MII Implementation Guide Core Dataset Base
2026.0.1 - Release Germany

MII Implementation Guide Core Dataset Base - Downloaded Version 2026.0.1 See the Directory of published versions

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

Active as of 2026-06-15

Definitions for the mii-pr-person-patient-pseudonymisiert resource profile

- Key Elements Table
- Differential Table
- Snapshot Table

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.
Short | Information about an individual or animal receiving health care services
Control | 0..*
Is Modifier | false
Summary | false
Alternate Names | SubjectOfCare Client Resident
Invariants | dom-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.
Short | Logical 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.
Control | 0..1
Type | id string
Is Modifier | false
Must Support | true
Summary | true
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.
Short | Metadata about the resource
Control | 0..1
Type | Meta
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-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.
Short | Profiles 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.
Control | 0..*
Type | canonical(StructureDefinition)
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-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.
Short | A 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.
Control | 0..1
Type | uri
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
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 Names | extensions, user content
Invariants | 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())
12. Patient.identifier
Definition | Ein Identifikator für den/die Patient*in An identifier for this patient.
Short | Patienten-IdentifikatorAn identifier for this patient
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 10..*
Type | Identifier
Is Modifier | false
Must Support | true
Summary | true
Requirements | Patients are almost always assigned specific numerical identifiers.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This 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 Name | PseudonymisierterIdentifier
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.
Short | Pseudonymisierter IdentifikatorAn identifier for this patient
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Is Modifier | false
Must Support | true
Summary | true
Requirements | Patients are almost always assigned specific numerical identifiers.
Pattern Value | `{ "type" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/v3-ObservationValue", "code" : "PSEUDED" }] } }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. Patient.identifier:PseudonymisierterIdentifier.use
Definition | The purpose of this identifier.
Short | usual | official | temp | secondary | old (If known)
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Control | 0..1
Binding | The codes SHALL be taken from IdentifierUse http://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 .
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. Patient.identifier:PseudonymisierterIdentifier.type
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Short | Description of identifier
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.
Control | 10..1
Binding | Unless not suitable, these codes SHALL be taken from Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type|4.0.1 (extensible to `http://hl7.org/fhir/ValueSet/identifier-type|4.0.1` ) A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows users to make use of identifiers when the identifier system is not known.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. Patient.identifier:PseudonymisierterIdentifier.type.coding
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 10..*
Type | Coding
Is Modifier | false
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Patient.identifier.type.coding`. The slices areUnordered and Open, and can be differentiated using the following discriminators: pattern @ $this
22. Patient.identifier:PseudonymisierterIdentifier.type.coding:pseuded
Slice Name | pseuded
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 10..1*
Type | Coding
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Pattern Value | `{ "system" : "http://terminology.hl7.org/CodeSystem/v3-ObservationValue", "code" : "PSEUDED" }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. Patient.identifier:PseudonymisierterIdentifier.type.coding:mr
Slice Name | mr
Definition | Wenn dieses Pseudonym einen pseudonymisierten organisationsinternen Patienten-Identifier (Medical Record Number) ersetzt, SOLL dieser Code zusätzlich gesetzt werden, um die funktionale Rolle des Identifiers unabhängig vom Standort-spezifischen system auffindbar zu machen. A reference to a code defined by a terminology system.
Short | Medical Record NumberCode defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 0..1*
Type | Coding
Is Modifier | false
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Pattern Value | `{ "system" : "http://terminology.hl7.org/CodeSystem/v2-0203", "code" : "MR" }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. Patient.identifier:AnonymisierterIdentifier
Slice Name | AnonymisierterIdentifier
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.
Short | Anonymisierter IdentifikatorAn identifier for this patient
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Is Modifier | false
Must Support | true
Summary | true
Requirements | Patients are almost always assigned specific numerical identifiers.
Pattern Value | `{ "type" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/v3-ObservationValue", "code" : "ANONYED" }] } }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. Patient.identifier:MaskierterVersichertenIdentifer
Slice Name | MaskierterVersichertenIdentifer
Definition | Identifier der Krankenversichertennummer, bei dem der Wert maskiert wurde. An identifier for this patient.
Short | Maskierter Identifier der Krankenversicherten-IDAn identifier for this patient
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1*
Type | Identifier(Identifier-Profil für die 10-stellige Krankenversichertennummer)
Is Modifier | false
Must Support | true
Summary | true
Requirements | Patients are almost always assigned specific numerical identifiers.
Pattern Value | `{ "type" : { "coding" : [{ "system" : "http://fhir.de/CodeSystem/identifier-type-de-basis", "code" : "KVZ10" }] } }`
Invariants | ele-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()`)
30. Patient.identifier:MaskierterVersichertenIdentifer.use
Definition | The purpose of this identifier.
Short | usual | official | temp | secondary | old (If known)
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Control | 0..1
Binding | The codes SHALL be taken from IdentifierUse http://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 .
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. 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.
Short | Description 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.
Control | 10..1
Binding | Unless not suitable, these codes SHALL be taken from Identifier Type DeBasis ValueSet http://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.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
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" }] }`
Invariants | ele-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()`)
34. Patient.identifier:MaskierterVersichertenIdentifer.system
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Short | The namespace for the identifier value
Comments | Identifier.system is always case sensitive.
Control | 10..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
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 Value | `http://fhir.de/sid/gkv/kvid-10`
Example | General: http://www.acme.com/identifiers/patient
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. 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.
