MII Implementation Guide Core Dataset Base
2026.0.0 - Release Germany

This page is part of the MII Implementation Guide Core Dataset Base (v2026.0.0: Release) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 2026.0.1. For a full list of available versions, see the Directory of published versions

Resource Profile: MII PR Person Patient (Pseudonymisiert) - Detailed Descriptions

Active as of 2025-07-22

Definitions for the mii-pr-person-patient-pseudonymisiert 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 or animal receiving care or other health-related services.

ShortInformation 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())
mii-pat-1: Falls die Geschlechtsangabe 'other' gewählt wird, muss die amtliche Differenzierung per Extension angegeben werden (gender.exists() and gender='other' implies gender.extension('http://fhir.de/StructureDefinition/gender-amtlich-de').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
Typeidstring
Is Modifierfalse
Must Supporttrue
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
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. Patient.meta.profile
Definition

A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.


A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

ShortProfiles this resource claims to conform to
Comments

It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

Control0..*
Typecanonical(StructureDefinition)
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()))
8. 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()))
10. 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())
12. Patient.identifier
Definition

Ein Identifikator für den/die Patient*in


An identifier for this patient.

ShortPatienten-IdentifikatorAn identifier for this patient
NoteThis is a business identifier, not a resource identifier (see discussion)
Control10..*
TypeIdentifier
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()))
SlicingThis element introduces a set of slices on Patient.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • pattern @ $this
  • 14. Patient.identifier:PseudonymisierterIdentifier
    Slice NamePseudonymisierterIdentifier
    Definition

    Ein Pseudonym ersetzt einen Originalwert. Die Verarbeitung ist umkehrbar. Zusätzliche Informationen sind erforderlich, um den Originalwert zu rekonstruieren, bspw. eine Trusted Third Party.


    An identifier for this patient.

    ShortPseudonymisierter IdentifikatorAn identifier for this patient
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..*
    TypeIdentifier
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    Patients are almost always assigned specific numerical identifiers.

    Pattern Value{
      "type" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/v3-ObservationValue",
          "code" : "PSEUDED"
        }]
      }
    }
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    16. Patient.identifier:AnonymisierterIdentifier
    Slice NameAnonymisierterIdentifier
    Definition

    Ein Anonymisierter Identifikator ersetzt einen Originalwert. Die Verarbeitung ist unumkehrbar. Der Originalwert kann nicht oder nur mit unverhältnismäßigem Aufwand rekonstruiert werden.


    An identifier for this patient.

    ShortAnonymisierter IdentifikatorAn identifier for this patient
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..*
    TypeIdentifier
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    Patients are almost always assigned specific numerical identifiers.

    Pattern Value{
      "type" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/v3-ObservationValue",
          "code" : "ANONYED"
        }]
      }
    }
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    18. Patient.identifier:MaskierterVersichertenIdentifer
    Slice NameMaskierterVersichertenIdentifer
    Definition

    Identifier der Krankenversichertennummer, bei dem der Wert maskiert wurde.


    An identifier for this patient.

    ShortMaskierter Identifier der Krankenversicherten-IDAn identifier for this patient
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..1*
    TypeIdentifier(Identifier-Profil für die 10-stellige Krankenversichertennummer)
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    Patients are almost always assigned specific numerical identifiers.

    Pattern Value{
      "type" : {
        "coding" : [{
          "system" : "http://fhir.de/CodeSystem/identifier-type-de-basis",
          "code" : "KVZ10"
        }]
      }
    }
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ide-masked-1: Identifier.value SOLLTE keinen Wert und SOLLTE die Extension Data Absent Reason mit Code 'masked' enthalten. (value.hasValue().not() and value.extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason' and value='masked').exists())
    20. Patient.identifier:MaskierterVersichertenIdentifer.use
    Definition

    The purpose of this identifier.

    Shortusual | official | temp | secondary | old (If known)
    Comments

    Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

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

    Identifies the purpose for this identifier, if known .

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

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

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    22. Patient.identifier:MaskierterVersichertenIdentifer.type
    Definition

    A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

    ShortDescription of identifier
    Comments

    This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

    Control10..1
    BindingUnless not suitable, these codes SHALL be taken from Identifier Type DeBasis ValueSethttp://hl7.org/fhir/ValueSet/identifier-type|4.0.1
    (extensible to http://fhir.de/ValueSet/identifier-type-de-basis)

    A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

    TypeCodeableConcept
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    Allows users to make use of identifiers when the identifier system is not known.

    Pattern Value{
      "coding" : [{
        "system" : "http://fhir.de/CodeSystem/identifier-type-de-basis",
        "code" : "KVZ10"
      }]
    }
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    kvid-2: Die type Codes 'GKV' und 'PKV' haben den Status 'retired', daher sollen diese nicht mehr verwendet werden (($this.coding.exists(system='http://fhir.de/CodeSystem/identifier-type-de-basis' and code='GKV') or $this.coding.exists(system='http://fhir.de/CodeSystem/identifier-type-de-basis' and code='PKV')).not())
    24. Patient.identifier:MaskierterVersichertenIdentifer.system
    Definition

    Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

    ShortThe namespace for the identifier value
    Comments

    Identifier.system is always case sensitive.

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

    There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

    Fixed Valuehttp://fhir.de/sid/gkv/kvid-10
    ExampleGeneral: http://www.acme.com/identifiers/patient
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    26. Patient.identifier:MaskierterVersichertenIdentifer.value
    Definition

    The portion of the identifier typically relevant to the user and which is unique within the context of the system.

    ShortThe value that is unique
    Comments

    If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

    Control10..1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    ExampleGeneral: 123456
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    kvid-1: Der unveränderliche Teil der KVID muss 10-stellig sein und mit einem Großbuchstaben anfangen (matches('^[A-Z][0-9]{9}$'))
    28. Patient.identifier:MaskierterVersichertenIdentifer.value.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.

    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())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis element introduces a set of slices on Patient.identifier.value.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 30. Patient.identifier:MaskierterVersichertenIdentifer.value.extension:data-absent-reason
      Slice Namedata-absent-reason
      Definition

      Provides a reason why the expected value or elements in the element that is extended are missing.

      Shortunknown | asked | temp | notasked | masked | unsupported | astext | error
      Control0..1
      TypeExtension(Data Absent Reason) (Extension Type: code)
      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())
      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())
      32. Patient.identifier:MaskierterVersichertenIdentifer.value.extension:data-absent-reason.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.

