-ec.relationship
            Definition

            The nature of the relationship between the patient and the contact person.

            ShortThe kind of relationship
            Control10..2*
            BindingUnless not suitable, these codes SHALL be taken from Contact Relationship Type .http://hl7.org/fhir/ValueSet/patient-contactrelationship
            (extensible to https://healthterminologies.gov.au/fhir/ValueSet/contact-relationship-type-3)
            TypeCodeableConcept
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            Used to determine which contact person is the most relevant to approach, depending on circumstances.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            SlicingThis element introduces a set of slices on Patient.contact.relationship. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
            • exists @ coding
            • 96. Patient.contact:mhr-ec.relationship:ec-type
              Slice Nameec-type
              Definition

              The type of emergency contact that can be entered in the My Health App.


              The nature of the relationship between the patient and the contact person.

              ShortThe type of emergency contactThe kind of relationship
              Control10..1*
              BindingThe codes SHALL be taken from Unless not suitable, these codes SHALL be taken from Emergency Contact Typehttp://hl7.org/fhir/ValueSet/patient-contactrelationship
              (required to http://ns.electronichealth.net.au/fhir/ValueSet/emergency-contact-type-1)
              TypeCodeableConcept
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Requirements

              Used to determine which contact person is the most relevant to approach, depending on circumstances.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              98. Patient.contact:mhr-ec.relationship:ec-type.coding
              Definition

              A reference to a code defined by a terminology system.

              ShortCode defined by a terminology system
              Comments

              Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

              Control10..1*
              TypeCoding
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Requirements

              Allows for alternative encodings within a code system, and translations to other code systems.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              100. Patient.contact:mhr-ec.relationship:ec-type.text
              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.

              ShortPlain text representation of the concept
              Comments

              Very often the text is the same as a displayName of one of the codings.

              Control0..01
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              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.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              102. Patient.contact:mhr-ec.relationship:ec-description
              Slice Nameec-description
              Definition

              An additional description of the type of emergency contact that can be entered in the My Health App.


              The nature of the relationship between the patient and the contact person.

              ShortAn additional description of the type of emergency contactThe kind of relationship
              Control0..1*
              BindingUnless not suitable, these codes SHALL be taken from Contact Relationship Type .http://hl7.org/fhir/ValueSet/patient-contactrelationship
              (extensible to https://healthterminologies.gov.au/fhir/ValueSet/contact-relationship-type-3)
              TypeCodeableConcept
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Requirements

              Used to determine which contact person is the most relevant to approach, depending on circumstances.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              104. Patient.contact:mhr-ec.relationship:ec-description.coding
              Definition

              A reference to a code defined by a terminology system.

              ShortCode defined by a terminology system
              Comments

              Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

              Control0..0*
              TypeCoding
              Is Modifierfalse
              Summarytrue
              Requirements

              Allows for alternative encodings within a code system, and translations to other code systems.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              106. Patient.contact:mhr-ec.relationship:ec-description.text
              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.

              ShortPlain text representation of the concept
              Comments

              Very often the text is the same as a displayName of one of the codings.

              Control10..1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summarytrue
              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.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              108. Patient.contact:mhr-ec.name
              Definition

              A name associated with the contact person.

              ShortA name associated with the contact person
              Control10..1
              TypeHumanName
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Requirements

              Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              110. Patient.contact:mhr-ec.telecom
              Definition

              A contact detail for the person, e.g. a telephone number or an email address.

              ShortA contact detail for the person
              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.

              Control10..*
              TypeContactPoint
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Requirements

              People have (primary) ways to contact them in some way such as phone, email.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              SlicingThis element introduces a set of slices on Patient.contact.telecom. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ system
              • 112. Patient.contact:mhr-ec.telecom:phone
                Slice Namephone
                Definition

                A contact detail for the person, e.g. a telephone number or an email address.

                ShortA contact detail for the person
                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.

                Control10..*
                TypeContactPoint
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Requirements

                People have (primary) ways to contact them in some way such as phone, email.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                114. Patient.contact:mhr-ec.telecom:phone.system
                Definition

                Telecommunications form for contact point - what communications system is required to make use of the contact.

                Shortphone | fax | email | pager | url | sms | other
                Control10..1
                This element is affected by the following invariants: cpt-2
                BindingThe codes SHALL be taken from ContactPointSystemhttp://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
                (required to http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1)

                Telecommunications form for contact point.

                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Fixed Valuephone
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                116. Patient.contact:mhr-ec.telecom:phone.value
                Definition

                The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

                ShortThe actual contact point details
                Comments

                Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

                Control10..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Requirements

                Need to support legacy numbers that are not in a tightly controlled format.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                118. Patient.contact:mhr-ec.telecom:phone.use
                Definition

                Identifies the purpose for the contact point.

                Shorthome | work | temp | old | mobile - purpose of this contact point
                Comments

                Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

                Control0..1
                BindingThe codes SHALL be taken from ContactPointUsehttp://hl7.org/fhir/ValueSet/contact-point-use|4.0.1
                (required to http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1)

                Use of contact point.

                Typecode
                Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                120. Patient.contact:mhr-ec.telecom:email
                Slice Nameemail
                Definition

                A contact detail for the person, e.g. a telephone number or an email address.

                ShortA contact detail for the person
                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.

                Control0..*
                TypeContactPoint
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Requirements

                People have (primary) ways to contact them in some way such as phone, email.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                122. Patient.contact:mhr-ec.telecom:email.system
                Definition

                Telecommunications form for contact point - what communications system is required to make use of the contact.

                Shortphone | fax | email | pager | url | sms | other
                Control10..1
                This element is affected by the following invariants: cpt-2
                BindingThe codes SHALL be taken from ContactPointSystemhttp://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
                (required to http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1)

                Telecommunications form for contact point.

                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Fixed Valueemail
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                124. Patient.contact:mhr-ec.telecom:email.value
                Definition

                The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

                ShortThe actual contact point details
                Comments

                Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

                Control10..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Requirements

                Need to support legacy numbers that are not in a tightly controlled format.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                126. Patient.contact:mhr-ec.telecom:email.use
                Definition

                Identifies the purpose for the contact point.

                Shorthome | work | temp | old | mobile - purpose of this contact point
                Comments

                Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

                Control0..1
                BindingThe codes SHALL be taken from ContactPointUsehttp://hl7.org/fhir/ValueSet/contact-point-use|4.0.1
                (required to http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1)

                Use of contact point.

                Typecode
                Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                128. Patient.communication
                Definition

                A language which may be used to communicate with the patient about his or her health.

                ShortA language which may be used to communicate with the patient about his or her health
                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.

                Control0..*
                TypeBackboneElement
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Requirements

                If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                130. Patient.communication.modifierExtension
                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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                ShortExtensions that cannot be ignored even if unrecognized
                Comments

                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.

                Control0..*
                TypeExtension
                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                Summarytrue
                Requirements

                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                Alternate Namesextensions, user content, modifiers
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                132. Patient.communication.language
                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.

                ShortThe language which can be used to communicate with the patient about his or her health
                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.

                Control1..1
                BindingUnless not suitable, these codes SHALL be taken from The codes SHOULD be taken from Common Languages in Australia .http://hl7.org/fhir/ValueSet/languages
                (extensible to https://healthterminologies.gov.au/fhir/ValueSet/common-languages-australia-2)
                TypeCodeableConcept
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Requirements

                Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                134. Patient.communication.preferred
                Definition

                Indicates whether or not the patient prefers this language (over other languages he masters up a certain level).

                ShortLanguage preference indicator
                Comments

                This language is specifically identified for communicating healthcare information.

                Control0..1
                Typeboolean
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summaryfalse
                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.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                136. Patient.link
                Definition

                Link to a Patient or RelatedPerson resource that concerns the same actual person.


                Link to another patient resource that concerns the same actual patient.

                ShortLink to a Patient or RelatedPerson resource that concerns the same actual personLink to another patient resource that concerns the same actual person
                Comments

                There is no assumption that linked patient records have mutual links.

                Control0..*
                TypeBackboneElement
                Is Modifiertrue because This element is labeled as a modifier because it might 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'
                Summarytrue
                Requirements

                There are multiple use cases:

                • Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and
                • Distribution of patient information across multiple servers.
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                138. Patient.link.modifierExtension
                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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                ShortExtensions that cannot be ignored even if unrecognized
                Comments

                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.

                Control0..*
                TypeExtension
                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                Summarytrue
                Requirements

                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                Alternate Namesextensions, user content, modifiers
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                140. Patient.link.other
                Definition

                The other patient resource that the link refers to.