Short | The 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.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Example | General: 123456
Invariants | ele-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}$')`)
38. 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.
Short | ExtensionAdditional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This 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
40. Patient.identifier:MaskierterVersichertenIdentifer.value.extension:data-absent-reason
Slice Name | data-absent-reason
Definition | Provides a reason why the expected value or elements in the element that is extended are missing.
Short | unknown | asked | temp | notasked | masked | unsupported | astext | error
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Data Absent Reason) (Extension Type: code)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
42. 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.
Short | ExtensionAdditional 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.
Control | 0..0*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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())
Slicing | This 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
44. Patient.identifier:MaskierterVersichertenIdentifer.value.extension:data-absent-reason.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/StructureDefinition/data-absent-reason`
46. 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).
Short | Value of extension
Control | 10..1
Binding | The codes SHALL be taken from For codes, see DataAbsentReason (required to `http://hl7.org/fhir/ValueSet/data-absent-reason` )
Type | code, 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] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Pattern Value | `masked`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
48. Patient.identifier:MaskierterVersichertenIdentifer.assigner
Definition | Organization that issued/manages the identifier.
Short | Organization 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.
Control | 10..1
Type | Reference(Organization, Organization)
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
50. 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.
Short | Logical 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).
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 10..1
Type | Identifier(Identifier-Profil für die Abbildung eines Institutionskennzeichens (IKNR))
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
52. Patient.identifier:MaskierterVersichertenIdentifer.assigner.identifier.use
Definition | The purpose of this identifier.
Short | usual | official | temp | secondary | old (If known)
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Control | 0..1
Binding | The codes SHALL be taken from IdentifierUse http://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 .
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
54. 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.
Short | Description 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.
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from Identifier Type DeBasis ValueSet http://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.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
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" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
56. 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.
Short | The namespace for the identifier value
Comments | Identifier.system is always case sensitive.
Control | 10..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
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 Value | `http://fhir.de/sid/arge-ik/iknr`
Example | General: http://www.acme.com/identifiers/patient
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
58. 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.
Short | The 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.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Example | General: 123456
Invariants | ele-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}$')`)
60. 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.
Short | AktivWhether 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.
Control | 0..1
Type | boolean
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Need to be able to mark a patient record as not to be used because it was created in error.
Meaning if Missing | This resource is generally assumed to be active if no value is provided for the active element
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
62. 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.
Short | Administratives 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.
Control | 0..1
Binding | The codes SHALL be taken from AdministrativeGender http://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.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Needed for identification of the individual, in combination with (at least) name and birth date.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
64. 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.
Short | ExtensionAdditional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This 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
66. Patient.gender.extension:other-amtlich
Slice Name | other-amtlich
Definition | Extension zur genaueren Differenzierung des administrativen Geschlechts
Short | Extension Administratives Geschlecht
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Differenzierung des administrativen Geschlechts 'other') (Extension Type: Coding)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
68. Patient.birthDate
Definition | Das Geburtsdatum der Patientin oder des Patienten The date of birth for the individual.
Short | GeburtsdatumThe 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).
Control | 0..1
Type | date
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Age of the individual drives many clinical processes.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
LOINC Code | 21112-8
70. Patient.deceased[x]
Definition | Indicates if the individual is deceased or not.
Short | Indicates 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.
Control | 0..1
Type | Choice of: boolean, dateTime
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
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.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
72. Patient.address
Definition | Eine Adresse der Patientin oder des Patienten An address for the individual.
Short | AdresseAn address for the individual
Comments | Patient may have multiple addresses with different uses or applicable periods.
Control | 0..*
Type | Address
Is Modifier | false
Must Support | true
Summary | true
Requirements | May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Patient.address`. The slices areUnordered and Open, and can be differentiated using the following discriminators: pattern @ $this
74. Patient.address:Strassenanschrift
Slice Name | Strassenanschrift
Definition | Eine Straßenanschrift der Patientin oder des Patienten An address for the individual.
Short | StraßenanschriftAn address for the individual
Comments | Patient may have multiple addresses with different uses or applicable periods.
Control | 0..*
Type | Address(Adresse, deutsches Basisprofil)
Is Modifier | false
Must Support | true
Summary | true
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" }`
Invariants | ele-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'))`)
76. Patient.address:Strassenanschrift.extension:Stadtteil
Slice Name | Stadtteil
Definition | A subsection of a municipality.
Short | Stadt- 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.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(ADXP Precinct) (Extension Type: string)
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
78. Patient.address:Strassenanschrift.use
Definition | The purpose of this address.
Short | home | 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.
Control | 0..1
Binding | The codes SHALL be taken from AddressUse http://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.
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Allows an appropriate address to be chosen from a list of many.
Example | General: home
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
80. 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.
Short | postal | 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).
Control | 10..1
Binding | The codes SHALL be taken from AddressType http://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).
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Example | General: both
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
82. 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.
Short | Straßenname mit Hausnummer oder Postfach sowie weitere Angaben zur ZustellungStreet name, number, direction & P.O. Box etc.
Control | 0..3*
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Example | General: 137 Nowhere Street Beipiel für Adresszeile mit Extensions für Straße und Hausnummer: Musterweg 42
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
84. Patient.address:Strassenanschrift.line.extension:Strasse
Slice Name | Strasse
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.