      Control0..0*
      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())
      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())
      SlicingThis element introduces a set of slices on Patient.identifier.value.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 34. Patient.identifier:MaskierterVersichertenIdentifer.value.extension:data-absent-reason.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://hl7.org/fhir/StructureDefinition/data-absent-reason
        36. Patient.identifier:MaskierterVersichertenIdentifer.value.extension:data-absent-reason.value[x]
        Definition

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


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

        ShortValue of extension
        Control10..1
        This element is affected by the following invariants: ext-1
        BindingThe codes SHALL be taken from For codes, see DataAbsentReason
        (required to http://hl7.org/fhir/ValueSet/data-absent-reason)
        Typecode, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, 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
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Pattern Valuemasked
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        38. Patient.identifier:MaskierterVersichertenIdentifer.assigner
        Definition

        Organization that issued/manages the identifier.

        ShortOrganization that issued id (may be just text)
        Comments

        The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

        Control10..1
        TypeReference(Organization, Organization)
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        40. Patient.identifier:MaskierterVersichertenIdentifer.assigner.identifier
        Definition

        An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

        ShortLogical reference, when literal reference is not known
        Comments

        When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

        When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

        Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

        Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control10..1
        TypeIdentifier(Identifier-Profil für die Abbildung eines Institutionskennzeichens (IKNR))
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        42. Patient.identifier:MaskierterVersichertenIdentifer.assigner.identifier.use
        Definition

        The purpose of this identifier.

        Shortusual | official | temp | secondary | old (If known)
        Comments

        Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

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

        Identifies the purpose for this identifier, if known .

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

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

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

        A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

        ShortDescription of identifier
        Comments

        This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

        Control0..1
        BindingUnless not suitable, these codes SHALL be taken from Identifier Type DeBasis ValueSethttp://hl7.org/fhir/ValueSet/identifier-type|4.0.1
        (extensible to http://fhir.de/ValueSet/identifier-type-de-basis)

        A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Allows users to make use of identifiers when the identifier system is not known.

        Pattern Value{
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "XX"
          }]
        }
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        46. Patient.identifier:MaskierterVersichertenIdentifer.assigner.identifier.system
        Definition

        Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

        ShortThe namespace for the identifier value
        Comments

        Identifier.system is always case sensitive.

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

        There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

        Fixed Valuehttp://fhir.de/sid/arge-ik/iknr
        ExampleGeneral: http://www.acme.com/identifiers/patient
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        48. Patient.identifier:MaskierterVersichertenIdentifer.assigner.identifier.value
        Definition

        The portion of the identifier typically relevant to the user and which is unique within the context of the system.

        ShortThe value that is unique
        Comments

        If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

        Control10..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        ExampleGeneral: 123456
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ik-1: Eine IK muss eine numerische 9-stellige Zeichenkette (mit Prüfziffer) sein (matches('^[0-9]{9}$'))
        50. Patient.active
        Definition

        Gibt an, ob diese Patient-Ressource aktiv verwendet wird.


        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.

        ShortAktivWhether 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
        Must Supporttrue
        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()))
        52. Patient.gender
        Definition

        männlich | weiblich | andere | unbekannt | unbestimmt | divers


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

        ShortAdministratives Geschlechtmale | 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.

        Control0..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()))
        54. Patient.gender.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.

        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())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on Patient.gender.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 56. Patient.gender.extension:other-amtlich
          Slice Nameother-amtlich
          Definition

          Extension zur genaueren Differenzierung des administrativen Geschlechts

          ShortExtension Administratives Geschlecht
          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(Differenzierung des administrativen Geschlechts 'other') (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())
          58. Patient.birthDate
          Definition

          Das Geburtsdatum der Patientin oder des Patienten


          The date of birth for the individual.

          ShortGeburtsdatumThe 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).

          Control0..1
          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.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          LOINC Code21112-8
          60. Patient.deceased[x]
          Definition

          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()))
          62. Patient.address
          Definition

          Eine Adresse der Patientin oder des Patienten


          An address for the individual.

          ShortAdresseAn address for the individual
          Comments

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

          Control0..*
          TypeAddress
          Is Modifierfalse
          Must Supporttrue
          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()))
          SlicingThis element introduces a set of slices on Patient.address. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • pattern @ $this
          • 64. Patient.address:Strassenanschrift
            Slice NameStrassenanschrift
            Definition

            Eine Straßenanschrift der Patientin oder des Patienten


            An address for the individual.

            ShortStraßenanschriftAn address for the individual
            Comments

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

            Control0..*
            TypeAddress(Adresse, deutsches Basisprofil)
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

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

            Pattern Value{
              "type" : "both"
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            pat-cnt-2or3-char: The content of the country element (if present) SHALL be selected EITHER from ValueSet ISO Country Alpha-2 http://hl7.org/fhir/ValueSet/iso3166-1-2 OR MAY be selected from ISO Country Alpha-3 Value Set http://hl7.org/fhir/ValueSet/iso3166-1-3, IF the country is not specified in value Set ISO Country Alpha-2 http://hl7.org/fhir/ValueSet/iso3166-1-2. (country.empty() or (country.memberOf('http://hl7.org/fhir/ValueSet/iso3166-1-2') or country.memberOf('http://hl7.org/fhir/ValueSet/iso3166-1-3')))
            66. Patient.address:Strassenanschrift.extension:Stadtteil
            Slice NameStadtteil
            Definition

            A subsection of a municipality.

            ShortStadt- oder Ortsteil
            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..1
            This element is affected by the following invariants: ele-1
            TypeExtension(ADXP Precinct) (Extension Type: string)
            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())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            68. Patient.address:Strassenanschrift.use
            Definition

            The purpose of this address.

            Shorthome | work | temp | old | billing - purpose of this address
            Comments

            Applications can assume that an address is current unless it explicitly says that it is temporary or old.

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

            The use of an address.

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

            Allows an appropriate address to be chosen from a list of many.

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

            Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both.

            Shortpostal | physical | both
            Comments

            The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource).


            The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource).

            Control10..1
            BindingThe codes SHALL be taken from AddressTypehttp://hl7.org/fhir/ValueSet/address-type|4.0.1
            (required to http://hl7.org/fhir/ValueSet/address-type|4.0.1)

            The type of an address (physical / postal).

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

            Diese Komponente kann Straßennamen, Hausnummer, Appartmentnummer, Postfach, c/o sowie weitere Zustellungshinweise enthalten. Die Informationen können in mehrere line-Komponenten aufgeteilt werden. Bei Verwendung der Extensions, um Straße, Hausnnummer und Postleitzahl strukturiert zu übermitteln, müssen diese Informationen stets vollständig auch in der line-Komponente, die sie erweitern, enthalten sein, um es Systemen, die diese Extensions nicht verwenden zu ermöglichen, auf diese Informationen zugreifen zu können.