                ShortThe other patient or related person resource that the link refers to
                Comments

                Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.

                Control1..1
                TypeReference(Patient, RelatedPerson)
                Is Modifierfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                142. Patient.link.type
                Definition

                The type of link between this patient resource and another patient resource.

                Shortreplaced-by | replaces | refer | seealso
                Control1..1
                BindingThe codes SHALL be taken from LinkTypehttp://hl7.org/fhir/ValueSet/link-type|4.0.1
                (required to http://hl7.org/fhir/ValueSet/link-type|4.0.1)

                The type of link between this patient resource and another patient resource.

                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

                Guidance on how to interpret the contents of this table can be foundhere

                0. Patient
                2. Patient.contact
                Must Supporttrue
                SlicingThis element introduces a set of slices on Patient.contact. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ extension('http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-mhr-special-processing-1').value.system
                • value @ extension('http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-mhr-special-processing-1').value.code
                • 4. Patient.contact:mhr-ec
                  Slice Namemhr-ec
                  Definition

                  This contact is an emergency contact for processing by the My Health Record System.

                  ShortThis contact is an emergency contact
                  Must Supporttrue
                  Invariantsinv-dh-pec-01: If a relationship is either 'Next of kin' or 'Emergency Contact', there shall be a second relationship representing additional information. (relationship.where(coding.where(system='http://terminology.hl7.org/CodeSystem/v2-0131' and code='C') or coding.where(system='http://terminology.hl7.org/CodeSystem/v2-0131' and code='N')).exists() implies relationship.text.exists())
                  inv-dh-pec-02: If a relationship is 'Carer', there shall not be a second relationship representing additional information. (relationship.where(coding.where(system='http://snomed.info/sct' and code='133932002').exists()).exists() implies relationship.text.empty())
                  6. Patient.contact:mhr-ec.extension
                  Control1..?
                  8. Patient.contact:mhr-ec.extension:special-processing
                  Slice Namespecial-processing
                  Control1..?
                  TypeExtension(MHR My Health Record Special Processing) (Extension Type: Coding)
                  Must Supporttrue
                  10. Patient.contact:mhr-ec.extension:special-processing.valueCoding
                  Must Supporttrue
                  12. Patient.contact:mhr-ec.extension:special-processing.valueCoding.system
                  Control1..?
                  Fixed Valuehttp://ns.electronichealth.net.au/fhir/CodeSystem/dh-mhr-special-processing-1
                  14. Patient.contact:mhr-ec.extension:special-processing.valueCoding.code
                  Control1..?
                  Fixed Valueemergency-contact
                  16. Patient.contact:mhr-ec.relationship
                  Control1..2
                  Must Supporttrue
                  SlicingThis element introduces a set of slices on Patient.contact.relationship. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                  • exists @ coding
                  • 18. Patient.contact:mhr-ec.relationship:ec-type
                    Slice Nameec-type
                    Definition

                    The type of emergency contact that can be entered in the My Health App.

                    ShortThe type of emergency contact
                    Control1..1
                    BindingThe codes SHALL be taken from Emergency Contact Type
                    (required to http://ns.electronichealth.net.au/fhir/ValueSet/emergency-contact-type-1)
                    TypeCodeableConcept
                    Must Supporttrue
                    20. Patient.contact:mhr-ec.relationship:ec-type.coding
                    Control1..1
                    Must Supporttrue
                    22. Patient.contact:mhr-ec.relationship:ec-type.text
                    Control0..0
                    24. Patient.contact:mhr-ec.relationship:ec-description
                    Slice Nameec-description
                    Definition

                    An additional description of the type of emergency contact that can be entered in the My Health App.

                    ShortAn additional description of the type of emergency contact
                    Control0..1
                    TypeCodeableConcept
                    Must Supporttrue
                    26. Patient.contact:mhr-ec.relationship:ec-description.coding
                    Control0..0
                    28. Patient.contact:mhr-ec.relationship:ec-description.text
                    Control1..1
                    Must Supporttrue
                    30. Patient.contact:mhr-ec.name
                    Control1..?
                    Must Supporttrue
                    32. Patient.contact:mhr-ec.telecom
                    Control1..?
                    Must Supporttrue
                    SlicingThis element introduces a set of slices on Patient.contact.telecom. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ system
                    • 34. Patient.contact:mhr-ec.telecom:phone
                      Slice Namephone
                      Control1..?
                      Must Supporttrue
                      36. Patient.contact:mhr-ec.telecom:phone.system
                      Control1..?
                      Typecode
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Fixed Valuephone
                      38. Patient.contact:mhr-ec.telecom:phone.value
                      Control1..?
                      Must Supporttrue
                      40. Patient.contact:mhr-ec.telecom:email
                      Slice Nameemail
                      Must Supporttrue
                      42. Patient.contact:mhr-ec.telecom:email.system
                      Control1..?
                      Typecode
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Fixed Valueemail
                      44. Patient.contact:mhr-ec.telecom:email.value
                      Control1..?
                      Must Supporttrue

                      Guidance on how to interpret the contents of this table can be foundhere

                      0. Patient
                      Definition

                      Demographics and other administrative information about an individual receiving care or other health-related services.

                      ShortA patient in the context of electronic exchange of health information
                      Control0..*
                      Is Modifierfalse
                      Summaryfalse
                      Alternate NamesSubjectOfCare Client Resident
                      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                      dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
                      dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                      dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                      dom-6: A resource should have narrative for robust management (text.`div`.exists())
                      inv-pat-0: If present, birth time's date shall be the birth date (birthDate.extension('http://hl7.org/fhir/StructureDefinition/patient-birthTime').exists() implies birthDate.extension('http://hl7.org/fhir/StructureDefinition/patient-birthTime').value.toString().substring(0,10) = birthDate.toString())
                      inv-pat-1: Individual gender identity shall be a member of the Gender Identity Response value set if any codes within that value set can apply (extension('http://hl7.org/fhir/StructureDefinition/individual-genderIdentity').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-genderIdentity').all(extension('value').value.memberOf('https://healthterminologies.gov.au/fhir/ValueSet/gender-identity-response-1')))
                      inv-pat-2: Individual pronouns shall be a member of the Australian Pronouns value set if any codes within that value set can apply (extension('http://hl7.org/fhir/StructureDefinition/individual-pronouns').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-pronouns').all(extension('value').value.memberOf('https://healthterminologies.gov.au/fhir/ValueSet/australian-pronouns-1')))
                      inv-pat-3: Recorded sex or gender type shall be a member of the AU Recorded Sex or Gender Type value set if any codes within that value set can apply (extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('type').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').all(extension('type').value.memberOf('http://terminology.hl7.org.au/ValueSet/rsg-type')))
                      inv-pat-4: Recorded sex or gender source document type shall be a member of the AU Recorded Sex or Gender (RSG) Source Document Type value set if any codes within that value set can apply (extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('sourceDocument').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').all(extension('sourceDocument').value.memberOf('http://terminology.hl7.org.au/ValueSet/rsg-source-document-type')))
                      inv-pat-5: Recorded sex or gender jurisdiction shall be a member of the Jurisdiction ValueSet - AU Extended value set if any codes within that value set can apply (extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').extension('jurisdiction').empty() or extension('http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender').all(extension('jurisdiction').value.memberOf('http://terminology.hl7.org.au/ValueSet/jurisdiction-extended')))
                      au-core-pat-01: At least one patient identifier shall be valid, or if not available, the Data Absent Reason extension shall be present ((identifier.where(system.count() + value.count() >1)).exists() xor identifier.extension('http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists())
                      au-core-pat-02: At least one patient name shall have a family name, or if not available, the Data Absent Reason extension shall be present (name.family.exists() xor name.extension('http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists())
                      2. Patient.id
                      Definition

                      The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

                      ShortLogical id of this artifact
                      Comments

                      The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

                      Control0..1
                      Typeid
                      Is Modifierfalse
                      Summarytrue
                      4. Patient.meta
                      Definition

                      The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

                      ShortMetadata about the resource
                      Control0..1
                      TypeMeta
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      6. Patient.implicitRules
                      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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                      ShortA set of rules under which this content was created
                      Comments

                      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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

                      Control0..1
                      Typeuri
                      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      8. Patient.language
                      Definition

                      The base language in which the resource is written.

                      ShortLanguage of the resource content
                      Comments

                      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).