Short | Strassenname (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.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(ADXP Street Name) (Extension Type: string)
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
86. Patient.address:Strassenanschrift.line.extension:Hausnummer
Slice Name | Hausnummer
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.
Short | 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.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(ADXP House Number) (Extension Type: string)
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
88. Patient.address:Strassenanschrift.line.extension:Adresszusatz
Slice Name | Adresszusatz
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.
Short | Adresszusatz
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.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(ADXP Additional Locator) (Extension Type: string)
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
90. Patient.address:Strassenanschrift.line.extension:Postfach
Slice Name | Postfach
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.
Short | Postfach
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.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(ADXP Post Box) (Extension Type: string)
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
92. Patient.address:Strassenanschrift.city
Definition | The name of the city, town, suburb, village or other community or delivery center.
Short | Name of city, town etc.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Alternate Names | Municpality
Example | General: Erewhon
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
94. 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.
Short | ExtensionAdditional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This 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
96. Patient.address:Strassenanschrift.city.extension:gemeindeschluessel
Slice Name | gemeindeschluessel
Definition | Optional Extension Element - found in all resources.
Short | Optional Extensions Element
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(ExtensionDestatisAgs) (Extension Type: Coding)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
98. Patient.address:Strassenanschrift.district
Definition | The name of the administrative area (county).
Short | District 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.
Control | 0..01
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Alternate Names | County
Example | General: Madison
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
100. Patient.address:Strassenanschrift.postalCode
Definition | Postleitzahl gemäß der im jeweiligen Land gültigen Konventionen A postal code designating a region defined by the postal service.
Short | PostleitzahlPostal code for area
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Alternate Names | Zip
Example | General: 9132
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
102. 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.
Short | StaatCountry (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.
Control | 10..1
Binding | The codes SHOULD be taken from For codes, see Iso3166-1-2 (preferred to `http://hl7.org/fhir/ValueSet/iso3166-1-2` )
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
104. Patient.link
Definition | Link to another patient resource that concerns the same actual patient.
Short | Link to another patient resource that concerns the same actual person
Comments | There is no assumption that linked patient records have mutual links.
Control | 0..*
Type | BackboneElement
Is Modifier | true 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'
Summary | true
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.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
106. 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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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())
108. Patient.link.other
Definition | The other patient resource that the link refers to.
Short | The 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.
Control | 1..1
Type | Reference(Patient, RelatedPerson)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
110. Patient.link.type
Definition | The type of link between this patient resource and another patient resource.
Short | replaced-by | replaces | refer | seealso
Control | 1..1
Binding | The codes SHALL be taken from LinkType http://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.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-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
Invariants | 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
Must Support | true
4. Patient.meta
Must Support | true
6. Patient.meta.profile
Must Support | true
8. Patient.identifier
Definition | Ein Identifikator für den/die Patient*in
Short | Patienten-Identifikator
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 1..?
Must Support | true
Slicing | This 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 Name | PseudonymisierterIdentifier
Definition | Ein Pseudonym ersetzt einen Originalwert. Die Verarbeitung ist umkehrbar. Zusätzliche Informationen sind erforderlich, um den Originalwert zu rekonstruieren, bspw. eine Trusted Third Party.
Short | Pseudonymisierter Identifikator
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Must Support | true
Pattern Value | `{ "type" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/v3-ObservationValue", "code" : "PSEUDED" }] } }`
12. Patient.identifier:PseudonymisierterIdentifier.type
Control | 1..?
Must Support | true
14. Patient.identifier:PseudonymisierterIdentifier.type.coding
Control | 1..?
Slicing | This element introduces a set of slices on `Patient.identifier.type.coding`. The slices areUnordered and Open, and can be differentiated using the following discriminators: pattern @ $this
16. Patient.identifier:PseudonymisierterIdentifier.type.coding:pseuded
Slice Name | pseuded
Control | 1..1
Must Support | true
Pattern Value | `{ "system" : "http://terminology.hl7.org/CodeSystem/v3-ObservationValue", "code" : "PSEUDED" }`
18. Patient.identifier:PseudonymisierterIdentifier.type.coding:mr
Slice Name | mr
Definition | Wenn dieses Pseudonym einen pseudonymisierten organisationsinternen Patienten-Identifier (Medical Record Number) ersetzt, SOLL dieser Code zusätzlich gesetzt werden, um die funktionale Rolle des Identifiers unabhängig vom Standort-spezifischen system auffindbar zu machen.
Short | Medical Record Number
Control | 0..1
Pattern Value | `{ "system" : "http://terminology.hl7.org/CodeSystem/v2-0203", "code" : "MR" }`
20. Patient.identifier:AnonymisierterIdentifier
Slice Name | AnonymisierterIdentifier
Definition | Ein Anonymisierter Identifikator ersetzt einen Originalwert. Die Verarbeitung ist unumkehrbar. Der Originalwert kann nicht oder nur mit unverhältnismäßigem Aufwand rekonstruiert werden.
Short | Anonymisierter Identifikator
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Must Support | true
Pattern Value | `{ "type" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/v3-ObservationValue", "code" : "ANONYED" }] } }`
22. Patient.identifier:MaskierterVersichertenIdentifer
Slice Name | MaskierterVersichertenIdentifer
Definition | Identifier der Krankenversichertennummer, bei dem der Wert maskiert wurde.