            This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.

            ShortStraßenname mit Hausnummer oder Postfach sowie weitere Angaben zur ZustellungStreet name, number, direction & P.O. Box etc.
            Control0..3*
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            ExampleGeneral: 137 Nowhere Street
            Beipiel für Adresszeile mit Extensions für Straße und Hausnummer: Musterweg 42
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            74. Patient.address:Strassenanschrift.line.extension:Strasse
            Slice NameStrasse
            Definition

            Strassenname (ohne Hausnummer) Bei Angabe einer Strasse in dieser Extension muss diese auch in Address.line angegeben werden um die Interoperabilität mit Systemen zu gewährleisten, die diese Extension nicht verwenden.

            ShortStrassenname (ohne Hausnummer)
            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..1
            This element is affected by the following invariants: ele-1
            TypeExtension(ADXP Street Name) (Extension Type: string)
            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())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            76. Patient.address:Strassenanschrift.line.extension:Hausnummer
            Slice NameHausnummer
            Definition

            Hausnummer, sowie Zusätze (Appartmentnummer, Etage...) Bei Angabe einer Hausnummer in dieser Extension muss diese auch in Address.line angegeben werden um die Interoperabilität mit Systemen zu gewährleisten, die diese Extension nicht verwenden.

            ShortHausnummer
            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..1
            This element is affected by the following invariants: ele-1
            TypeExtension(ADXP House Number) (Extension Type: string)
            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())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            78. Patient.address:Strassenanschrift.line.extension:Adresszusatz
            Slice NameAdresszusatz
            Definition

            Zusätzliche Informationen, wie z.B. "3. Etage", "Appartment C" Bei Angabe einer Zusatzinformation in dieser Extension muss diese auch in Address.line angegeben werden um die Interoperabilität mit Systemen zu gewährleisten, die diese Extension nicht verwenden.

            ShortAdresszusatz
            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..1
            This element is affected by the following invariants: ele-1
            TypeExtension(ADXP Additional Locator) (Extension Type: string)
            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())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            80. Patient.address:Strassenanschrift.line.extension:Postfach
            Slice NamePostfach
            Definition

            Postfach-Adresse. Bei Angabe eines Postfaches in dieser Extension muss das Postfach auch in Address.line angegeben werden um die Interoperabilität mit Systemen zu gewährleisten, die diese Extension nicht verwenden. Eine Postfach-Adresse darf nicht in Verbindung mit Address.type "physical" oder "both" verwendet werden.

            ShortPostfach
            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..1
            This element is affected by the following invariants: ele-1
            TypeExtension(ADXP Post Box) (Extension Type: string)
            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())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            82. Patient.address:Strassenanschrift.city
            Definition

            The name of the city, town, suburb, village or other community or delivery center.

            ShortName of city, town etc.
            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Alternate NamesMunicpality
            ExampleGeneral: Erewhon
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            84. Patient.address:Strassenanschrift.city.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.

            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())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on Patient.address.city.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 86. Patient.address:Strassenanschrift.city.extension:gemeindeschluessel
              Slice Namegemeindeschluessel
              Definition

              Optional Extension Element - found in all resources.

              ShortOptional Extensions Element
              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(ExtensionDestatisAgs) (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())
              88. Patient.address:Strassenanschrift.district
              Definition

              The name of the administrative area (county).

              ShortDistrict name (aka county)
              Comments

              District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.

              Control0..01
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Alternate NamesCounty
              ExampleGeneral: Madison
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              90. Patient.address:Strassenanschrift.postalCode
              Definition

              Postleitzahl gemäß der im jeweiligen Land gültigen Konventionen


              A postal code designating a region defined by the postal service.

              ShortPostleitzahlPostal code for area
              Control10..1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summarytrue
              Alternate NamesZip
              ExampleGeneral: 9132
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              92. Patient.address:Strassenanschrift.country
              Definition

              Staat (vorzugsweise als 2-Stelliger ISO-Ländercode). Es obliegt abgeleiteten Profilen, hier die Verwendung der ISO-Ländercodes verbindlich vorzuschreiben


              Country - a nation as commonly understood or generally accepted.

              ShortStaatCountry (e.g. can be ISO 3166 2 or 3 letter code)
              Comments

              ISO 3166 3 letter codes can be used in place of a human readable country name.

              Control10..1
              BindingThe codes SHOULD be taken from For codes, see Iso3166-1-2
              (preferred to http://hl7.org/fhir/ValueSet/iso3166-1-2)
              Typestring
              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()))
              94. Patient.link
              Definition

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

              ShortLink 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()))
              96. 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())
              98. 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()))
              100. 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
              Invariantsmii-pat-1: Falls die Geschlechtsangabe 'other' gewählt wird, muss die amtliche Differenzierung per Extension angegeben werden (gender.exists() and gender='other' implies gender.extension('http://fhir.de/StructureDefinition/gender-amtlich-de').exists())
              2. Patient.id
              Must Supporttrue
              4. Patient.meta
              Must Supporttrue
              6. Patient.meta.profile
              Must Supporttrue
              8. Patient.identifier
              Definition

              Ein Identifikator für den/die Patient*in

              ShortPatienten-Identifikator
              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control1..?
              Must Supporttrue
              SlicingThis element introduces a set of slices on Patient.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • pattern @ $this
              • 10. Patient.identifier:PseudonymisierterIdentifier
                Slice NamePseudonymisierterIdentifier
                Definition

                Ein Pseudonym ersetzt einen Originalwert. Die Verarbeitung ist umkehrbar. Zusätzliche Informationen sind erforderlich, um den Originalwert zu rekonstruieren, bspw. eine Trusted Third Party.

                ShortPseudonymisierter Identifikator
                NoteThis is a business identifier, not a resource identifier (see discussion)
                Control0..*
                Must Supporttrue
                Pattern Value{
                  "type" : {
                    "coding" : [{
                      "system" : "http://terminology.hl7.org/CodeSystem/v3-ObservationValue",
                      "code" : "PSEUDED"
                    }]
                  }
                }
                12. Patient.identifier:AnonymisierterIdentifier
                Slice NameAnonymisierterIdentifier
                Definition

                Ein Anonymisierter Identifikator ersetzt einen Originalwert. Die Verarbeitung ist unumkehrbar. Der Originalwert kann nicht oder nur mit unverhältnismäßigem Aufwand rekonstruiert werden.