                      Control0..1
                      BindingThe codes SHOULD be taken from CommonLanguages
                      (preferred to http://hl7.org/fhir/ValueSet/languages)

                      A human language.

                      Additional BindingsPurpose
                      AllLanguagesMax Binding
                      Typecode
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      10. Patient.text
                      Definition

                      A human-readable narrative that contains a summary of the resource and can 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.

                      ShortText summary of the resource, for human interpretation
                      Comments

                      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 information is added later.

                      Control0..1
                      TypeNarrative
                      Is Modifierfalse
                      Summaryfalse
                      Alternate Namesnarrative, html, xhtml, display
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      12. Patient.contained
                      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.

                      ShortContained, inline Resources
                      Comments

                      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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

                      Control0..*
                      TypeResource
                      Is Modifierfalse
                      Summaryfalse
                      Alternate Namesinline resources, anonymous resources, contained resources
                      14. Patient.extension
                      Definition

                      An Extension

                      ShortExtension
                      Control0..*
                      TypeExtension
                      Is Modifierfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      SlicingThis element introduces a set of slices on Patient.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 16. Patient.extension:birthPlace
                        Slice NamebirthPlace
                        Definition

                        The registered place of birth of the patient. A sytem may use the address.text if they don't store the birthPlace address in discrete elements.

                        ShortPlace of Birth for patient
                        Control0..1
                        TypeExtension(Patient Birth Place) (Extension Type: Address)
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        18. Patient.extension:indigenousStatus
                        Slice NameindigenousStatus
                        Definition

                        National Health Data Dictionary (NHDD) based indigenous status for a person.

                        ShortIndigenous status
                        Comments

                        This concept is equivalent to Australian Institute of Health and Welfare data element 602543 Person—Indigenous status, code N.

                        Control0..1
                        This element is affected by the following invariants: ele-1
                        TypeExtension(Australian Indigenous Status) (Extension Type: Coding)
                        Is Modifierfalse
                        Must Supporttrue
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        20. Patient.extension:veteranStatus
                        Slice NameveteranStatus
                        Definition

                        Veteran / Australian Defence Force (ADF) status for a person.

                        ShortVeteran / Australian Defence Force (ADF) status
                        Comments

                        This concept is equivalent to Australian Institute of Health and Welfare data element 737931 Person—ADF veteran status, code N.

                        Control0..*
                        This element is affected by the following invariants: ele-1
                        TypeExtension(Australian Veteran Status) (Extension Type: Coding)
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        22. Patient.extension:closingTheGapRegistration
                        Slice NameclosingTheGapRegistration
                        Definition

                        Indication of eligibility for the Closing the Gap co-payment.

                        ShortClosing the Gap co-payment eligibility indicator
                        Comments

                        This concept is equivalent to Australian Institute of Health and Welfare data element 603671 Patient—Closing the Gap co-payment eligibility indicator.

                        Control0..1
                        This element is affected by the following invariants: ele-1
                        TypeExtension(Closing the Gap Registration) (Extension Type: boolean)
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        24. Patient.extension:mothersMaidenName
                        Slice NamemothersMaidenName
                        Definition

                        Mother's maiden (unmarried) name, commonly collected to help verify patient identity.

                        ShortMother's Maiden name
                        Control0..1
                        TypeExtension(Patient Mother's Maiden Name) (Extension Type: string)
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        26. Patient.extension:interpreterRequired
                        Slice NameinterpreterRequired
                        Definition

                        Indicates whether an interpreter is required to facilitate communication in a healthcare setting. While this extension is named patient-interpreterRequired for backwards compatibility, it may also be used on RelatedPerson, Practitioner, and Encounter.

                        ShortWhether an interpreter is required
                        Comments

                        The individual does not speak the default language of the organization, and hence requires an interpreter. If other languages are in the Communications list, then that would be the type of interpreter required.

                        While this extension is named patient-interpreterRequired for backwards compatibility, it may also be used on RelatedPerson, Practitioner, and Encounter.

                        When used on Patient, RelatedPerson, or Practitioner, it indicates a default or assumed need for an interpreter. When used on Encounter, it indicates that an interpreter is needed to facilitate communication between some participants in that Encounter. The encounter-level evaluation of whether an interpreter is needed might involve evaluating the language proficiencies of the participants.

                        Control0..1
                        TypeExtension(Interpreter Required) (Extension Type: boolean)
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        28. Patient.extension:dateOfArrival
                        Slice NamedateOfArrival
                        Definition

                        The date a person first arrived in Australia, from another country, with the intention of living in Australia for one year or more. This date is captured once for a person and is not subsequently updated with subsequent arrivals.

                        ShortThe date a person first arrived in Australia, from another country, with the intention of living in Australia for one year or more
                        Comments

                        See Australian Bureau of Statics (ABS) 1200.0.55.007 - Year of Arrival Standard, 2014, Version 1.5 for further information. This concept is equivalent to Australian Institute of Health and Welfare data element 269447 Person—year of first arrival in Australia.

                        Control0..1
                        This element is affected by the following invariants: ele-1
                        TypeExtension(Date of Arrival in Australia) (Extension Type: date)
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        30. Patient.extension:genderIdentity
                        Slice NamegenderIdentity
                        Definition

                        An individual's personal sense of being a man, woman, boy, girl, nonbinary, or something else.

                        ShortGender identity shall be a member of the Gender Identity Response value set if any codes within that value set can apply
                        Comments

                        This represents an individual’s identity, ascertained by asking them what that identity is.

                        Control0..*
                        This element is affected by the following invariants: inv-pat-1
                        TypeExtension(Individual Gender Identity) (Complex Extension)
                        Is Modifierfalse
                        Must Supporttrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        32. Patient.extension:individualPronouns
                        Slice NameindividualPronouns
                        Definition

                        The pronouns to use when referring to an individual in verbal or written communication.

                        ShortPronouns shall be a member of the Australian Pronouns value set if any codes within that value set can apply
                        Control0..*
                        This element is affected by the following invariants: inv-pat-2
                        TypeExtension(Individual Pronouns) (Complex Extension)
                        Is Modifierfalse
                        Must Supporttrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        34. Patient.extension:recordedSexOrGender
                        Slice NamerecordedSexOrGender
                        Definition

                        A sex or gender property for the individual from a document or other record

                        ShortRecorded sex or gender type shall be a member of the AU Recorded Sex or Gender Type value set if any codes within that value set can apply. Recorded sex or gender source document type shall be a member of the AU Recorded Sex or Gender (RSG) Source Document Type value set if any codes within that value set can apply. Recorded sex or gender jurisdiction shall be a member of the Jurisdiction - ValueSet AU Extended value set if any codes within that value set can apply
                        Comments

                        The type of recorded sex or gender is populated in the extension:type.value[x] of the Person Recorded Sex or Gender extension and shall contain one of the codes from the AU Recorded Sex or Gender Type value set if any of the codes within the value set can apply.

                        The document from which the sex or gender property was acquired is populated in the extension:sourceDocument.value[x] of the Person Recorded Sex or Gender extension and shall contain one of the codes from the AU Recorded Sex or Gender (RSG) Source Document Type value set if any of the codes within the value set can apply.

                        The jurisdiction that issued the document where the sex or gender was acquired is populated in the extension:jurisdiction.value[x] of the Person Recorded Sex or Gender extension and shall contain one of the codes from the Jurisdiction ValueSet - AU Extended value set if any of the codes within the value set can apply.

                        Control0..*
                        This element is affected by the following invariants: inv-pat-3, inv-pat-4, inv-pat-5
                        TypeExtension(Person Recorded Sex Or Gender) (Complex Extension)
                        Is Modifierfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        36. Patient.modifierExtension
                        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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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.

                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                        ShortExtensions that cannot be ignored
                        Comments

                        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.

                        Control0..*
                        TypeExtension
                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                        Summaryfalse
                        Requirements

                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                        Alternate Namesextensions, user content
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        38. Patient.identifier
                        Definition

                        An identifier for this patient.

                        ShortIdentifies this patient across multiple systems
                        NoteThis is a business identifier, not a resource identifier (see discussion)
                        Control1..*
                        This element is affected by the following invariants: au-core-pat-01
                        TypeIdentifier(Identifier, AU IHI, AU Medicare Card Number, AU DVA Number, AU Health Care Card Number, AU Pensioner Concession Card Number, AU Commonwealth Seniors Health Card Number, AU Medical Record Number, AU Insurance Member Number, AU Patient Internal Identifier)
                        Is Modifierfalse
                        Must Supporttrue
                        Must Support TypesNo must-support rules about the choice of types/profiles
                        Summarytrue
                        Requirements

                        Patients are almost always assigned specific numerical identifiers.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        SlicingThis element introduces a set of slices on Patient.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • pattern @ type
                        • 40. Patient.identifier:ihi
                          Slice Nameihi
                          Definition

                          An identifier for this patient.