Short | Maskierter Identifier der Krankenversicherten-ID
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1
Type | Identifier(Identifier-Profil für die 10-stellige Krankenversichertennummer)
Must Support | true
Pattern Value | `{ "type" : { "coding" : [{ "system" : "http://fhir.de/CodeSystem/identifier-type-de-basis", "code" : "KVZ10" }] } }`
Invariants | 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()`)
24. Patient.identifier:MaskierterVersichertenIdentifer.type
Control | 1..?
Must Support | true
26. Patient.identifier:MaskierterVersichertenIdentifer.system
Must Support | true
28. Patient.identifier:MaskierterVersichertenIdentifer.value
Must Support | true
30. Patient.identifier:MaskierterVersichertenIdentifer.value.extension
Slicing | This 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
32. Patient.identifier:MaskierterVersichertenIdentifer.value.extension:data-absent-reason
Slice Name | data-absent-reason
Control | 0..1
Type | Extension(Data Absent Reason) (Extension Type: code)
Must Support | true
34. Patient.identifier:MaskierterVersichertenIdentifer.value.extension:data-absent-reason.value[x]
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Pattern Value | `masked`
36. Patient.identifier:MaskierterVersichertenIdentifer.assigner
Control | 1..?
Must Support | true
38. Patient.identifier:MaskierterVersichertenIdentifer.assigner.identifier
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 1..?
Type | Identifier(Identifier-Profil für die Abbildung eines Institutionskennzeichens (IKNR))
Must Support | true
40. Patient.identifier:MaskierterVersichertenIdentifer.assigner.identifier.type
Must Support | true
42. Patient.identifier:MaskierterVersichertenIdentifer.assigner.identifier.system
Must Support | true
44. Patient.identifier:MaskierterVersichertenIdentifer.assigner.identifier.value
Must Support | true
46. Patient.active
Definition | Gibt an, ob diese Patient-Ressource aktiv verwendet wird.
Short | Aktiv
Must Support | true
48. Patient.gender
Definition | männlich | weiblich | andere | unbekannt | unbestimmt | divers
Short | Administratives Geschlecht
Must Support | true
50. Patient.gender.extension
Slicing | This 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
52. Patient.gender.extension:other-amtlich
Slice Name | other-amtlich
Definition | Extension zur genaueren Differenzierung des administrativen Geschlechts
Short | Extension Administratives Geschlecht
Control | 0..1
Type | Extension(Differenzierung des administrativen Geschlechts 'other') (Extension Type: Coding)
Must Support | true
54. Patient.birthDate
Definition | Das Geburtsdatum der Patientin oder des Patienten
Short | Geburtsdatum
Must Support | true
LOINC Code |
56. Patient.address
Definition | Eine Adresse der Patientin oder des Patienten
Short | Adresse
Must Support | true
Slicing | This element introduces a set of slices on `Patient.address`. The slices areUnordered and Open, and can be differentiated using the following discriminators: pattern @ $this
58. Patient.address:Strassenanschrift
Slice Name | Strassenanschrift
Definition | Eine Straßenanschrift der Patientin oder des Patienten
Short | Straßenanschrift
Control | 0..*
Type | Address(Adresse, deutsches Basisprofil)
Must Support | true
Pattern Value | `{ "type" : "both" }`
Invariants | 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'))`)
60. Patient.address:Strassenanschrift.type
Control | 1..?
Must Support | true
62. Patient.address:Strassenanschrift.city
64. Patient.address:Strassenanschrift.city.extension
Slicing | This 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
66. Patient.address:Strassenanschrift.city.extension:gemeindeschluessel
Slice Name | gemeindeschluessel
Control | 0..1
Type | Extension(ExtensionDestatisAgs) (Extension Type: Coding)
Must Support | true
68. Patient.address:Strassenanschrift.postalCode
Control | 1..?
Must Support | true
70. Patient.address:Strassenanschrift.country
Control | 1..?
Must Support | true

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.
Short | Information about an individual or animal receiving health care services
Control | 0..*
Is Modifier | false
Summary | false
Alternate Names | SubjectOfCare Client Resident
Invariants | dom-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.
Short | Logical 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.
Control | 0..1
Type | id
Is Modifier | false
Must Support | true
Summary | true
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.
Short | Metadata about the resource
Control | 0..1
Type | Meta
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-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.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`)
Slicing | This 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.
Short | Version 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.
Control | 0..1
Type | id
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-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.
Short | When 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.
Control | 0..1
Type | instant
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-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.
Short | Identifies 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.
Control | 0..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-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.
Short | Profiles 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.
Control | 0..*
Type | canonical(StructureDefinition)
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-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.
Short | Security 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.
Control | 0..*
Binding | Unless 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.
Type | Coding
Is Modifier | false
Summary | true
Invariants | ele-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.
Short | Tags 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.
Control | 0..*
Binding | For 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".
Type | Coding
Is Modifier | false
Summary | true
Invariants | ele-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.
Short | A 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.
Control | 0..1
Type | uri
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-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.
Short | Language 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).
Control | 0..1
Binding | The codes SHOULD be taken from CommonLanguages (preferred to `http://hl7.org/fhir/ValueSet/languages|4.0.1` ) A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-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.
Short | Text 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.
Control | 0..1
Type | Narrative
Is Modifier | false
Summary | false
Alternate Names | narrative, html, xhtml, display
Invariants | ele-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.
Short | Contained, 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.