                ShortAnonymisierter Identifikator
                NoteThis is a business identifier, not a resource identifier (see discussion)
                Control0..*
                Must Supporttrue
                Pattern Value{
                  "type" : {
                    "coding" : [{
                      "system" : "http://terminology.hl7.org/CodeSystem/v3-ObservationValue",
                      "code" : "ANONYED"
                    }]
                  }
                }
                14. Patient.identifier:MaskierterVersichertenIdentifer
                Slice NameMaskierterVersichertenIdentifer
                Definition

                Identifier der Krankenversichertennummer, bei dem der Wert maskiert wurde.

                ShortMaskierter Identifier der Krankenversicherten-ID
                NoteThis is a business identifier, not a resource identifier (see discussion)
                Control0..1
                TypeIdentifier(Identifier-Profil für die 10-stellige Krankenversichertennummer)
                Must Supporttrue
                Pattern Value{
                  "type" : {
                    "coding" : [{
                      "system" : "http://fhir.de/CodeSystem/identifier-type-de-basis",
                      "code" : "KVZ10"
                    }]
                  }
                }
                Invariantside-masked-1: Identifier.value SOLLTE keinen Wert und SOLLTE die Extension Data Absent Reason mit Code 'masked' enthalten. (value.hasValue().not() and value.extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason' and value='masked').exists())
                16. Patient.identifier:MaskierterVersichertenIdentifer.type
                Control1..?
                Must Supporttrue
                18. Patient.identifier:MaskierterVersichertenIdentifer.system
                Must Supporttrue
                20. Patient.identifier:MaskierterVersichertenIdentifer.value
                Must Supporttrue
                22. Patient.identifier:MaskierterVersichertenIdentifer.value.extension
                SlicingThis element introduces a set of slices on Patient.identifier.value.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 24. Patient.identifier:MaskierterVersichertenIdentifer.value.extension:data-absent-reason
                  Slice Namedata-absent-reason
                  Control0..1
                  TypeExtension(Data Absent Reason) (Extension Type: code)
                  Must Supporttrue
                  26. Patient.identifier:MaskierterVersichertenIdentifer.value.extension:data-absent-reason.value[x]
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Pattern Valuemasked
                  28. Patient.identifier:MaskierterVersichertenIdentifer.assigner
                  Control1..?
                  Must Supporttrue
                  30. Patient.identifier:MaskierterVersichertenIdentifer.assigner.identifier
                  NoteThis is a business identifier, not a resource identifier (see discussion)
                  Control1..?
                  TypeIdentifier(Identifier-Profil für die Abbildung eines Institutionskennzeichens (IKNR))
                  Must Supporttrue
                  32. Patient.identifier:MaskierterVersichertenIdentifer.assigner.identifier.type
                  Must Supporttrue
                  34. Patient.identifier:MaskierterVersichertenIdentifer.assigner.identifier.system
                  Must Supporttrue
                  36. Patient.identifier:MaskierterVersichertenIdentifer.assigner.identifier.value
                  Must Supporttrue
                  38. Patient.active
                  Definition

                  Gibt an, ob diese Patient-Ressource aktiv verwendet wird.

                  ShortAktiv
                  Must Supporttrue
                  40. Patient.gender
                  Definition

                  männlich | weiblich | andere | unbekannt | unbestimmt | divers

                  ShortAdministratives Geschlecht
                  Must Supporttrue
                  42. Patient.gender.extension
                  SlicingThis element introduces a set of slices on Patient.gender.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 44. Patient.gender.extension:other-amtlich
                    Slice Nameother-amtlich
                    Definition

                    Extension zur genaueren Differenzierung des administrativen Geschlechts

                    ShortExtension Administratives Geschlecht
                    Control0..1
                    TypeExtension(Differenzierung des administrativen Geschlechts 'other') (Extension Type: Coding)
                    Must Supporttrue
                    46. Patient.birthDate
                    Definition

                    Das Geburtsdatum der Patientin oder des Patienten

                    ShortGeburtsdatum
                    Must Supporttrue
                    LOINC Code
                    48. Patient.address
                    Definition

                    Eine Adresse der Patientin oder des Patienten

                    ShortAdresse
                    Must Supporttrue
                    SlicingThis element introduces a set of slices on Patient.address. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • pattern @ $this
                    • 50. Patient.address:Strassenanschrift
                      Slice NameStrassenanschrift
                      Definition

                      Eine Straßenanschrift der Patientin oder des Patienten

                      ShortStraßenanschrift
                      Control0..*
                      TypeAddress(Adresse, deutsches Basisprofil)
                      Must Supporttrue
                      Pattern Value{
                        "type" : "both"
                      }
                      Invariantspat-cnt-2or3-char: The content of the country element (if present) SHALL be selected EITHER from ValueSet ISO Country Alpha-2 http://hl7.org/fhir/ValueSet/iso3166-1-2 OR MAY be selected from ISO Country Alpha-3 Value Set http://hl7.org/fhir/ValueSet/iso3166-1-3, IF the country is not specified in value Set ISO Country Alpha-2 http://hl7.org/fhir/ValueSet/iso3166-1-2. (country.empty() or (country.memberOf('http://hl7.org/fhir/ValueSet/iso3166-1-2') or country.memberOf('http://hl7.org/fhir/ValueSet/iso3166-1-3')))
                      52. Patient.address:Strassenanschrift.type
                      Control1..?
                      Must Supporttrue
                      54. Patient.address:Strassenanschrift.city
                      56. Patient.address:Strassenanschrift.city.extension
                      SlicingThis element introduces a set of slices on Patient.address.city.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 58. Patient.address:Strassenanschrift.city.extension:gemeindeschluessel
                        Slice Namegemeindeschluessel
                        Control0..1
                        TypeExtension(ExtensionDestatisAgs) (Extension Type: Coding)
                        Must Supporttrue
                        60. Patient.address:Strassenanschrift.postalCode
                        Control1..?
                        Must Supporttrue
                        62. Patient.address:Strassenanschrift.country
                        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 or animal receiving care or other health-related services.

                        ShortInformation 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())
                        mii-pat-1: Falls die Geschlechtsangabe 'other' gewählt wird, muss die amtliche Differenzierung per Extension angegeben werden (gender.exists() and gender='other' implies gender.extension('http://fhir.de/StructureDefinition/gender-amtlich-de').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
                        Must Supporttrue
                        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
                        Must Supporttrue
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        6. Patient.meta.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
                        8. Patient.meta.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.meta.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 10. Patient.meta.versionId
                          Definition

                          The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

                          ShortVersion specific identifier
                          Comments

                          The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

                          Control0..1
                          Typeid
                          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()))
                          12. Patient.meta.lastUpdated
                          Definition

                          When the resource last changed - e.g. when the version changed.