                          ShortIdentifies this patient across multiple systems
                          NoteThis is a business identifier, not a resource identifier (see discussion)
                          Control0..1
                          TypeIdentifier(AU IHI)
                          Is Modifierfalse
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          Patients are almost always assigned specific numerical identifiers.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          42. Patient.identifier:medicare
                          Slice Namemedicare
                          Definition

                          An identifier for this patient.

                          ShortIdentifies this patient across multiple systems
                          NoteThis is a business identifier, not a resource identifier (see discussion)
                          Control0..*
                          TypeIdentifier(AU Medicare Card Number)
                          Is Modifierfalse
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          Patients are almost always assigned specific numerical identifiers.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          44. Patient.identifier:dva
                          Slice Namedva
                          Definition

                          An identifier for this patient.

                          ShortIdentifies this patient across multiple systems
                          NoteThis is a business identifier, not a resource identifier (see discussion)
                          Control0..1
                          TypeIdentifier(AU DVA Number)
                          Is Modifierfalse
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          Patients are almost always assigned specific numerical identifiers.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          46. Patient.active
                          Definition

                          Whether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules.

                          It is often used to filter patient lists to exclude inactive patients

                          Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death.

                          ShortWhether this patient's record is in active use
                          Comments

                          If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient.

                          Control0..1
                          Typeboolean
                          Is Modifiertrue because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Requirements

                          Need to be able to mark a patient record as not to be used because it was created in error.

                          Meaning if MissingThis resource is generally assumed to be active if no value is provided for the active element
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          48. Patient.name
                          Definition

                          A name associated with the individual.

                          ShortA name associated with the patient
                          Comments

                          A patient may have multiple names with different uses or applicable periods. At least one name SHOULD be the name the patient is considered to have for administrative and record keeping purposes - family name is used to enable matching against patient records.

                          Control1..*
                          This element is affected by the following invariants: au-core-pat-02
                          TypeHumanName
                          Is Modifierfalse
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          Need to be able to track the patient by multiple names. Examples are your official name and a partner name.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          au-core-pat-03: At least text, family name, or given name shall be present, or if neither is available, the Data Absent Reason extension shall be present ((text.exists() or family.exists() or given.exists()) xor extension('http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists())
                          50. Patient.name.id
                          Definition

                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                          ShortUnique id for inter-element referencing
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          52. Patient.name.extension
                          Definition

                          May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                          ShortAdditional content defined by implementations
                          Comments

                          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.

                          Control0..*
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesextensions, user content
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          SlicingThis element introduces a set of slices on Patient.name.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 54. Patient.name.use
                            Definition

                            Identifies the purpose for this name.

                            Shortusual | official | temp | nickname | anonymous | old | maiden
                            Comments

                            Applications can assume that a name is current unless it explicitly says that it is temporary or old.

                            Control0..1
                            BindingThe codes SHALL be taken from NameUse
                            (required to http://hl7.org/fhir/ValueSet/name-use|4.0.1)

                            The use of a human name.

                            Typecode
                            Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supporttrue
                            Summarytrue
                            Requirements

                            Allows the appropriate name for a particular context of use to be selected from among a set of names.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            56. Patient.name.text
                            Definition

                            Specifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts.

                            ShortText representation of the full name
                            Comments

                            Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

                            Control0..1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supporttrue
                            Summarytrue
                            Requirements

                            A renderable, unencoded form.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            58. Patient.name.family
                            Definition

                            The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.

                            ShortFamily name (often called 'Surname')
                            Comments

                            Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).

                            Control0..1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supporttrue
                            Summarytrue
                            Alternate Namessurname
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            60. Patient.name.given
                            Definition

                            Given name.

                            ShortGiven names (not always 'first'). Includes middle names
                            Comments

                            If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first.

                            Control0..*
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supporttrue
                            Summarytrue
                            Alternate Namesfirst name, middle name
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            62. Patient.name.prefix
                            Definition

                            Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name.

                            ShortParts that come before the name
                            Control0..*
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            64. Patient.name.suffix
                            Definition

                            Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name.

                            ShortParts that come after the name
                            Control0..*
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            66. Patient.name.period
                            Definition

                            Indicates the period of time when this name was valid for the named person.

                            ShortTime period when name was/is in use
                            Control0..1
                            TypePeriod
                            Is Modifierfalse
                            Summarytrue
                            Requirements

                            Allows names to be placed in historical context.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            68. Patient.telecom
                            Definition

                            A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted.

                            ShortA contact detail for the individual
                            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 might 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).

                            Control0..*
                            TypeContactPoint
                            Is Modifierfalse
                            Must Supporttrue
                            Summarytrue
                            Requirements

                            People have (primary) ways to contact them in some way such as phone, email.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            70. Patient.telecom.id
                            Definition

                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                            ShortUnique id for inter-element referencing
                            Control0..1
                            Typestring
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            72. Patient.telecom.extension
                            Definition

                            May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                            ShortAdditional content defined by implementations
                            Comments

                            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.

                            Control0..*
                            TypeExtension
                            Is Modifierfalse
                            Summaryfalse
                            Alternate Namesextensions, user content
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            SlicingThis element introduces a set of slices on Patient.telecom.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 74. Patient.telecom.system
                              Definition

                              Telecommunications form for contact point - what communications system is required to make use of the contact.

                              Shortphone | fax | email | pager | url | sms | other
                              Control0..1
                              This element is affected by the following invariants: cpt-2
                              BindingThe codes SHALL be taken from ContactPointSystem
                              (required to http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1)

                              Telecommunications form for contact point.

                              Typecode
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supporttrue
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              76. Patient.telecom.value
                              Definition

                              The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

                              ShortThe actual contact point details
                              Comments

                              Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

                              Control0..1
                              Typestring
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supporttrue
                              Summarytrue
                              Requirements

                              Need to support legacy numbers that are not in a tightly controlled format.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              78. Patient.telecom.use
                              Definition

                              Identifies the purpose for the contact point.

                              Shorthome | work | temp | old | mobile - purpose of this contact point
                              Comments

                              Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

                              Control0..1
                              BindingThe codes SHALL be taken from ContactPointUse
                              (required to http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1)

                              Use of contact point.

                              Typecode
                              Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supporttrue
                              Summarytrue
                              Requirements

                              Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              80. Patient.telecom.rank
                              Definition

                              Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.

                              ShortSpecify preferred order of use (1 = highest)
                              Comments

                              Note that rank does not necessarily follow the order in which the contacts are represented in the instance.

                              Control0..1
                              TypepositiveInt
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              82. Patient.telecom.period
                              Definition

                              Time period when the contact point was/is in use.

                              ShortTime period when the contact point was/is in use
                              Control0..1
                              TypePeriod
                              Is Modifierfalse
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              84. Patient.gender
                              Definition

                              Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes.

                              Shortmale | female | other | unknown
                              Comments

                              The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex.

                              Control1..1
                              BindingThe codes SHALL be taken from AdministrativeGender
                              (required to http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1)

                              The gender of a person used for administrative purposes.

                              Typecode
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supporttrue
                              Summarytrue
                              Requirements

                              Needed for identification of the individual, in combination with (at least) name and birth date.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              86. Patient.birthDate
                              Definition

                              The date of birth for the individual.

                              ShortDate of birth extended for time and accuracy indicator
                              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 maternity/infant care systems).

                              Control1..1
                              This element is affected by the following invariants: inv-pat-0
                              Typedate
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supporttrue
                              Summarytrue
                              Requirements

                              Age of the individual drives many clinical processes. May include accuracy indicator and specific birth time.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              LOINC Code21112-8
                              88. Patient.birthDate.id
                              Definition

                              unique id for the element within a resource (for internal references)

                              Shortxml:id (or equivalent in JSON)
                              Control0..1
                              Typestring
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              90. Patient.birthDate.extension
                              Definition

                              An Extension

                              ShortExtension
                              Control0..*
                              TypeExtension
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              SlicingThis element introduces a set of slices on Patient.birthDate.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 92. Patient.birthDate.extension:accuracyIndicator
                                Slice NameaccuracyIndicator
                                Definition

                                General date accuracy indicator coding.