Control | 0..*
Type | Resource
Is Modifier | false
Summary | false
Alternate Names | inline 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
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 Names | extensions, user content
Invariants | 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()`)
34. Patient.identifier
Definition | Ein Identifikator für den/die Patient*in
Short | Patienten-Identifikator
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 1..*
Type | Identifier
Is Modifier | false
Must Support | true
Summary | true
Requirements | Patients are almost always assigned specific numerical identifiers.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This 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 Name | PseudonymisierterIdentifier
Definition | Ein Pseudonym ersetzt einen Originalwert. Die Verarbeitung ist umkehrbar. Zusätzliche Informationen sind erforderlich, um den Originalwert zu rekonstruieren, bspw. eine Trusted Third Party.
Short | Pseudonymisierter Identifikator
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Is Modifier | false
Must Support | true
Summary | true
Requirements | Patients are almost always assigned specific numerical identifiers.
Pattern Value | `{ "type" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/v3-ObservationValue", "code" : "PSEUDED" }] } }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
38. Patient.identifier:PseudonymisierterIdentifier.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
40. Patient.identifier:PseudonymisierterIdentifier.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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`)
Slicing | This 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
42. Patient.identifier:PseudonymisierterIdentifier.use
Definition | The purpose of this identifier.
Short | usual | official | temp | secondary | old (If known)
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Control | 0..1
Binding | The 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 .
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
44. Patient.identifier:PseudonymisierterIdentifier.type
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Short | Description of identifier
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.
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from Identifier Type Codes (extensible to `http://hl7.org/fhir/ValueSet/identifier-type|4.0.1` ) A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows users to make use of identifiers when the identifier system is not known.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
46. Patient.identifier:PseudonymisierterIdentifier.type.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
48. Patient.identifier:PseudonymisierterIdentifier.type.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`)
Slicing | This element introduces a set of slices on `Patient.identifier.type.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
50. Patient.identifier:PseudonymisierterIdentifier.type.coding
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 1..*
Type | Coding
Is Modifier | false
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Patient.identifier.type.coding`. The slices areUnordered and Open, and can be differentiated using the following discriminators: pattern @ $this
52. Patient.identifier:PseudonymisierterIdentifier.type.coding:pseuded
Slice Name | pseuded
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 1..1
Type | Coding
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Pattern Value | `{ "system" : "http://terminology.hl7.org/CodeSystem/v3-ObservationValue", "code" : "PSEUDED" }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
54. Patient.identifier:PseudonymisierterIdentifier.type.coding:mr
Slice Name | mr
Definition | Wenn dieses Pseudonym einen pseudonymisierten organisationsinternen Patienten-Identifier (Medical Record Number) ersetzt, SOLL dieser Code zusätzlich gesetzt werden, um die funktionale Rolle des Identifiers unabhängig vom Standort-spezifischen system auffindbar zu machen.
Short | Medical Record Number
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 0..1
Type | Coding
Is Modifier | false
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Pattern Value | `{ "system" : "http://terminology.hl7.org/CodeSystem/v2-0203", "code" : "MR" }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
56. Patient.identifier:PseudonymisierterIdentifier.type.text
Definition | A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Short | Plain text representation of the concept
Comments | Very often the text is the same as a displayName of one of the codings.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
58. Patient.identifier:PseudonymisierterIdentifier.system
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Short | The namespace for the identifier value
Comments | Identifier.system is always case sensitive.
Control | 0..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
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.
Example | General: http://www.acme.com/identifiers/patient
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
60. Patient.identifier:PseudonymisierterIdentifier.value
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Short | The value that is unique
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.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Example | General: 123456
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
62. Patient.identifier:PseudonymisierterIdentifier.period
Definition | Time period during which identifier is/was valid for use.
Short | Time period when id is/was valid for use
Control | 0..1
Type | Period
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
64. Patient.identifier:PseudonymisierterIdentifier.assigner
Definition | Organization that issued/manages the identifier.
Short | Organization 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.
Control | 0..1
Type | Reference(Organization)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
66. Patient.identifier:AnonymisierterIdentifier
Slice Name | AnonymisierterIdentifier
Definition | Ein Anonymisierter Identifikator ersetzt einen Originalwert. Die Verarbeitung ist unumkehrbar. Der Originalwert kann nicht oder nur mit unverhältnismäßigem Aufwand rekonstruiert werden.
Short | Anonymisierter Identifikator
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Is Modifier | false
Must Support | true
Summary | true
Requirements | Patients are almost always assigned specific numerical identifiers.
Pattern Value | `{ "type" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/v3-ObservationValue", "code" : "ANONYED" }] } }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
68. Patient.identifier:MaskierterVersichertenIdentifer
Slice Name | MaskierterVersichertenIdentifer
Definition | Identifier der Krankenversichertennummer, bei dem der Wert maskiert wurde.
Short | Maskierter Identifier der Krankenversicherten-ID
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1
Type | Identifier(Identifier-Profil für die 10-stellige Krankenversichertennummer)
Is Modifier | false
Must Support | true
Summary | true
Requirements | Patients are almost always assigned specific numerical identifiers.
Pattern Value | `{ "type" : { "coding" : [{ "system" : "http://fhir.de/CodeSystem/identifier-type-de-basis", "code" : "KVZ10" }] } }`
Invariants | ele-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()`)
70. 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.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
72. 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`)
Slicing | This 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
74. Patient.identifier:MaskierterVersichertenIdentifer.use
Definition | The purpose of this identifier.