                          ShortWhen the resource version last changed
                          Comments

                          This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

                          Control0..1
                          Typeinstant
                          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()))
                          14. Patient.meta.source
                          Definition

                          A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

                          ShortIdentifies where the resource comes from
                          Comments

                          In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

                          This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

                          Control0..1
                          Typeuri
                          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()))
                          16. Patient.meta.profile
                          Definition

                          A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

                          ShortProfiles this resource claims to conform to
                          Comments

                          It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

                          Control0..*
                          Typecanonical(StructureDefinition)
                          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()))
                          18. Patient.meta.security
                          Definition

                          Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

                          ShortSecurity Labels applied to this resource
                          Comments

                          The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

                          Control0..*
                          BindingUnless not suitable, these codes SHALL be taken from All Security Labels
                          (extensible to http://hl7.org/fhir/ValueSet/security-labels|4.0.1)

                          Security Labels from the Healthcare Privacy and Security Classification System.

                          TypeCoding
                          Is Modifierfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          20. Patient.meta.tag
                          Definition

                          Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

                          ShortTags applied to this resource
                          Comments

                          The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

                          Control0..*
                          BindingFor example codes, see CommonTags
                          (example to http://hl7.org/fhir/ValueSet/common-tags|4.0.1)

                          Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

                          TypeCoding
                          Is Modifierfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          22. 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()))
                          24. 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|4.0.1)

                          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()))
                          26. 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()))
                          28. 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
                          30. Patient.extension
                          Definition

                          May be used to represent additional information that is not part of the basic definition of the resource. 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())
                          32. 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())
                          34. Patient.identifier
                          Definition

                          Ein Identifikator für den/die Patient*in

                          ShortPatienten-Identifikator
                          NoteThis is a business identifier, not a resource identifier (see discussion)
                          Control1..*
                          TypeIdentifier
                          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()))
                          SlicingThis element introduces a set of slices on Patient.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • pattern @ $this
                          • 36. Patient.identifier:PseudonymisierterIdentifier
                            Slice NamePseudonymisierterIdentifier
                            Definition

                            Ein Pseudonym ersetzt einen Originalwert. Die Verarbeitung ist umkehrbar. Zusätzliche Informationen sind erforderlich, um den Originalwert zu rekonstruieren, bspw. eine Trusted Third Party.

                            ShortPseudonymisierter Identifikator
                            NoteThis is a business identifier, not a resource identifier (see discussion)
                            Control0..*
                            TypeIdentifier
                            Is Modifierfalse
                            Must Supporttrue
                            Summarytrue
                            Requirements

                            Patients are almost always assigned specific numerical identifiers.

                            Pattern Value{
                              "type" : {
                                "coding" : [{
                                  "system" : "http://terminology.hl7.org/CodeSystem/v3-ObservationValue",
                                  "code" : "PSEUDED"
                                }]
                              }
                            }
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            38. Patient.identifier:AnonymisierterIdentifier
                            Slice NameAnonymisierterIdentifier
                            Definition

                            Ein Anonymisierter Identifikator ersetzt einen Originalwert. Die Verarbeitung ist unumkehrbar. Der Originalwert kann nicht oder nur mit unverhältnismäßigem Aufwand rekonstruiert werden.

                            ShortAnonymisierter Identifikator
                            NoteThis is a business identifier, not a resource identifier (see discussion)
                            Control0..*
                            TypeIdentifier
                            Is Modifierfalse
                            Must Supporttrue
                            Summarytrue
                            Requirements

                            Patients are almost always assigned specific numerical identifiers.

                            Pattern Value{
                              "type" : {
                                "coding" : [{
                                  "system" : "http://terminology.hl7.org/CodeSystem/v3-ObservationValue",
                                  "code" : "ANONYED"
                                }]
                              }
                            }
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            40. Patient.identifier:MaskierterVersichertenIdentifer
                            Slice NameMaskierterVersichertenIdentifer
                            Definition

                            Identifier der Krankenversichertennummer, bei dem der Wert maskiert wurde.

                            ShortMaskierter Identifier der Krankenversicherten-ID
                            NoteThis is a business identifier, not a resource identifier (see discussion)
                            Control0..1
                            TypeIdentifier(Identifier-Profil für die 10-stellige Krankenversichertennummer)
                            Is Modifierfalse
                            Must Supporttrue
                            Summarytrue
                            Requirements

                            Patients are almost always assigned specific numerical identifiers.

                            Pattern Value{
                              "type" : {
                                "coding" : [{
                                  "system" : "http://fhir.de/CodeSystem/identifier-type-de-basis",
                                  "code" : "KVZ10"
                                }]
                              }
                            }
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ide-masked-1: Identifier.value SOLLTE keinen Wert und SOLLTE die Extension Data Absent Reason mit Code 'masked' enthalten. (value.hasValue().not() and value.extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason' and value='masked').exists())
                            42. Patient.identifier:MaskierterVersichertenIdentifer.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
                            44. Patient.identifier:MaskierterVersichertenIdentifer.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.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 46. Patient.identifier:MaskierterVersichertenIdentifer.use
                              Definition

                              The purpose of this identifier.

                              Shortusual | official | temp | secondary | old (If known)
                              Comments

                              Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

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

                              Identifies the purpose for this identifier, if known .

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

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

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

                              A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                              ShortDescription of identifier
                              Comments

                              This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                              Control1..1
                              BindingUnless not suitable, these codes SHALL be taken from Identifier Type DeBasis ValueSet
                              (extensible to http://fhir.de/ValueSet/identifier-type-de-basis)

                              A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supporttrue
                              Summarytrue
                              Requirements

                              Allows users to make use of identifiers when the identifier system is not known.

                              Pattern Value{
                                "coding" : [{
                                  "system" : "http://fhir.de/CodeSystem/identifier-type-de-basis",
                                  "code" : "KVZ10"
                                }]
                              }
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              kvid-2: Die type Codes 'GKV' und 'PKV' haben den Status 'retired', daher sollen diese nicht mehr verwendet werden (($this.coding.exists(system='http://fhir.de/CodeSystem/identifier-type-de-basis' and code='GKV') or $this.coding.exists(system='http://fhir.de/CodeSystem/identifier-type-de-basis' and code='PKV')).not())
                              50. Patient.identifier:MaskierterVersichertenIdentifer.system
                              Definition

                              Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                              ShortThe namespace for the identifier value
                              Comments

                              Identifier.system is always case sensitive.