                                ShortBirth date accuracy indicator
                                Comments

                                In some circumstances, systems may only have date or datetime data that has unknown or estimated parts. This coding establishes the accuracy of the day, month and year parts.

                                Control0..1
                                This element is affected by the following invariants: ele-1
                                TypeExtension(Date Accuracy Indicator) (Extension Type: Coding)
                                Is Modifierfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                94. Patient.birthDate.extension:birthTime
                                Slice NamebirthTime
                                Definition

                                The time of day that the patient was born. This includes the date to ensure that the timezone information can be communicated effectively.

                                ShortBirth time
                                Comments

                                The patient prefix on the extension was retained to ensure backward compatibility with existing data (the content itself is provided to assist in sharing data across patient resources effectively)

                                Control0..1
                                This element is affected by the following invariants: inv-pat-0
                                TypeExtension(Patient/Person/RelatedPerson/Practitioner Birth Time) (Extension Type: dateTime)
                                Is Modifierfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                96. Patient.birthDate.value
                                Definition

                                The actual value

                                ShortPrimitive value for date
                                Control0..1
                                Typedate
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                98. Patient.deceased[x]
                                Definition

                                Indicates if the individual is deceased or not. Deceased date accuracy indicator is optional.

                                ShortIndicates if the individual is deceased or not
                                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.

                                Control0..1
                                TypeChoice of: boolean, dateTime
                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                Is Modifiertrue because This 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.
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                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.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                SlicingThis element introduces a set of slices on Patient.deceased[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                • type @ $this
                                • 100. Patient.deceased[x]:deceasedBoolean
                                  Slice NamedeceasedBoolean
                                  Definition

                                  Boolean indicator if the individual is deceased or not.

                                  ShortDeceased indicator
                                  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.

                                  Control0..1
                                  Typeboolean
                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                  Is Modifiertrue because This 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.
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  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.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  102. Patient.deceased[x]:deceasedDateTime
                                  Slice NamedeceasedDateTime
                                  Definition

                                  Individual deceased date-time with optional accuracy indicator.

                                  ShortDeceased date time
                                  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.

                                  Control0..1
                                  TypedateTime
                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                  Is Modifiertrue because This 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.
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  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.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  104. Patient.deceased[x]:deceasedDateTime.id
                                  Definition

                                  unique id for the element within a resource (for internal references)

                                  Shortxml:id (or equivalent in JSON)
                                  Control0..1
                                  Typestring
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  106. Patient.deceased[x]:deceasedDateTime.extension
                                  Definition

                                  An Extension

                                  ShortExtension
                                  Control0..*
                                  TypeExtension
                                  Is Modifierfalse
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  SlicingThis element introduces a set of slices on Patient.deceased[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 108. Patient.deceased[x]:deceasedDateTime.extension:accuracyIndicator
                                    Slice NameaccuracyIndicator
                                    Definition

                                    General date accuracy indicator coding.

                                    ShortDeceased date accuracy indicator
                                    Comments

                                    In some circumstances, systems may only have date or datetime data that has unknown or estimated parts. This coding establishes the accuracy of the day, month and year parts.

                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    TypeExtension(Date Accuracy Indicator) (Extension Type: Coding)
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    110. Patient.deceased[x]:deceasedDateTime.value
                                    Definition

                                    The actual value

                                    ShortPrimitive value for dateTime
                                    Control0..1
                                    TypedateTime
                                    Is Modifierfalse
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    Summaryfalse
                                    112. Patient.address
                                    Definition

                                    An address for the individual.

                                    ShortAn address for the individual
                                    Comments

                                    The address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource).

                                    Control0..*
                                    TypeAddress(Australian Address, Address)
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Must Support TypesNo must-support rules about the choice of types/profiles
                                    Summarytrue
                                    Requirements

                                    May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    114. Patient.maritalStatus
                                    Definition

                                    This field contains a patient's most recent marital (civil) status.

                                    ShortMarital (civil) status of a patient
                                    Control0..1
                                    BindingUnless not suitable, these codes SHALL be taken from Marital Status Codes
                                    (extensible to http://hl7.org/fhir/ValueSet/marital-status)

                                    The domestic partnership status of a person.

                                    TypeCodeableConcept
                                    Is Modifierfalse
                                    Summaryfalse
                                    Requirements

                                    Most, if not all systems capture it.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    116. Patient.multipleBirth[x]
                                    Definition

                                    Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer).

                                    ShortWhether patient is part of a multiple birth
                                    Comments

                                    Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in triplets would be valueInteger=2 and the third born would have valueInteger=3 If a boolean value was provided for this triplets example, then all 3 patient records would have valueBoolean=true (the ordering is not indicated).

                                    Control0..1
                                    TypeChoice of: boolean, integer
                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summaryfalse
                                    Requirements

                                    For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    118. Patient.photo
                                    Definition

                                    Image of the patient.

                                    ShortImage of the patient
                                    Comments

                                    Guidelines:

                                    • Use id photos, not clinical photos.
                                    • Limit dimensions to thumbnail.
                                    • Keep byte count low to ease resource updates.
                                    Control0..*
                                    TypeAttachment
                                    Is Modifierfalse
                                    Summaryfalse
                                    Requirements

                                    Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    120. Patient.contact
                                    Definition

                                    A contact party (e.g. guardian, partner, friend) for the patient.

                                    ShortA contact party (e.g. guardian, partner, friend) for the patient
                                    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.

                                    Control0..*
                                    TypeBackboneElement
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summaryfalse
                                    Requirements

                                    Need to track people you can contact about the patient.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    pat-1: SHALL at least contain a contact's details or a reference to an organization (name.exists() or telecom.exists() or address.exists() or organization.exists())
                                    SlicingThis element introduces a set of slices on Patient.contact. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ extension('http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-mhr-special-processing-1').value.system
                                    • value @ extension('http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-mhr-special-processing-1').value.code
                                    • 122. Patient.contact.id
                                      Definition

                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                      ShortUnique id for inter-element referencing
                                      Control0..1
                                      Typestring
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      124. Patient.contact.extension
                                      Definition

                                      May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                      ShortAdditional content defined by implementations
                                      Comments

                                      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.

                                      Control0..*
                                      TypeExtension
                                      Is Modifierfalse
                                      Summaryfalse
                                      Alternate Namesextensions, user content
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      126. Patient.contact.modifierExtension
                                      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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                      ShortExtensions that cannot be ignored even if unrecognized
                                      Comments

                                      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.

                                      Control0..*
                                      TypeExtension
                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                      Summarytrue
                                      Requirements

                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                      Alternate Namesextensions, user content, modifiers
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      128. Patient.contact.relationship
                                      Definition

                                      The nature of the relationship between the patient and the contact person.

                                      ShortThe kind of relationship
                                      Control0..*
                                      BindingUnless not suitable, these codes SHALL be taken from Contact Relationship Type .
                                      (extensible to https://healthterminologies.gov.au/fhir/ValueSet/contact-relationship-type-3)
                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summaryfalse
                                      Requirements

                                      Used to determine which contact person is the most relevant to approach, depending on circumstances.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      130. Patient.contact.name
                                      Definition

                                      A name associated with the contact person.

                                      ShortA name associated with the contact person
                                      Control0..1
                                      TypeHumanName
                                      Is Modifierfalse
                                      Summaryfalse
                                      Requirements

                                      Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      132. Patient.contact.telecom
                                      Definition

                                      A contact detail for the person, e.g. a telephone number or an email address.

                                      ShortA contact detail for the person
                                      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.

                                      Control0..*
                                      TypeContactPoint
                                      Is Modifierfalse
                                      Summaryfalse
                                      Requirements

                                      People have (primary) ways to contact them in some way such as phone, email.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      134. Patient.contact.address
                                      Definition

                                      Address for the contact person.

                                      ShortAddress for the contact person
                                      Comments

                                      The address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource).

                                      Control0..1
                                      TypeAddress(Address, Australian Address)
                                      Is Modifierfalse
                                      Summaryfalse
                                      Requirements

                                      Need to keep track where the contact person can be contacted per postal mail or visited.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      136. Patient.contact.gender
                                      Definition

                                      Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes.

                                      Shortmale | female | other | unknown
                                      Control0..1
                                      BindingThe codes SHALL be taken from AdministrativeGender
                                      (required to http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1)

                                      The gender of a person used for administrative purposes.

