Medtech ALEX® Implementation Guide
0.0.1 - draft International flag

Medtech ALEX® Implementation Guide - Local Development build (v0.0.1) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: AlexPatient - Detailed Descriptions

Active as of 2025-01-20

Definitions for the alex-patient resource profile.

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

0. Patient
Definition

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


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

ShortA patient in an Australian healthcare contextInformation about an individual or animal receiving health care services
Control0..*
Is Modifierfalse
Summaryfalse
Alternate NamesSubjectOfCare Client Resident
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
inv-pat-0: If present, birth time's date shall be the birth date (birthDate.extension('http://hl7.org/fhir/StructureDefinition/patient-birthTime').exists() implies birthDate.extension('http://hl7.org/fhir/StructureDefinition/patient-birthTime').value.toString().substring(0,10) = birthDate.toString())
2. Patient.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

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

An Extension


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.

ShortExtensionAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

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

    ShortPlace of Birth for patient
    Control0..0
    This element is affected by the following invariants: ele-1
    TypeExtension(Patient Birth Place) (Extension Type: Address)
    Is Modifierfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    8. Patient.extension:indigenousStatus
    Slice NameindigenousStatus
    Definition

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

    ShortIndigenous status
    Comments

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

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

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

    ShortClosing the Gap co-payment eligibility indicator
    Comments

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

    Control0..0
    This element is affected by the following invariants: ele-1
    TypeExtension(Closing the Gap Registration) (Extension Type: boolean)
    Is Modifierfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    12. Patient.extension:mothersMaidenName
    Slice NamemothersMaidenName
    Definition

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

    ShortMother's Maiden name
    Control0..0
    This element is affected by the following invariants: ele-1
    TypeExtension(Patient Mother's Maiden Name) (Extension Type: string)
    Is Modifierfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    14. Patient.extension:interpreterRequired
    Slice NameinterpreterRequired
    Definition

    This Patient requires an interpreter to communicate healthcare information to the practitioner.

    ShortWhether the patient needs an interpreter
    Comments

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

    Control0..0
    This element is affected by the following invariants: ele-1
    TypeExtension(Patient Interpreter Required) (Extension Type: boolean)
    Is Modifierfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    16. Patient.extension:dateOfArrival
    Slice NamedateOfArrival
    Definition

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

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

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

    Control0..0
    This element is affected by the following invariants: ele-1
    TypeExtension(Date of Arrival in Australia) (Extension Type: date)
    Is Modifierfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    18. Patient.extension:genderIdentity
    Slice NamegenderIdentity
    Definition

    The gender the patient identifies with. The Patient's gender identity is used as guidance (e.g. for staff) about how to interact with the patient.

    ShortThe patient's gender identity
    Control0..0
    This element is affected by the following invariants: ele-1
    TypeExtension(genderIdentity) (Extension Type: CodeableConcept)
    Is Modifierfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    24. Patient.extension:sexAtBirth
    Slice NamesexAtBirth
    Definition

    Patient Resource - Patient Sex at Birth

    ShortExtension
    Control1..1
    TypeExtension(Sex at Birth extension) (Extension Type: CodeableConcept)
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    26. Patient.extension:patientRegistrationStatus
    Slice NamepatientRegistrationStatus
    Definition

    Patient Resource - Registration Status (Patient Register Screen)

    ShortExtension
    Control0..1
    TypeExtension(Patient Registration status extension) (Extension Type: CodeableConcept)
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    28. Patient.extension:patientLocation
    Slice NamepatientLocation
    Definition

    Patient Resource - Patient Location by Reference

    ShortExtension
    Control0..1
    TypeExtension(Patient Location extension) (Extension Type: Reference)
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    30. Patient.extension:patientEthnicity
    Slice NamepatientEthnicity
    Definition

    Patient Resource - Ethnicity

    ShortExtension
    Control0..1
    TypeExtension(Patient ethnicity extension) (Extension Type: CodeableConcept)
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    32. Patient.extension:isAccountHolder
    Slice NameisAccountHolder
    Definition