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

                              There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                              Fixed Valuehttp://fhir.de/sid/gkv/kvid-10
                              ExampleGeneral: http://www.acme.com/identifiers/patient
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              52. Patient.identifier:MaskierterVersichertenIdentifer.value
                              Definition

                              The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                              ShortThe value that is unique
                              Comments

                              If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                              Control1..1
                              Typestring
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supporttrue
                              Summarytrue
                              ExampleGeneral: 123456
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              kvid-1: Der unveränderliche Teil der KVID muss 10-stellig sein und mit einem Großbuchstaben anfangen (matches('^[A-Z][0-9]{9}$'))
                              54. Patient.identifier:MaskierterVersichertenIdentifer.value.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
                              56. Patient.identifier:MaskierterVersichertenIdentifer.value.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.identifier.value.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 58. Patient.identifier:MaskierterVersichertenIdentifer.value.extension:data-absent-reason
                                Slice Namedata-absent-reason
                                Definition

                                Provides a reason why the expected value or elements in the element that is extended are missing.

                                Shortunknown | asked | temp | notasked | masked | unsupported | astext | error
                                Control0..1
                                TypeExtension(Data Absent Reason) (Extension Type: code)
                                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())
                                60. Patient.identifier:MaskierterVersichertenIdentifer.value.extension:data-absent-reason.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
                                This element is affected by the following invariants: ele-1
                                Typeid
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                62. Patient.identifier:MaskierterVersichertenIdentifer.value.extension:data-absent-reason.extension
                                Definition

                                An Extension

                                ShortExtension
                                Control0..0
                                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.identifier.value.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 64. Patient.identifier:MaskierterVersichertenIdentifer.value.extension:data-absent-reason.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://hl7.org/fhir/StructureDefinition/data-absent-reason
                                  66. Patient.identifier:MaskierterVersichertenIdentifer.value.extension:data-absent-reason.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
                                  This element is affected by the following invariants: ext-1
                                  BindingThe codes SHALL be taken from DataAbsentReason
                                  (required to http://hl7.org/fhir/ValueSet/data-absent-reason)
                                  Typecode
                                  [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
                                  Pattern Valuemasked
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  68. Patient.identifier:MaskierterVersichertenIdentifer.value.value
                                  Definition

                                  The actual value

                                  ShortPrimitive value for string
                                  Control0..1
                                  Typestring
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  Max Length:1048576
                                  70. Patient.identifier:MaskierterVersichertenIdentifer.period
                                  Definition

                                  Time period during which identifier is/was valid for use.

                                  ShortTime period when id is/was valid for use
                                  Control0..1
                                  TypePeriod
                                  Is Modifierfalse
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  72. Patient.identifier:MaskierterVersichertenIdentifer.assigner
                                  Definition

                                  Organization that issued/manages the identifier.

                                  ShortOrganization that issued id (may be just text)
                                  Comments

                                  The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                                  Control1..1
                                  TypeReference(Organization)
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  74. Patient.identifier:MaskierterVersichertenIdentifer.assigner.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
                                  76. Patient.identifier:MaskierterVersichertenIdentifer.assigner.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.identifier.assigner.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 78. Patient.identifier:MaskierterVersichertenIdentifer.assigner.reference
                                    Definition

                                    A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                    ShortLiteral reference, Relative, internal or absolute URL
                                    Comments

                                    Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                    Control0..1
                                    This element is affected by the following invariants: ref-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()))
                                    80. Patient.identifier:MaskierterVersichertenIdentifer.assigner.type
                                    Definition

                                    The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                    The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                    ShortType the reference refers to (e.g. "Patient")
                                    Comments

                                    This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                    Control0..1
                                    BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                    (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

                                    Aa resource (or, for logical models, the URI of the logical model).

                                    Typeuri
                                    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.identifier:MaskierterVersichertenIdentifer.assigner.identifier
                                    Definition

                                    An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                    ShortLogical reference, when literal reference is not known
                                    Comments

                                    When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                    When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                    Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                    Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                    NoteThis is a business identifier, not a resource identifier (see discussion)
                                    Control1..1
                                    TypeIdentifier(Identifier-Profil für die Abbildung eines Institutionskennzeichens (IKNR))
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    84. Patient.identifier:MaskierterVersichertenIdentifer.assigner.identifier.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
                                    86. Patient.identifier:MaskierterVersichertenIdentifer.assigner.identifier.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.identifier.assigner.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 88. Patient.identifier:MaskierterVersichertenIdentifer.assigner.identifier.use
                                      Definition

                                      The purpose of this identifier.

                                      Shortusual | official | temp | secondary | old (If known)
                                      Comments

                                      Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

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

                                      Identifies the purpose for this identifier, if known .

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

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

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      90. Patient.identifier:MaskierterVersichertenIdentifer.assigner.identifier.type
                                      Definition

                                      A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                                      ShortDescription of identifier
                                      Comments

                                      This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                                      Control0..1
                                      BindingUnless not suitable, these codes SHALL be taken from Identifier Type DeBasis ValueSet
                                      (extensible to http://fhir.de/ValueSet/identifier-type-de-basis)

                                      A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summarytrue
                                      Requirements

                                      Allows users to make use of identifiers when the identifier system is not known.

                                      Pattern Value{
                                        "coding" : [{
                                          "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                                          "code" : "XX"
                                        }]
                                      }
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      92. Patient.identifier:MaskierterVersichertenIdentifer.assigner.identifier.system
                                      Definition

                                      Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                                      ShortThe namespace for the identifier value
                                      Comments

                                      Identifier.system is always case sensitive.

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

                                      There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                                      Fixed Valuehttp://fhir.de/sid/arge-ik/iknr
                                      ExampleGeneral: http://www.acme.com/identifiers/patient
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      94. Patient.identifier:MaskierterVersichertenIdentifer.assigner.identifier.value
                                      Definition

                                      The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                                      ShortThe value that is unique
                                      Comments

                                      If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                                      Control1..1
                                      Typestring
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supporttrue
                                      Summarytrue
                                      ExampleGeneral: 123456
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ik-1: Eine IK muss eine numerische 9-stellige Zeichenkette (mit Prüfziffer) sein (matches('^[0-9]{9}$'))
                                      96. Patient.identifier:MaskierterVersichertenIdentifer.assigner.identifier.period
                                      Definition

                                      Time period during which identifier is/was valid for use.

                                      ShortTime period when id is/was valid for use
                                      Control0..1
                                      TypePeriod
                                      Is Modifierfalse
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      98. Patient.identifier:MaskierterVersichertenIdentifer.assigner.identifier.assigner
                                      Definition

                                      Organization that issued/manages the identifier.