                                      Typecode
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summaryfalse
                                      Requirements

                                      Needed to address the person correctly.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      138. Patient.contact.organization
                                      Definition

                                      Organization on behalf of which the contact is acting or for which the contact is working.

                                      ShortOrganization that is associated with the contact
                                      Control0..1
                                      This element is affected by the following invariants: pat-1
                                      TypeReference(Organization)
                                      Is Modifierfalse
                                      Summaryfalse
                                      Requirements

                                      For guardians or business related contacts, the organization is relevant.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      140. Patient.contact.period
                                      Definition

                                      The period during which this contact person or organization is valid to be contacted relating to this patient.

                                      ShortThe period during which this contact person or organization is valid to be contacted relating to this patient
                                      Control0..1
                                      TypePeriod
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      142. Patient.contact:mhr-ec
                                      Slice Namemhr-ec
                                      Definition

                                      This contact is an emergency contact for processing by the My Health Record System.

                                      ShortThis contact is an emergency contact
                                      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.

                                      Control0..*
                                      TypeBackboneElement
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summaryfalse
                                      Requirements

                                      Need to track people you can contact about the patient.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      pat-1: SHALL at least contain a contact's details or a reference to an organization (name.exists() or telecom.exists() or address.exists() or organization.exists())
                                      inv-dh-pec-01: If a relationship is either 'Next of kin' or 'Emergency Contact', there shall be a second relationship representing additional information. (relationship.where(coding.where(system='http://terminology.hl7.org/CodeSystem/v2-0131' and code='C') or coding.where(system='http://terminology.hl7.org/CodeSystem/v2-0131' and code='N')).exists() implies relationship.text.exists())
                                      inv-dh-pec-02: If a relationship is 'Carer', there shall not be a second relationship representing additional information. (relationship.where(coding.where(system='http://snomed.info/sct' and code='133932002').exists()).exists() implies relationship.text.empty())
                                      144. Patient.contact:mhr-ec.id
                                      Definition

                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                      ShortUnique id for inter-element referencing
                                      Control0..1
                                      Typestring
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      146. Patient.contact:mhr-ec.extension
                                      Definition

                                      An Extension

                                      ShortExtension
                                      Control1..*
                                      TypeExtension
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      SlicingThis element introduces a set of slices on Patient.contact.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 148. Patient.contact:mhr-ec.extension:special-processing
                                        Slice Namespecial-processing
                                        Definition

                                        Used by the My Health Record system to identify elements for special processing.

                                        ShortMHR special processing is relevent to the element
                                        Control1..1
                                        This element is affected by the following invariants: ele-1
                                        TypeExtension(MHR My Health Record Special Processing) (Extension Type: Coding)
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        150. Patient.contact:mhr-ec.extension:special-processing.id
                                        Definition

                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                        ShortUnique id for inter-element referencing
                                        Control0..1
                                        Typestring
                                        Is Modifierfalse
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        Summaryfalse
                                        152. Patient.contact:mhr-ec.extension:special-processing.extension
                                        Definition

                                        May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                        ShortAdditional content defined by implementations
                                        Comments

                                        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.

                                        Control0..*
                                        TypeExtension
                                        Is Modifierfalse
                                        Summaryfalse
                                        Alternate Namesextensions, user content
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        SlicingThis element introduces a set of slices on Patient.contact.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • value @ url
                                        • 154. Patient.contact:mhr-ec.extension:special-processing.url
                                          Definition

                                          Source of the definition for the extension code - a logical name or a URL.

                                          Shortidentifies the meaning of the extension
                                          Comments

                                          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.

                                          Control1..1
                                          Typeuri
                                          Is Modifierfalse
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          Summaryfalse
                                          Fixed Valuehttp://ns.electronichealth.net.au/fhir/StructureDefinition/dh-mhr-special-processing-1
                                          156. Patient.contact:mhr-ec.extension:special-processing.value[x]
                                          Definition

                                          Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                          ShortValue of extension
                                          Control1..1
                                          BindingThe codes SHALL be taken from ADHA My Health Record Special Processing
                                          (required to http://ns.electronichealth.net.au/fhir/ValueSet/dh-mhr-special-processing-1)
                                          TypeCoding
                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          SlicingThis element introduces a set of slices on Patient.contact.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                          • type @ $this
                                          • 158. Patient.contact:mhr-ec.extension:special-processing.value[x]:valueCoding
                                            Slice NamevalueCoding
                                            Definition

                                            Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                            ShortValue of extension
                                            Control1..1
                                            BindingThe codes SHALL be taken from ADHA My Health Record Special Processing
                                            (required to http://ns.electronichealth.net.au/fhir/ValueSet/dh-mhr-special-processing-1)
                                            TypeCoding
                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                            Is Modifierfalse
                                            Must Supporttrue
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            160. Patient.contact:mhr-ec.extension:special-processing.value[x]:valueCoding.id
                                            Definition

                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                            ShortUnique id for inter-element referencing
                                            Control0..1
                                            Typestring
                                            Is Modifierfalse
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            Summaryfalse
                                            162. Patient.contact:mhr-ec.extension:special-processing.value[x]:valueCoding.extension
                                            Definition

                                            May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                            ShortAdditional content defined by implementations
                                            Comments

                                            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.

                                            Control0..*
                                            TypeExtension
                                            Is Modifierfalse
                                            Summaryfalse
                                            Alternate Namesextensions, user content
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            SlicingThis element introduces a set of slices on Patient.contact.extension.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • value @ url
                                            • 164. Patient.contact:mhr-ec.extension:special-processing.value[x]:valueCoding.system
                                              Definition

                                              The identification of the code system that defines the meaning of the symbol in the code.

                                              ShortIdentity of the terminology system
                                              Comments

                                              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 reference to some definition that establishes the system clearly and unambiguously.

                                              Control1..1
                                              Typeuri
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summarytrue
                                              Requirements

                                              Need to be unambiguous about the source of the definition of the symbol.

                                              Fixed Valuehttp://ns.electronichealth.net.au/fhir/CodeSystem/dh-mhr-special-processing-1
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              166. Patient.contact:mhr-ec.extension:special-processing.value[x]:valueCoding.version
                                              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.

                                              ShortVersion of the system - if relevant
                                              Comments

                                              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.

                                              NoteThis is a business version Id, not a resource version Id (see discussion)
                                              Control0..1
                                              Typestring
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              168. Patient.contact:mhr-ec.extension:special-processing.value[x]:valueCoding.code
                                              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).

                                              ShortSymbol in syntax defined by the system
                                              Control1..1
                                              Typecode
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summarytrue
                                              Requirements

                                              Need to refer to a particular code in the system.

                                              Fixed Valueemergency-contact
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              170. Patient.contact:mhr-ec.extension:special-processing.value[x]:valueCoding.display
                                              Definition

                                              A representation of the meaning of the code in the system, following the rules of the system.

                                              ShortRepresentation defined by the system
                                              Control0..1
                                              Typestring
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summarytrue
                                              Requirements

                                              Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              172. Patient.contact:mhr-ec.extension:special-processing.value[x]:valueCoding.userSelected
                                              Definition

                                              Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                              ShortIf this coding was chosen directly by the user
                                              Comments

                                              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.

                                              Control0..1
                                              Typeboolean
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summarytrue
                                              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.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              174. Patient.contact:mhr-ec.modifierExtension
                                              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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                              ShortExtensions that cannot be ignored even if unrecognized
                                              Comments

                                              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.

                                              Control0..*
                                              TypeExtension
                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                              Summarytrue
                                              Requirements

                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                              Alternate Namesextensions, user content, modifiers
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              176. Patient.contact:mhr-ec.relationship
                                              Definition

                                              The nature of the relationship between the patient and the contact person.

                                              ShortThe kind of relationship
                                              Control1..2
                                              BindingUnless not suitable, these codes SHALL be taken from Contact Relationship Type .
                                              (extensible to https://healthterminologies.gov.au/fhir/ValueSet/contact-relationship-type-3)
                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summaryfalse
                                              Requirements

                                              Used to determine which contact person is the most relevant to approach, depending on circumstances.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              SlicingThis element introduces a set of slices on Patient.contact.relationship. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                              • exists @ coding
                                              • 178. Patient.contact:mhr-ec.relationship:ec-type
                                                Slice Nameec-type
                                                Definition

                                                The type of emergency contact that can be entered in the My Health App.