    Patient Resource - Patient Account Holder status (Patient Register Screen)

    ShortExtension
    Control0..1
    TypeExtension(Account Holder extension) (Extension Type: boolean)
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    34. Patient.extension:accountGroup
    Slice NameaccountGroup
    Definition

    Patient Resource - Patient Account Group

    ShortExtension
    Control0..1
    TypeExtension(Patient Account Group extension) (Extension Type: CodeableConcept)
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    36. Patient.extension:accountHeldBy
    Slice NameaccountHeldBy
    Definition

    Patient Resource - Patient Account Held By Reference (Patient Register Screen)

    ShortExtension
    Control0..1
    TypeExtension(Account Held By extension) (Extension Type: Reference)
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    38. Patient.modifierExtension
    Definition

    May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

    ShortExtensions that cannot be ignored
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

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

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

    An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.


    An identifier for this patient.

    ShortIdentifies this patient across multiple systemsAn identifier for this patient
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..*
    This element is affected by the following invariants: ele-1, au-core-pat-01
    TypeIdentifier(AU IHI, AU Medicare Card Number, AU DVA Number, AU Health Care Card Number, AU Pensioner Concession Card Number, AU Commonwealth Seniors Health Card Number)
    Is Modifierfalse
    Must Supporttrue
    Must Support TypesNo must-support rules about the choice of types/profiles
    Requirements

    Patients are almost always assigned specific numerical identifiers.

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

      An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.


      An identifier for this patient.

      ShortIdentifies this patient across multiple systemsAn identifier for this patient
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..*
      This element is affected by the following invariants: ele-1
      TypeIdentifier(AU IHI)
      Is Modifierfalse
      Must Supporttrue
      Requirements

      Patients are almost always assigned specific numerical identifiers.

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

      An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.


      An identifier for this patient.

      ShortIdentifies this patient across multiple systemsAn identifier for this patient
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..*
      This element is affected by the following invariants: ele-1
      TypeIdentifier(AU Medicare Card Number)
      Is Modifierfalse
      Must Supporttrue
      Requirements

      Patients are almost always assigned specific numerical identifiers.

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

      An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.


      An identifier for this patient.

      ShortIdentifies this patient across multiple systemsAn identifier for this patient
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..*
      This element is affected by the following invariants: ele-1
      TypeIdentifier(AU DVA Number)
      Is Modifierfalse
      Must Supporttrue
      Requirements

      Patients are almost always assigned specific numerical identifiers.

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

      The purpose of this identifier.

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

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

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

      Identifies the purpose for this identifier, if known .

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

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

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

      Entitlement type associated with a DVA issued Veteran Card.


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

      ShortDescription of identifier
      Comments

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

      Control10..1
      BindingThe codes SHALL be taken from Unless not suitable, these codes SHALL be taken from The DVA Entitlement for Patienthttp://hl7.org/fhir/ValueSet/identifier-type
      (required to https://alexapi.medtechglobal.com.au/fhir/ValueSet/patient-dva-entitlement)
      TypeCodeableConcept
      Is Modifierfalse
      Summarytrue
      Requirements

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

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

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

      ShortThe namespace for the identifier value
      Comments

      Identifier.system is always case sensitive.

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

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

      Fixed Valuehttp://ns.electronichealth.net.au/id/dva
      Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      54. Patient.identifier:dva.value
      Definition

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

      ShortDVA numberThe value that is unique
      Comments

      This concept is equivalent to Australian Institute of Health and Welfare data element 339127 Person—government funding identifier, Department of Veterans' Affairs file number AAXXNNNNA.


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

      Control10..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Max Length:9
      Example<br/><b>General</b>:123456 <br/><b>DVA number</b>:NBUR9080
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      56. Patient.identifier:healthcare
      Slice Namehealthcare
      Definition

      An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.


      An identifier for this patient.