                                      ShortOrganization that issued id (may be just text)
                                      Comments

                                      The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                                      Control0..1
                                      TypeReference(Organization)
                                      Is Modifierfalse
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      100. Patient.identifier:MaskierterVersichertenIdentifer.assigner.display
                                      Definition

                                      Plain text narrative that identifies the resource in addition to the resource reference.

                                      ShortText alternative for the resource
                                      Comments

                                      This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                      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()))
                                      102. Patient.active
                                      Definition

                                      Gibt an, ob diese Patient-Ressource aktiv verwendet wird.

                                      ShortAktiv
                                      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
                                      Must Supporttrue
                                      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()))
                                      104. 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. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.

                                      Control0..*
                                      TypeHumanName
                                      Is Modifierfalse
                                      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()))
                                      106. 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
                                      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()))
                                      108. Patient.gender
                                      Definition

                                      männlich | weiblich | andere | unbekannt | unbestimmt | divers

                                      ShortAdministratives Geschlecht
                                      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.

                                      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
                                      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()))
                                      110. Patient.gender.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
                                      112. Patient.gender.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.gender.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 114. Patient.gender.extension:other-amtlich
                                        Slice Nameother-amtlich
                                        Definition

                                        Extension zur genaueren Differenzierung des administrativen Geschlechts

                                        ShortExtension Administratives Geschlecht
                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        TypeExtension(Differenzierung des administrativen Geschlechts 'other') (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())
                                        116. Patient.gender.value
                                        Definition

                                        Primitive value for code

                                        ShortPrimitive value for code
                                        Control0..1
                                        Typestring
                                        Is Modifierfalse
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        Summaryfalse
                                        118. Patient.birthDate
                                        Definition

                                        Das Geburtsdatum der Patientin oder des Patienten

                                        ShortGeburtsdatum
                                        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).

                                        Control0..1
                                        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.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        LOINC Code21112-8
                                        120. Patient.deceased[x]
                                        Definition

                                        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()))
                                        122. Patient.address
                                        Definition

                                        Eine Adresse der Patientin oder des Patienten

                                        ShortAdresse
                                        Comments

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

                                        Control0..*
                                        TypeAddress
                                        Is Modifierfalse
                                        Must Supporttrue
                                        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()))
                                        SlicingThis element introduces a set of slices on Patient.address. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • pattern @ $this
                                        • 124. Patient.address:Strassenanschrift
                                          Slice NameStrassenanschrift
                                          Definition

                                          Eine Straßenanschrift der Patientin oder des Patienten

                                          ShortStraßenanschrift
                                          Comments

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

                                          Control0..*
                                          TypeAddress(Adresse, deutsches Basisprofil)
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Summarytrue
                                          Requirements

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

                                          Pattern Value{
                                            "type" : "both"
                                          }
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          pat-cnt-2or3-char: The content of the country element (if present) SHALL be selected EITHER from ValueSet ISO Country Alpha-2 http://hl7.org/fhir/ValueSet/iso3166-1-2 OR MAY be selected from ISO Country Alpha-3 Value Set http://hl7.org/fhir/ValueSet/iso3166-1-3, IF the country is not specified in value Set ISO Country Alpha-2 http://hl7.org/fhir/ValueSet/iso3166-1-2. (country.empty() or (country.memberOf('http://hl7.org/fhir/ValueSet/iso3166-1-2') or country.memberOf('http://hl7.org/fhir/ValueSet/iso3166-1-3')))
                                          126. Patient.address:Strassenanschrift.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
                                          128. Patient.address:Strassenanschrift.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.address.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                          • value @ url
                                          • 130. Patient.address:Strassenanschrift.extension:Stadtteil
                                            Slice NameStadtteil
                                            Definition

                                            A subsection of a municipality.

                                            ShortStadt- oder Ortsteil
                                            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..1
                                            This element is affected by the following invariants: ele-1
                                            TypeExtension(ADXP Precinct) (Extension Type: string)
                                            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())
                                            132. Patient.address:Strassenanschrift.use
                                            Definition

                                            The purpose of this address.

                                            Shorthome | work | temp | old | billing - purpose of this address
                                            Comments

                                            Applications can assume that an address is current unless it explicitly says that it is temporary or old.

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

                                            The use of an address.

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

                                            Allows an appropriate address to be chosen from a list of many.

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

                                            Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both.

                                            Shortpostal | physical | both
                                            Comments

                                            The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource).

                                            Control1..1
                                            BindingThe codes SHALL be taken from AddressType
                                            (required to http://hl7.org/fhir/ValueSet/address-type|4.0.1)

                                            The type of an address (physical / postal).

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

                                            Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts.

                                            ShortText representation of the address
                                            Comments

                                            Can provide both a text representation and parts. Applications updating an address 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
                                            Summarytrue
                                            Requirements

                                            A renderable, unencoded form.

                                            ExampleGeneral: 137 Nowhere Street, Erewhon 9132
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            138. Patient.address:Strassenanschrift.line
                                            Definition

                                            Diese Komponente kann Straßennamen, Hausnummer, Appartmentnummer, Postfach, c/o sowie weitere Zustellungshinweise enthalten. Die Informationen können in mehrere line-Komponenten aufgeteilt werden. Bei Verwendung der Extensions, um Straße, Hausnnummer und Postleitzahl strukturiert zu übermitteln, müssen diese Informationen stets vollständig auch in der line-Komponente, die sie erweitern, enthalten sein, um es Systemen, die diese Extensions nicht verwenden zu ermöglichen, auf diese Informationen zugreifen zu können.

                                            ShortStraßenname mit Hausnummer oder Postfach sowie weitere Angaben zur Zustellung
                                            Control0..3
                                            Typestring
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summarytrue
                                            ExampleGeneral: 137 Nowhere Street
                                            Beipiel für Adresszeile mit Extensions für Straße und Hausnummer: Musterweg 42
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            140. Patient.address:Strassenanschrift.line.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
                                            142. Patient.address:Strassenanschrift.line.extension
                                            Definition

                                            May be used to represent additional information that is not part of the basic definition of the resource. 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.address.line.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • value @ url
                                            • 144. Patient.address:Strassenanschrift.line.extension:Strasse
                                              Slice NameStrasse
                                              Definition

                                              Strassenname (ohne Hausnummer) Bei Angabe einer Strasse in dieser Extension muss diese auch in Address.line angegeben werden um die Interoperabilität mit Systemen zu gewährleisten, die diese Extension nicht verwenden.