                                                ShortThe type of emergency contact
                                                Control1..1
                                                BindingThe codes SHALL be taken from Emergency Contact Type
                                                (required to http://ns.electronichealth.net.au/fhir/ValueSet/emergency-contact-type-1)
                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Must Supporttrue
                                                Summaryfalse
                                                Requirements

                                                Used to determine which contact person is the most relevant to approach, depending on circumstances.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                180. Patient.contact:mhr-ec.relationship:ec-type.id
                                                Definition

                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                ShortUnique id for inter-element referencing
                                                Control0..1
                                                Typestring
                                                Is Modifierfalse
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                Summaryfalse
                                                182. Patient.contact:mhr-ec.relationship:ec-type.extension
                                                Definition

                                                May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                ShortAdditional content defined by implementations
                                                Comments

                                                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.

                                                Control0..*
                                                TypeExtension
                                                Is Modifierfalse
                                                Summaryfalse
                                                Alternate Namesextensions, user content
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                SlicingThis element introduces a set of slices on Patient.contact.relationship.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                • value @ url
                                                • 184. Patient.contact:mhr-ec.relationship:ec-type.coding
                                                  Definition

                                                  A reference to a code defined by a terminology system.

                                                  ShortCode defined by a terminology system
                                                  Comments

                                                  Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                  Control1..1
                                                  TypeCoding
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summarytrue
                                                  Requirements

                                                  Allows for alternative encodings within a code system, and translations to other code systems.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  186. Patient.contact:mhr-ec.relationship:ec-type.text
                                                  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.

                                                  ShortPlain text representation of the concept
                                                  Comments

                                                  Very often the text is the same as a displayName of one of the codings.

                                                  Control0..0
                                                  Typestring
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  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.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  188. Patient.contact:mhr-ec.relationship:ec-description
                                                  Slice Nameec-description
                                                  Definition

                                                  An additional description of the type of emergency contact that can be entered in the My Health App.

                                                  ShortAn additional description of the type of emergency contact
                                                  Control0..1
                                                  BindingUnless not suitable, these codes SHALL be taken from Contact Relationship Type .
                                                  (extensible to https://healthterminologies.gov.au/fhir/ValueSet/contact-relationship-type-3)
                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summaryfalse
                                                  Requirements

                                                  Used to determine which contact person is the most relevant to approach, depending on circumstances.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  190. Patient.contact:mhr-ec.relationship:ec-description.id
                                                  Definition

                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                  ShortUnique id for inter-element referencing
                                                  Control0..1
                                                  Typestring
                                                  Is Modifierfalse
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  Summaryfalse
                                                  192. Patient.contact:mhr-ec.relationship:ec-description.extension
                                                  Definition

                                                  May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                  ShortAdditional content defined by implementations
                                                  Comments

                                                  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.

                                                  Control0..*
                                                  TypeExtension
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Alternate Namesextensions, user content
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  SlicingThis element introduces a set of slices on Patient.contact.relationship.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                  • value @ url
                                                  • 194. Patient.contact:mhr-ec.relationship:ec-description.coding
                                                    Definition

                                                    A reference to a code defined by a terminology system.

                                                    ShortCode defined by a terminology system
                                                    Comments

                                                    Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                    Control0..0
                                                    TypeCoding
                                                    Is Modifierfalse
                                                    Summarytrue
                                                    Requirements

                                                    Allows for alternative encodings within a code system, and translations to other code systems.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    196. Patient.contact:mhr-ec.relationship:ec-description.text
                                                    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.

                                                    ShortPlain text representation of the concept
                                                    Comments

                                                    Very often the text is the same as a displayName of one of the codings.

                                                    Control1..1
                                                    Typestring
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Must Supporttrue
                                                    Summarytrue
                                                    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.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    198. Patient.contact:mhr-ec.name
                                                    Definition

                                                    A name associated with the contact person.

                                                    ShortA name associated with the contact person
                                                    Control1..1
                                                    TypeHumanName
                                                    Is Modifierfalse
                                                    Must Supporttrue
                                                    Summaryfalse
                                                    Requirements

                                                    Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    200. Patient.contact:mhr-ec.telecom
                                                    Definition

                                                    A contact detail for the person, e.g. a telephone number or an email address.

                                                    ShortA contact detail for the person
                                                    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.

                                                    Control1..*
                                                    TypeContactPoint
                                                    Is Modifierfalse
                                                    Must Supporttrue
                                                    Summaryfalse
                                                    Requirements

                                                    People have (primary) ways to contact them in some way such as phone, email.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    SlicingThis element introduces a set of slices on Patient.contact.telecom. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                    • value @ system
                                                    • 202. Patient.contact:mhr-ec.telecom:phone
                                                      Slice Namephone
                                                      Definition

                                                      A contact detail for the person, e.g. a telephone number or an email address.

                                                      ShortA contact detail for the person
                                                      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.

                                                      Control1..*
                                                      TypeContactPoint
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Summaryfalse
                                                      Requirements

                                                      People have (primary) ways to contact them in some way such as phone, email.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      204. Patient.contact:mhr-ec.telecom:phone.id
                                                      Definition

                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                      ShortUnique id for inter-element referencing
                                                      Control0..1
                                                      Typestring
                                                      Is Modifierfalse
                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                      Summaryfalse
                                                      206. Patient.contact:mhr-ec.telecom:phone.extension
                                                      Definition

                                                      May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                      ShortAdditional content defined by implementations
                                                      Comments

                                                      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.

                                                      Control0..*
                                                      TypeExtension
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Alternate Namesextensions, user content
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      SlicingThis element introduces a set of slices on Patient.contact.telecom.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                      • value @ url
                                                      • 208. Patient.contact:mhr-ec.telecom:phone.system
                                                        Definition

                                                        Telecommunications form for contact point - what communications system is required to make use of the contact.

                                                        Shortphone | fax | email | pager | url | sms | other
                                                        Control1..1
                                                        This element is affected by the following invariants: cpt-2
                                                        BindingThe codes SHALL be taken from ContactPointSystem
                                                        (required to http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1)

                                                        Telecommunications form for contact point.

                                                        Typecode
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Must Supporttrue
                                                        Summarytrue
                                                        Fixed Valuephone
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        210. Patient.contact:mhr-ec.telecom:phone.value
                                                        Definition

                                                        The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

                                                        ShortThe actual contact point details
                                                        Comments

                                                        Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

                                                        Control1..1
                                                        Typestring
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Must Supporttrue
                                                        Summarytrue
                                                        Requirements

                                                        Need to support legacy numbers that are not in a tightly controlled format.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        212. Patient.contact:mhr-ec.telecom:phone.use
                                                        Definition

                                                        Identifies the purpose for the contact point.

                                                        Shorthome | work | temp | old | mobile - purpose of this contact point
                                                        Comments

                                                        Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

                                                        Control0..1
                                                        BindingThe codes SHALL be taken from ContactPointUse
                                                        (required to http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1)

                                                        Use of contact point.

                                                        Typecode
                                                        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Summarytrue
                                                        Requirements

                                                        Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        214. Patient.contact:mhr-ec.telecom:phone.rank
                                                        Definition

                                                        Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.

                                                        ShortSpecify preferred order of use (1 = highest)
                                                        Comments

                                                        Note that rank does not necessarily follow the order in which the contacts are represented in the instance.

                                                        Control0..1
                                                        TypepositiveInt
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Summarytrue
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        216. Patient.contact:mhr-ec.telecom:phone.period
                                                        Definition

                                                        Time period when the contact point was/is in use.

                                                        ShortTime period when the contact point was/is in use
                                                        Control0..1
                                                        TypePeriod
                                                        Is Modifierfalse
                                                        Summarytrue
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        218. Patient.contact:mhr-ec.telecom:email
                                                        Slice Nameemail
                                                        Definition

                                                        A contact detail for the person, e.g. a telephone number or an email address.

                                                        ShortA contact detail for the person
                                                        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.

                                                        Control0..*
                                                        TypeContactPoint
                                                        Is Modifierfalse
                                                        Must Supporttrue
                                                        Summaryfalse
                                                        Requirements

                                                        People have (primary) ways to contact them in some way such as phone, email.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        220. Patient.contact:mhr-ec.telecom:email.id
                                                        Definition

                                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                        ShortUnique id for inter-element referencing
                                                        Control0..1
                                                        Typestring
                                                        Is Modifierfalse
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        Summaryfalse
                                                        222. Patient.contact:mhr-ec.telecom:email.extension
                                                        Definition

                                                        May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                        ShortAdditional content defined by implementations
                                                        Comments

                                                        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.