      ShortIdentifies this patient across multiple systemsAn identifier for this patient
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..1*
      This element is affected by the following invariants: ele-1
      TypeIdentifier(AU Health Care Card Number)
      Is Modifierfalse
      Must Supporttrue
      Requirements

      Patients are almost always assigned specific numerical identifiers.

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

      An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.


      An identifier for this patient.

      ShortIdentifies this patient across multiple systemsAn identifier for this patient
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..1*
      This element is affected by the following invariants: ele-1
      TypeIdentifier(AU Pensioner Concession Card Number)
      Is Modifierfalse
      Must Supporttrue
      Requirements

      Patients are almost always assigned specific numerical identifiers.

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

      An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.


      An identifier for this patient.

      ShortIdentifies this patient across multiple systemsAn identifier for this patient
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..1*
      This element is affected by the following invariants: ele-1
      TypeIdentifier(AU Commonwealth Seniors Health Card Number)
      Is Modifierfalse
      Must Supporttrue
      Requirements

      Patients are almost always assigned specific numerical identifiers.

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

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

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

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

      ShortWhether this patient's record is in active use
      Comments

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

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

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

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

      A name associated with the individual.

      ShortA name associated with the patient
      Comments

      A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.

      Control10..2*
      TypeHumanName
      Is Modifierfalse
      Summarytrue
      Requirements

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

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

        A name associated with the individual.

        ShortA name associated with the patient
        Comments

        A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.

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

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

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

        Identifies the purpose for this name.

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

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

        Control10..1
        BindingThe codes SHALL be taken from NameUsehttp://hl7.org/fhir/ValueSet/name-use|4.0.1
        (required to http://hl7.org/fhir/ValueSet/name-use|4.0.1)

        The use of a human name.

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

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

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

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

        ShortFamily name (often called 'Surname')
        Comments

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

        Control10..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Alternate Namessurname
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        72. Patient.name:official.given
        Definition

        Given name.

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

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

        Control10..*
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Alternate Namesfirst name, middle name
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        74. Patient.name:preferred
        Slice Namepreferred
        Definition

        A name associated with the individual.

        ShortA name associated with the patient
        Comments

        A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.

        Control0..1*
        TypeHumanName
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

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

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

        Identifies the purpose for this name.

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

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

        Control10..1
        BindingThe codes SHALL be taken from NameUsehttp://hl7.org/fhir/ValueSet/name-use|4.0.1
        (required to http://hl7.org/fhir/ValueSet/name-use|4.0.1)

        The use of a human name.

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

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

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

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

        ShortFamily name (often called 'Surname')
        Comments

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

        Control0..01
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Alternate Namessurname
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        80. Patient.name:preferred.given
        Definition

        Given name.

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

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

        Control10..1*
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Alternate Namesfirst name, middle name
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        82. Patient.telecom
        Definition

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

        ShortA contact detail for the individual
        Comments

        A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).

        Control0..*
        TypeContactPoint
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

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

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

        The date of birth for the individual.

        ShortDate of birth extended for time and accuracy indicatorThe date of birth for the individual
        Comments

        At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternity/infant care systems).

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

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


        Age of the individual drives many clinical processes.

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

        General date accuracy indicator coding.

        ShortDate accuracy indicator
        Comments

        In some circumstances, systems may capture date or dateTime data that has unknown or estimated parts. This coding indicates the accuracy of the day, month and year parts. This concept is equivalent to Australian Institute of Health and Welfare data element 294418 Date—accuracy indicator.

        Control0..0
        This element is affected by the following invariants: ele-1
        TypeExtension(Date Accuracy Indicator) (Extension Type: Coding)
        Is Modifierfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        88. Patient.birthDate.extension:birthTime
        Slice NamebirthTime
        Definition

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

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

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


        Indicates if the individual is deceased or not.

        ShortIndicates if the individual is deceased or not
        Comments

        If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.

        Control0..01
        Is Modifiertrue because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
        Summarytrue
        Requirements

        The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.

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

          Boolean indicator if the individual is deceased or not.


          Indicates if the individual is deceased or not.

          ShortDeceased indicatorIndicates if the individual is deceased or not
          Comments

          If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.