Short | usual | official | temp | secondary | old (If known)
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Control | 0..1
Binding | The 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 .
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
76. 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.
Short | Description 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.
Control | 1..1
Binding | Unless 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.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
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" }] }`
Invariants | ele-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()`)
78. Patient.identifier:MaskierterVersichertenIdentifer.system
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Short | The namespace for the identifier value
Comments | Identifier.system is always case sensitive.
Control | 1..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
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 Value | `http://fhir.de/sid/gkv/kvid-10`
Example | General: http://www.acme.com/identifiers/patient
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
80. 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.
Short | The 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.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Example | General: 123456
Invariants | ele-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}$')`)
82. Patient.identifier:MaskierterVersichertenIdentifer.value.id
Definition | unique id for the element within a resource (for internal references)
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
84. Patient.identifier:MaskierterVersichertenIdentifer.value.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This 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
86. Patient.identifier:MaskierterVersichertenIdentifer.value.extension:data-absent-reason
Slice Name | data-absent-reason
Definition | Provides a reason why the expected value or elements in the element that is extended are missing.
Short | unknown | asked | temp | notasked | masked | unsupported | astext | error
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Data Absent Reason) (Extension Type: code)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`)
88. 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.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
90. Patient.identifier:MaskierterVersichertenIdentifer.value.extension:data-absent-reason.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This 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
92. Patient.identifier:MaskierterVersichertenIdentifer.value.extension:data-absent-reason.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/StructureDefinition/data-absent-reason`
94. 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).
Short | Value of extension
Control | 1..1
Binding | The codes SHALL be taken from DataAbsentReason (required to `http://hl7.org/fhir/ValueSet/data-absent-reason` )
Type | code
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Pattern Value | `masked`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
96. Patient.identifier:MaskierterVersichertenIdentifer.value.value
Definition | The actual value
Short | Primitive value for string
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Max Length: | 1048576
98. Patient.identifier:MaskierterVersichertenIdentifer.period
Definition | Time period during which identifier is/was valid for use.
Short | Time period when id is/was valid for use
Control | 0..1
Type | Period
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
100. Patient.identifier:MaskierterVersichertenIdentifer.assigner
Definition | Organization that issued/manages the identifier.
Short | Organization 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.
Control | 1..1
Type | Reference(Organization)
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
102. 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.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
104. 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`)
Slicing | This 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
106. 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.
Short | Literal 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.
Control | 0..1 This element is affected by the following invariants: ref-1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
108. 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).
Short | Type 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.
Control | 0..1
Binding | Unless 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).
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
110. 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.
Short | Logical 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).
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 1..1
Type | Identifier(Identifier-Profil für die Abbildung eines Institutionskennzeichens (IKNR))
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
112. 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.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
114. 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`)
Slicing | This 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
116. Patient.identifier:MaskierterVersichertenIdentifer.assigner.identifier.use
Definition | The purpose of this identifier.
Short | usual | official | temp | secondary | old (If known)
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Control | 0..1
Binding | The 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 .
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
118. 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.
Short | Description 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.
Control | 0..1
Binding | Unless 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.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
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" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
120. 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.
Short | The namespace for the identifier value
Comments | Identifier.system is always case sensitive.
Control | 1..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
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 Value | `http://fhir.de/sid/arge-ik/iknr`
Example | General: http://www.acme.com/identifiers/patient
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
122. 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.
Short | The 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.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Example | General: 123456
Invariants | ele-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}$')`)
124. Patient.identifier:MaskierterVersichertenIdentifer.assigner.identifier.period
Definition | Time period during which identifier is/was valid for use.
Short | Time period when id is/was valid for use
Control | 0..1
Type | Period
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
126. Patient.identifier:MaskierterVersichertenIdentifer.assigner.identifier.assigner
Definition | Organization that issued/manages the identifier.
Short | Organization 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.
Control | 0..1
Type | Reference(Organization)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
128. Patient.identifier:MaskierterVersichertenIdentifer.assigner.display
Definition | Plain text narrative that identifies the resource in addition to the resource reference.
Short | Text 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.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
130. Patient.active
Definition | Gibt an, ob diese Patient-Ressource aktiv verwendet wird.
Short | Aktiv
Comments | If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient.
Control | 0..1
Type | boolean
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Need to be able to mark a patient record as not to be used because it was created in error.
Meaning if Missing | This resource is generally assumed to be active if no value is provided for the active element
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
132. Patient.name
Definition | A name associated with the individual.
Short | A 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.
Control | 0..*
Type | HumanName
Is Modifier | false
Summary | true
Requirements | Need to be able to track the patient by multiple names. Examples are your official name and a partner name.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
134. Patient.telecom
Definition | A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted.
Short | A contact detail for the individual
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).
Control | 0..*
Type | ContactPoint
Is Modifier | false
Summary | true
Requirements | People have (primary) ways to contact them in some way such as phone, email.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
136. Patient.gender
Definition | männlich | weiblich | andere | unbekannt | unbestimmt | divers
Short | Administratives 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.