                                                        Control0..*
                                                        TypeExtension
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Alternate Namesextensions, user content
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        SlicingThis element introduces a set of slices on Patient.contact.telecom.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                        • value @ url
                                                        • 224. Patient.contact:mhr-ec.telecom:email.system
                                                          Definition

                                                          Telecommunications form for contact point - what communications system is required to make use of the contact.

                                                          Shortphone | fax | email | pager | url | sms | other
                                                          Control1..1
                                                          This element is affected by the following invariants: cpt-2
                                                          BindingThe codes SHALL be taken from ContactPointSystem
                                                          (required to http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1)

                                                          Telecommunications form for contact point.

                                                          Typecode
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supporttrue
                                                          Summarytrue
                                                          Fixed Valueemail
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          226. Patient.contact:mhr-ec.telecom:email.value
                                                          Definition

                                                          The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

                                                          ShortThe actual contact point details
                                                          Comments

                                                          Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

                                                          Control1..1
                                                          Typestring
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supporttrue
                                                          Summarytrue
                                                          Requirements

                                                          Need to support legacy numbers that are not in a tightly controlled format.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          228. Patient.contact:mhr-ec.telecom:email.use
                                                          Definition

                                                          Identifies the purpose for the contact point.

                                                          Shorthome | work | temp | old | mobile - purpose of this contact point
                                                          Comments

                                                          Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

                                                          Control0..1
                                                          BindingThe codes SHALL be taken from ContactPointUse
                                                          (required to http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1)

                                                          Use of contact point.

                                                          Typecode
                                                          Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summarytrue
                                                          Requirements

                                                          Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          230. Patient.contact:mhr-ec.telecom:email.rank
                                                          Definition

                                                          Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.

                                                          ShortSpecify preferred order of use (1 = highest)
                                                          Comments

                                                          Note that rank does not necessarily follow the order in which the contacts are represented in the instance.

                                                          Control0..1
                                                          TypepositiveInt
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summarytrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          232. Patient.contact:mhr-ec.telecom:email.period
                                                          Definition

                                                          Time period when the contact point was/is in use.

                                                          ShortTime period when the contact point was/is in use
                                                          Control0..1
                                                          TypePeriod
                                                          Is Modifierfalse
                                                          Summarytrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          234. Patient.contact:mhr-ec.address
                                                          Definition

                                                          Address for the contact person.

                                                          ShortAddress for the contact person
                                                          Comments

                                                          The address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource).

                                                          Control0..1
                                                          TypeAddress(Address, Australian Address)
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Need to keep track where the contact person can be contacted per postal mail or visited.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          236. Patient.contact:mhr-ec.gender
                                                          Definition

                                                          Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes.

                                                          Shortmale | female | other | unknown
                                                          Control0..1
                                                          BindingThe codes SHALL be taken from AdministrativeGender
                                                          (required to http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1)

                                                          The gender of a person used for administrative purposes.

                                                          Typecode
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summaryfalse
                                                          Requirements

                                                          Needed to address the person correctly.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          238. Patient.contact:mhr-ec.organization
                                                          Definition

                                                          Organization on behalf of which the contact is acting or for which the contact is working.

                                                          ShortOrganization that is associated with the contact
                                                          Control0..1
                                                          This element is affected by the following invariants: pat-1
                                                          TypeReference(Organization)
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Requirements

                                                          For guardians or business related contacts, the organization is relevant.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          240. Patient.contact:mhr-ec.period
                                                          Definition

                                                          The period during which this contact person or organization is valid to be contacted relating to this patient.

                                                          ShortThe period during which this contact person or organization is valid to be contacted relating to this patient
                                                          Control0..1
                                                          TypePeriod
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          242. Patient.communication
                                                          Definition

                                                          A language which may be used to communicate with the patient about his or her health.

                                                          ShortA language which may be used to communicate with the patient about his or her health
                                                          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.

                                                          Control0..*
                                                          TypeBackboneElement
                                                          Is Modifierfalse
                                                          Must Supporttrue
                                                          Summaryfalse
                                                          Requirements

                                                          If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          244. Patient.communication.id
                                                          Definition

                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                          ShortUnique id for inter-element referencing
                                                          Control0..1
                                                          Typestring
                                                          Is Modifierfalse
                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                          Summaryfalse
                                                          246. Patient.communication.extension
                                                          Definition

                                                          May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                          ShortAdditional content defined by implementations
                                                          Comments

                                                          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.

                                                          Control0..*
                                                          TypeExtension
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Alternate Namesextensions, user content
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          248. Patient.communication.modifierExtension
                                                          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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                          ShortExtensions that cannot be ignored even if unrecognized
                                                          Comments

                                                          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.

                                                          Control0..*
                                                          TypeExtension
                                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                          Summarytrue
                                                          Requirements

                                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                          Alternate Namesextensions, user content, modifiers
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          250. Patient.communication.language
                                                          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.

                                                          ShortThe language which can be used to communicate with the patient about his or her health
                                                          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.

                                                          Control1..1
                                                          BindingUnless not suitable, these codes SHALL be taken from Common Languages in Australia .
                                                          (extensible to https://healthterminologies.gov.au/fhir/ValueSet/common-languages-australia-2)
                                                          TypeCodeableConcept
                                                          Is Modifierfalse
                                                          Must Supporttrue
                                                          Summaryfalse
                                                          Requirements

                                                          Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          252. Patient.communication.preferred
                                                          Definition

                                                          Indicates whether or not the patient prefers this language (over other languages he masters up a certain level).

                                                          ShortLanguage preference indicator
                                                          Comments

                                                          This language is specifically identified for communicating healthcare information.

                                                          Control0..1
                                                          Typeboolean
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supporttrue
                                                          Summaryfalse
                                                          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.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          254. Patient.generalPractitioner
                                                          Definition

                                                          Patient's nominated care provider.

                                                          ShortPatient's nominated primary care provider
                                                          Comments

                                                          This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues.

                                                          Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type.

                                                          Control0..*
                                                          TypeReference(Organization, Practitioner, PractitionerRole)
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Alternate NamescareProvider
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          256. Patient.managingOrganization
                                                          Definition

                                                          Organization that is the custodian of the patient record.

                                                          ShortOrganization that is the custodian of the patient record
                                                          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).

                                                          Control0..1
                                                          TypeReference(Organization)
                                                          Is Modifierfalse
                                                          Summarytrue
                                                          Requirements

                                                          Need to know who recognizes this patient record, manages and updates it.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          258. Patient.link
                                                          Definition

                                                          Link to a Patient or RelatedPerson resource that concerns the same actual person.

                                                          ShortLink to a Patient or RelatedPerson resource that concerns the same actual person
                                                          Comments

                                                          There is no assumption that linked patient records have mutual links.

                                                          Control0..*
                                                          TypeBackboneElement
                                                          Is Modifiertrue because This element is labeled as a modifier because it might 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'
                                                          Summarytrue
                                                          Requirements

                                                          There are multiple use cases:

                                                          • Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and
                                                          • Distribution of patient information across multiple servers.
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          260. Patient.link.id
                                                          Definition

                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                          ShortUnique id for inter-element referencing
                                                          Control0..1
                                                          Typestring
                                                          Is Modifierfalse
                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                          Summaryfalse
                                                          262. Patient.link.extension
                                                          Definition

                                                          May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                          ShortAdditional content defined by implementations
                                                          Comments

                                                          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.

                                                          Control0..*
                                                          TypeExtension
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Alternate Namesextensions, user content
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          264. Patient.link.modifierExtension
                                                          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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                          ShortExtensions that cannot be ignored even if unrecognized
                                                          Comments

                                                          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.

                                                          Control0..*
                                                          TypeExtension
                                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                          Summarytrue
                                                          Requirements

                                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                          Alternate Namesextensions, user content, modifiers
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          266. Patient.link.other
                                                          Definition

                                                          The other patient resource that the link refers to.

                                                          ShortThe other patient or related person resource that the link refers to
                                                          Comments

                                                          Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.

                                                          Control1..1
                                                          TypeReference(Patient, RelatedPerson)
                                                          Is Modifierfalse
                                                          Summarytrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          268. Patient.link.type
                                                          Definition

                                                          The type of link between this patient resource and another patient resource.

                                                          Shortreplaced-by | replaces | refer | seealso
                                                          Control1..1
                                                          BindingThe codes SHALL be taken from LinkType
                                                          (required to http://hl7.org/fhir/ValueSet/link-type|4.0.1)

                                                          The type of link between this patient resource and another patient resource.

                                                          Typecode
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summarytrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))