          Control0..01
          Typeboolean, dateTime
          Is Modifiertrue because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.

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

          Individual deceased date-time with optional accuracy indicator.


          Indicates if the individual is deceased or not.

          ShortDeceased date timeIndicates if the individual is deceased or not
          Comments

          If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.

          Control0..01
          TypedateTime, boolean
          Is Modifiertrue because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.

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

          An Australian address expressed using postal conventions (as opposed to GPS or other location definition formats).


          An address for the individual.

          ShortAn address for the individual
          Comments

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


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

          Control0..2*
          This element is affected by the following invariants: ele-1
          TypeAddress(Address)
          Is Modifierfalse
          Must Supporttrue
          Requirements

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

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          inv-add-0: The address shall at least have text or a line (text.exists() or line.exists())
          inv-add-1: If asserting no fixed address, the type shall be 'physical' (extension('http://hl7.org.au/fhir/StructureDefinition/no-fixed-address').exists() implies type='physical')
          inv-add-2: If asserting no fixed address, the address text shall begin with 'NO FIXED ADDRESS' (extension('http://hl7.org.au/fhir/StructureDefinition/no-fixed-address').exists() implies text.startsWith('NO FIXED ADDRESS'))
          99. Patient.maritalStatus
          Definition

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

          ShortMarital (civil) status of a patient
          Control0..01
          BindingUnless not suitable, these codes SHALL be taken from Marital Status Codeshttp://hl7.org/fhir/ValueSet/marital-status
          (extensible to http://hl7.org/fhir/ValueSet/marital-status)

          The domestic partnership status of a person.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Most, if not all systems capture it.

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

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

          ShortWhether patient is part of a multiple birth
          Comments

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

          Control0..01
          TypeChoice of: boolean, integer
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Requirements

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

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

          Image of the patient.

          ShortImage of the patient
          Comments

          Guidelines:

          • Use id photos, not clinical photos.
          • Limit dimensions to thumbnail.
          • Keep byte count low to ease resource updates.
          Control0..0*
          TypeAttachment
          Is Modifierfalse
          Summaryfalse
          Requirements

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

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

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

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

          Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.

          Control0..2*
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Requirements

          Need to track people you can contact about the patient.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          pat-1: SHALL at least contain a contact's details or a reference to an organization (name.exists() or telecom.exists() or address.exists() or organization.exists())
          pat-1: SHALL at least contain a contact's details or a reference to an organization (name.exists() or telecom.exists() or address.exists() or organization.exists())
          107. Patient.contact.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

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

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

          Patient's nominated care provider.

          ShortPatient's nominated primary care provider
          Comments

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

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

          Control0..*
          TypeReference(Organization, Practitioner, PractitionerRole)
          Is Modifierfalse
          Must Supporttrue
          Must Support TypesNo must-support rules about the choice of types/profiles
          Summaryfalse
          Alternate NamescareProvider
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          111. Patient.link
          Definition

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


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

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

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

          Control0..0*
          TypeBackboneElement
          Is Modifiertrue because This element is labeled as a modifier because it might not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'
          Summarytrue
          Requirements

          There are multiple use cases:

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

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

          0. Patient
          2. Patient.extension
          Control1..?
          4. Patient.extension:birthPlace
          Slice NamebirthPlace
          Control0..0
          6. Patient.extension:indigenousStatus
          Slice NameindigenousStatus
          Must Supporttrue
          8. Patient.extension:closingTheGapRegistration
          Slice NameclosingTheGapRegistration
          Control0..0
          10. Patient.extension:mothersMaidenName
          Slice NamemothersMaidenName
          Control0..0
          12. Patient.extension:interpreterRequired
          Slice NameinterpreterRequired
          Control0..0
          14. Patient.extension:dateOfArrival
          Slice NamedateOfArrival
          Control0..0
          16. Patient.extension:genderIdentity
          Slice NamegenderIdentity
          Control0..0
          18. Patient.extension:sexAtBirth
          Slice NamesexAtBirth
          Control1..1
          TypeExtension(Sex at Birth extension) (Extension Type: CodeableConcept)
          Must Supporttrue
          20. Patient.extension:patientRegistrationStatus
          Slice NamepatientRegistrationStatus
          Control0..1
          TypeExtension(Patient Registration status extension) (Extension Type: CodeableConcept)
          Must Supporttrue
          22. Patient.extension:patientLocation
          Slice NamepatientLocation
          Control0..1
          TypeExtension(Patient Location extension) (Extension Type: Reference)
          Must Supporttrue
          24. Patient.extension:patientEthnicity
          Slice NamepatientEthnicity
          Control0..1
          TypeExtension(Patient ethnicity extension) (Extension Type: CodeableConcept)
          Must Supporttrue
          26. Patient.extension:isAccountHolder
          Slice NameisAccountHolder
          Control0..1
          TypeExtension(Account Holder extension) (Extension Type: boolean)
          Must Supporttrue
          28. Patient.extension:accountGroup
          Slice NameaccountGroup
          Control0..1
          TypeExtension(Patient Account Group extension) (Extension Type: CodeableConcept)
          Must Supporttrue
          30. Patient.extension:accountHeldBy
          Slice NameaccountHeldBy
          Control0..1
          TypeExtension(Account Held By extension) (Extension Type: Reference)
          Must Supporttrue
          32. Patient.identifier
          NoteThis is a business identifier, not a resource identifier (see discussion)
          TypeIdentifier(AU IHI, AU Medicare Card Number, AU DVA Number, AU Health Care Card Number, AU Pensioner Concession Card Number, AU Commonwealth Seniors Health Card Number)
          Must Supporttrue
          Must Support TypesNo must-support rules about the choice of types/profiles
          SlicingThis element introduces a set of slices on Patient.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • pattern @ type
          • 34. Patient.identifier:ihi
            Slice Nameihi
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..*
            TypeIdentifier(AU IHI)
            Must Supporttrue
            36. Patient.identifier:medicare
            Slice Namemedicare
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..*
            TypeIdentifier(AU Medicare Card Number)
            Must Supporttrue
            38. Patient.identifier:dva
            Slice Namedva
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..*
            TypeIdentifier(AU DVA Number)
            Must Supporttrue
            40. Patient.identifier:dva.type
            BindingThe codes SHALL be taken from The DVA Entitlement for Patient
            (required to https://alexapi.medtechglobal.com.au/fhir/ValueSet/patient-dva-entitlement)
            42. Patient.identifier:healthcare
            Slice Namehealthcare
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..1
            TypeIdentifier(AU Health Care Card Number)
            Must Supporttrue
            44. Patient.identifier:pen
            Slice Namepen
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..1
            TypeIdentifier(AU Pensioner Concession Card Number)
            Must Supporttrue
            46. Patient.identifier:sen
            Slice Namesen
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..1
            TypeIdentifier(AU Commonwealth Seniors Health Card Number)
            Must Supporttrue
            48. Patient.name
            Control1..2
            SlicingThis element introduces a set of slices on Patient.name. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ use
            • 50. Patient.name:official
              Slice Nameofficial
              Control1..1
              Must Supporttrue
              52. Patient.name:official.use
              Control1..?
              Pattern Valueofficial
              54. Patient.name:official.family
              Control1..?
              Must Supporttrue
              56. Patient.name:official.given
              Control1..?
              Must Supporttrue
              58. Patient.name:preferred
              Slice Namepreferred
              Control0..1
              Must Supporttrue
              60. Patient.name:preferred.use
              Control1..?
              Pattern Valueusual
              62. Patient.name:preferred.family
              Control0..0
              Must Supporttrue
              64. Patient.name:preferred.given
              Control1..1
              Must Supporttrue
              66. Patient.telecom
              Must Supporttrue
              68. Patient.birthDate
              Control1..?
              Must Supporttrue
              LOINC Code
              70. Patient.birthDate.extension:accuracyIndicator
              Slice NameaccuracyIndicator
              Control0..0
              72. Patient.birthDate.extension:birthTime
              Slice NamebirthTime
              Control0..0
              74. Patient.deceased[x]
              Control0..0
              76. Patient.deceased[x]:deceasedBoolean
              Slice NamedeceasedBoolean
              Control0..0
              Typeboolean
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              78. Patient.deceased[x]:deceasedDateTime
              Slice NamedeceasedDateTime
              Control0..0
              TypedateTime
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              80. Patient.address
              Control0..2
              TypeAddress(Address)
              Must Supporttrue
              82. Patient.maritalStatus
              Control0..0
              84. Patient.multipleBirth[x]
              Control0..0
              86. Patient.photo
              Control0..0
              88. Patient.contact
              Control0..2
              Must Supporttrue
              90. Patient.generalPractitioner
              Must Supporttrue
              92. Patient.link
              Control0..0