                                              ShortStrassenname (ohne Hausnummer)
                                              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..1
                                              This element is affected by the following invariants: ele-1
                                              TypeExtension(ADXP Street Name) (Extension Type: string)
                                              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())
                                              146. Patient.address:Strassenanschrift.line.extension:Hausnummer
                                              Slice NameHausnummer
                                              Definition

                                              Hausnummer, sowie Zusätze (Appartmentnummer, Etage...) Bei Angabe einer Hausnummer in dieser Extension muss diese auch in Address.line angegeben werden um die Interoperabilität mit Systemen zu gewährleisten, die diese Extension nicht verwenden.

                                              ShortHausnummer
                                              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..1
                                              This element is affected by the following invariants: ele-1
                                              TypeExtension(ADXP House Number) (Extension Type: string)
                                              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())
                                              148. Patient.address:Strassenanschrift.line.extension:Adresszusatz
                                              Slice NameAdresszusatz
                                              Definition

                                              Zusätzliche Informationen, wie z.B. "3. Etage", "Appartment C" Bei Angabe einer Zusatzinformation in dieser Extension muss diese auch in Address.line angegeben werden um die Interoperabilität mit Systemen zu gewährleisten, die diese Extension nicht verwenden.

                                              ShortAdresszusatz
                                              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..1
                                              This element is affected by the following invariants: ele-1
                                              TypeExtension(ADXP Additional Locator) (Extension Type: string)
                                              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())
                                              150. Patient.address:Strassenanschrift.line.extension:Postfach
                                              Slice NamePostfach
                                              Definition

                                              Postfach-Adresse. Bei Angabe eines Postfaches in dieser Extension muss das Postfach auch in Address.line angegeben werden um die Interoperabilität mit Systemen zu gewährleisten, die diese Extension nicht verwenden. Eine Postfach-Adresse darf nicht in Verbindung mit Address.type "physical" oder "both" verwendet werden.

                                              ShortPostfach
                                              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..1
                                              This element is affected by the following invariants: ele-1
                                              TypeExtension(ADXP Post Box) (Extension Type: string)
                                              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())
                                              152. Patient.address:Strassenanschrift.line.value
                                              Definition

                                              The actual value

                                              ShortPrimitive value for string
                                              Control0..1
                                              Typestring
                                              Is Modifierfalse
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              Summaryfalse
                                              Max Length:1048576
                                              154. Patient.address:Strassenanschrift.city
                                              Definition

                                              The name of the city, town, suburb, village or other community or delivery center.

                                              ShortName of city, town etc.
                                              Control0..1
                                              Typestring
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summarytrue
                                              Alternate NamesMunicpality
                                              ExampleGeneral: Erewhon
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              156. Patient.address:Strassenanschrift.city.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
                                              158. Patient.address:Strassenanschrift.city.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.address.city.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • value @ url
                                              • 160. Patient.address:Strassenanschrift.city.extension:gemeindeschluessel
                                                Slice Namegemeindeschluessel
                                                Definition

                                                Optional Extension Element - found in all resources.

                                                ShortOptional Extensions Element
                                                Control0..1
                                                This element is affected by the following invariants: ele-1
                                                TypeExtension(ExtensionDestatisAgs) (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())
                                                162. Patient.address:Strassenanschrift.city.value
                                                Definition

                                                The actual value

                                                ShortPrimitive value for string
                                                Control0..1
                                                Typestring
                                                Is Modifierfalse
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                Summaryfalse
                                                Max Length:1048576
                                                164. Patient.address:Strassenanschrift.district
                                                Definition

                                                The name of the administrative area (county).

                                                ShortDistrict name (aka county)
                                                Comments

                                                District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.

                                                Control0..0
                                                Typestring
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Summarytrue
                                                Alternate NamesCounty
                                                ExampleGeneral: Madison
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                166. Patient.address:Strassenanschrift.state
                                                Definition

                                                Name (oder Kürzel) des Bundeslandes.

                                                ShortBundesland
                                                Control0..1
                                                BindingThe codes SHOULD be taken from ISO-3166-2:de-Laendercodes
                                                (preferred to http://fhir.de/ValueSet/iso/bundeslaender)
                                                Typestring
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Summarytrue
                                                Alternate NamesProvince, Territory
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                168. Patient.address:Strassenanschrift.postalCode
                                                Definition

                                                Postleitzahl gemäß der im jeweiligen Land gültigen Konventionen

                                                ShortPostleitzahl
                                                Control1..1
                                                Typestring
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Must Supporttrue
                                                Summarytrue
                                                Alternate NamesZip
                                                ExampleGeneral: 9132
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                170. Patient.address:Strassenanschrift.country
                                                Definition

                                                Staat (vorzugsweise als 2-Stelliger ISO-Ländercode). Es obliegt abgeleiteten Profilen, hier die Verwendung der ISO-Ländercodes verbindlich vorzuschreiben

                                                ShortStaat
                                                Comments

                                                ISO 3166 3 letter codes can be used in place of a human readable country name.

                                                Control1..1
                                                BindingThe codes SHOULD be taken from Iso3166-1-2
                                                (preferred to http://hl7.org/fhir/ValueSet/iso3166-1-2)
                                                Typestring
                                                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()))
                                                172. Patient.address:Strassenanschrift.period
                                                Definition

                                                Time period when address was/is in use.

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

                                                Allows addresses to be placed in historical context.

                                                ExampleGeneral: { "start" : "2010-03-23", "end" : "2010-07-01" }
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                174. 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|4.0.1)

                                                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()))
                                                176. 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()))
                                                178. 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()))
                                                180. 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
                                                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())
                                                182. 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
                                                184. 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())
                                                186. 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())
                                                188. 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 PatientContactRelationship
                                                (extensible to http://hl7.org/fhir/ValueSet/patient-contactrelationship|4.0.1)

                                                The nature of the relationship between a patient and a contact person for that patient.

                                                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()))
                                                190. 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()))
                                                192. 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()))
                                                194. Patient.contact.address
                                                Definition

                                                Address for the contact person.

                                                ShortAddress for the contact person
                                                Control0..1
                                                TypeAddress
                                                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()))
                                                196. 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()))
                                                198. 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()))
                                                200. 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()))
                                                202. 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
                                                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()))
                                                204. 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
                                                206. 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())
                                                208. 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())
                                                210. 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
                                                BindingThe codes SHOULD be taken from CommonLanguages
                                                (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

                                                A human language.

                                                Additional BindingsPurpose
                                                AllLanguagesMax Binding
                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                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()))
                                                212. 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
                                                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()))
                                                214. 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()))
                                                216. 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()))
                                                218. Patient.link
                                                Definition

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

                                                ShortLink 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()))
                                                220. 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
                                                222. 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())
                                                224. 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())
                                                226. 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()))
                                                228. 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()))