Control | 0..1
Binding | The 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.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Needed for identification of the individual, in combination with (at least) name and birth date.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
138. Patient.gender.id
Definition | unique id for the element within a resource (for internal references)
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
140. Patient.gender.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This 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
142. Patient.gender.extension:other-amtlich
Slice Name | other-amtlich
Definition | Extension zur genaueren Differenzierung des administrativen Geschlechts
Short | Extension Administratives Geschlecht
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Differenzierung des administrativen Geschlechts 'other') (Extension Type: Coding)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`)
144. Patient.gender.value
Definition | Primitive value for code
Short | Primitive value for code
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
146. Patient.birthDate
Definition | Das Geburtsdatum der Patientin oder des Patienten
Short | Geburtsdatum
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).
Control | 0..1
Type | date
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Age of the individual drives many clinical processes.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
LOINC Code | 21112-8
148. Patient.deceased[x]
Definition | Indicates if the individual is deceased or not.
Short | Indicates 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.
Control | 0..1
Type | Choice of: boolean, dateTime
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
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.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
150. Patient.address
Definition | Eine Adresse der Patientin oder des Patienten
Short | Adresse
Comments | Patient may have multiple addresses with different uses or applicable periods.
Control | 0..*
Type | Address
Is Modifier | false
Must Support | true
Summary | true
Requirements | May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Patient.address`. The slices areUnordered and Open, and can be differentiated using the following discriminators: pattern @ $this
152. Patient.address:Strassenanschrift
Slice Name | Strassenanschrift
Definition | Eine Straßenanschrift der Patientin oder des Patienten
Short | Straßenanschrift
Comments | Patient may have multiple addresses with different uses or applicable periods.
Control | 0..*
Type | Address(Adresse, deutsches Basisprofil)
Is Modifier | false
Must Support | true
Summary | true
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" }`
Invariants | ele-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'))`)
154. 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.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
156. 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`)
Slicing | This 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
158. Patient.address:Strassenanschrift.extension:Stadtteil
Slice Name | Stadtteil
Definition | A subsection of a municipality.
Short | Stadt- 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.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(ADXP Precinct) (Extension Type: string)
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`)
160. Patient.address:Strassenanschrift.use
Definition | The purpose of this address.
Short | home | 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.
Control | 0..1
Binding | The codes SHALL be taken from AddressUse (required to `http://hl7.org/fhir/ValueSet/address-use|4.0.1` ) The use of an address.
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Allows an appropriate address to be chosen from a list of many.
Example | General: home
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
162. 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.
Short | postal | 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).
Control | 1..1
Binding | The 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).
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Example | General: both
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
164. 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.
Short | Text 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.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | A renderable, unencoded form.
Example | General: 137 Nowhere Street, Erewhon 9132
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
166. 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.
Short | Straßenname mit Hausnummer oder Postfach sowie weitere Angaben zur Zustellung
Control | 0..3
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Example | General: 137 Nowhere Street Beipiel für Adresszeile mit Extensions für Straße und Hausnummer: Musterweg 42
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
168. Patient.address:Strassenanschrift.line.id
Definition | unique id for the element within a resource (for internal references)
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
170. 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`)
Slicing | This 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
172. Patient.address:Strassenanschrift.line.extension:Strasse
Slice Name | Strasse
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.
Short | Strassenname (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.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(ADXP Street Name) (Extension Type: string)
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`)
174. Patient.address:Strassenanschrift.line.extension:Hausnummer
Slice Name | Hausnummer
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.
Short | 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.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(ADXP House Number) (Extension Type: string)
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`)
176. Patient.address:Strassenanschrift.line.extension:Adresszusatz
Slice Name | Adresszusatz
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.
Short | Adresszusatz
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.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(ADXP Additional Locator) (Extension Type: string)
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`)
178. Patient.address:Strassenanschrift.line.extension:Postfach
Slice Name | Postfach
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.
Short | Postfach
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.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(ADXP Post Box) (Extension Type: string)
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`)
180. Patient.address:Strassenanschrift.line.value
Definition | The actual value
Short | Primitive value for string
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Max Length: | 1048576
182. Patient.address:Strassenanschrift.city
Definition | The name of the city, town, suburb, village or other community or delivery center.
Short | Name of city, town etc.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Alternate Names | Municpality
Example | General: Erewhon
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
184. Patient.address:Strassenanschrift.city.id
Definition | unique id for the element within a resource (for internal references)
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
186. Patient.address:Strassenanschrift.city.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This 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
188. Patient.address:Strassenanschrift.city.extension:gemeindeschluessel
Slice Name | gemeindeschluessel
Definition | Optional Extension Element - found in all resources.
Short | Optional Extensions Element
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(ExtensionDestatisAgs) (Extension Type: Coding)
Is Modifier | false
Must Support | true
Summary | false
Invariants | 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()`)
190. Patient.address:Strassenanschrift.city.value
Definition | The actual value
Short | Primitive value for string
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Max Length: | 1048576
192. Patient.address:Strassenanschrift.district
Definition | The name of the administrative area (county).
Short | District 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.
Control | 0..0
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Alternate Names | County
Example | General: Madison
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
194. Patient.address:Strassenanschrift.state
Definition | Name (oder Kürzel) des Bundeslandes.
Short | Bundesland
Control | 0..1
Binding | The codes SHOULD be taken from ISO-3166-2:de-Laendercodes (preferred to `http://fhir.de/ValueSet/iso/bundeslaender` )
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Alternate Names | Province, Territory
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
196. Patient.address:Strassenanschrift.postalCode
Definition | Postleitzahl gemäß der im jeweiligen Land gültigen Konventionen
Short | Postleitzahl
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Alternate Names | Zip
Example | General: 9132
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
198. Patient.address:Strassenanschrift.country
Definition | Staat (vorzugsweise als 2-Stelliger ISO-Ländercode). Es obliegt abgeleiteten Profilen, hier die Verwendung der ISO-Ländercodes verbindlich vorzuschreiben
Short | Staat
Comments | ISO 3166 3 letter codes can be used in place of a human readable country name.
Control | 1..1
Binding | The codes SHOULD be taken from Iso3166-1-2 (preferred to `http://hl7.org/fhir/ValueSet/iso3166-1-2` )
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
200. Patient.address:Strassenanschrift.period
Definition | Time period when address was/is in use.
Short | Time period when address was/is in use
Control | 0..1
Type | Period
Is Modifier | false
Summary | true
Requirements | Allows addresses to be placed in historical context.
Example | General: { "start" : "2010-03-23", "end" : "2010-07-01" }
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
202. Patient.maritalStatus
Definition | This field contains a patient's most recent marital (civil) status.
Short | Marital (civil) status of a patient
Control | 0..1
Binding | Unless 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.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Most, if not all systems capture it.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
204. Patient.multipleBirth[x]
Definition | Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer).
Short | Whether 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).
Control | 0..1
Type | Choice of: boolean, integer
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
206. Patient.photo
Definition | Image of the patient.
Short | Image of the patient
Comments | Guidelines: Use id photos, not clinical photos. Limit dimensions to thumbnail. Keep byte count low to ease resource updates.
Control | 0..*
Type | Attachment
Is Modifier | false
Summary | false
Requirements | Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
208. Patient.contact
Definition | A contact party (e.g. guardian, partner, friend) for the patient.
Short | A 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.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | Need to track people you can contact about the patient.
Invariants | ele-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()`)
210. 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.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
212. 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`)
214. 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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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()`)
216. Patient.contact.relationship
Definition | The nature of the relationship between the patient and the contact person.
Short | The kind of relationship
Control | 0..*
Binding | Unless 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.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Used to determine which contact person is the most relevant to approach, depending on circumstances.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
218. Patient.contact.name
Definition | A name associated with the contact person.
Short | A name associated with the contact person
Control | 0..1
Type | HumanName
Is Modifier | false
Summary | false
Requirements | Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
220. Patient.contact.telecom
Definition | A contact detail for the person, e.g. a telephone number or an email address.
Short | A 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.
Control | 0..*
Type | ContactPoint
Is Modifier | false
Summary | false
Requirements | People have (primary) ways to contact them in some way such as phone, email.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
222. Patient.contact.address
Definition | Address for the contact person.
Short | Address for the contact person
Control | 0..1
Type | Address
Is Modifier | false
Summary | false
Requirements | Need to keep track where the contact person can be contacted per postal mail or visited.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
224. Patient.contact.gender
Definition | Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes.
Short | male | female | other | unknown
Control | 0..1
Binding | The 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.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Needed to address the person correctly.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
226. Patient.contact.organization
Definition | Organization on behalf of which the contact is acting or for which the contact is working.
Short | Organization that is associated with the contact
Control | 0..1 This element is affected by the following invariants: pat-1
Type | Reference(Organization)
Is Modifier | false
Summary | false
Requirements | For guardians or business related contacts, the organization is relevant.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
228. Patient.contact.period
Definition | The period during which this contact person or organization is valid to be contacted relating to this patient.
Short | The period during which this contact person or organization is valid to be contacted relating to this patient
Control | 0..1
Type | Period
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
230. Patient.communication
Definition | A language which may be used to communicate with the patient about his or her health.
Short | A 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.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
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.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
232. 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.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
234. 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`)
236. 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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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()`)
238. 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.
Short | The 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.
Control | 1..1
Binding | The codes SHOULD be taken from CommonLanguages (preferred to `http://hl7.org/fhir/ValueSet/languages|4.0.1` ) A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
240. Patient.communication.preferred
Definition | Indicates whether or not the patient prefers this language (over other languages he masters up a certain level).
Short | Language preference indicator
Comments | This language is specifically identified for communicating healthcare information.
Control | 0..1
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
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.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
242. Patient.generalPractitioner
Definition | Patient's nominated care provider.
Short | Patient'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.
Control | 0..*
Type | Reference(Organization, Practitioner, PractitionerRole)
Is Modifier | false
Summary | false
Alternate Names | careProvider
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
244. Patient.managingOrganization
Definition | Organization that is the custodian of the patient record.
Short | Organization 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).
Control | 0..1
Type | Reference(Organization)
Is Modifier | false
Summary | true
Requirements | Need to know who recognizes this patient record, manages and updates it.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
246. Patient.link
Definition | Link to another patient resource that concerns the same actual patient.
Short | Link to another patient resource that concerns the same actual person
Comments | There is no assumption that linked patient records have mutual links.
Control | 0..*
Type | BackboneElement
Is Modifier | true 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'
Summary | true
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.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
248. 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.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
250. 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`)
252. 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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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()`)
254. Patient.link.other
Definition | The other patient resource that the link refers to.
Short | The 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.
Control | 1..1
Type | Reference(Patient, RelatedPerson)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
256. Patient.link.type
Definition | The type of link between this patient resource and another patient resource.
Short | replaced-by | replaces | refer | seealso
Control | 1..1
Binding | The 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.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)