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

              0. Patient
              Definition

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

              ShortA patient in an Australian healthcare context
              Control0..*
              Is Modifierfalse
              Summaryfalse
              Alternate NamesSubjectOfCare Client Resident
              Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
              dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
              dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
              dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
              dom-6: A resource should have narrative for robust management (text.`div`.exists())
              inv-pat-0: If present, birth time's date shall be the birth date (birthDate.extension('http://hl7.org/fhir/StructureDefinition/patient-birthTime').exists() implies birthDate.extension('http://hl7.org/fhir/StructureDefinition/patient-birthTime').value.toString().substring(0,10) = birthDate.toString())
              2. Patient.id
              Definition

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

              ShortLogical id of this artifact
              Comments

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

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

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

              ShortMetadata about the resource
              Control0..1
              TypeMeta
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              6. Patient.implicitRules
              Definition

              A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

              ShortA set of rules under which this content was created
              Comments

              Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

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

              The base language in which the resource is written.

              ShortLanguage of the resource content
              Comments

              Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

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

              A human language.

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

              A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

              ShortText summary of the resource, for human interpretation
              Comments

              Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

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

              These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

              ShortContained, inline Resources
              Comments

              This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

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

              An Extension

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

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

                ShortPlace of Birth for patient
                Control0..0
                This element is affected by the following invariants: ele-1
                TypeExtension(Patient Birth Place) (Extension Type: Address)
                Is Modifierfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                18. Patient.extension:indigenousStatus
                Slice NameindigenousStatus
                Definition

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

                ShortIndigenous status
                Comments

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

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

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

                ShortClosing the Gap co-payment eligibility indicator
                Comments

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

                Control0..0
                This element is affected by the following invariants: ele-1
                TypeExtension(Closing the Gap Registration) (Extension Type: boolean)
                Is Modifierfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                22. Patient.extension:mothersMaidenName
                Slice NamemothersMaidenName
                Definition

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

                ShortMother's Maiden name
                Control0..0
                This element is affected by the following invariants: ele-1
                TypeExtension(Patient Mother's Maiden Name) (Extension Type: string)
                Is Modifierfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                24. Patient.extension:interpreterRequired
                Slice NameinterpreterRequired
                Definition

                This Patient requires an interpreter to communicate healthcare information to the practitioner.

                ShortWhether the patient needs an interpreter
                Comments

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

                Control0..0
                This element is affected by the following invariants: ele-1
                TypeExtension(Patient Interpreter Required) (Extension Type: boolean)
                Is Modifierfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                26. Patient.extension:dateOfArrival
                Slice NamedateOfArrival
                Definition

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

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

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

                Control0..0
                This element is affected by the following invariants: ele-1
                TypeExtension(Date of Arrival in Australia) (Extension Type: date)
                Is Modifierfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                28. Patient.extension:genderIdentity
                Slice NamegenderIdentity
                Definition

                The gender the patient identifies with. The Patient's gender identity is used as guidance (e.g. for staff) about how to interact with the patient.

                ShortThe patient's gender identity
                Control0..0
                This element is affected by the following invariants: ele-1
                TypeExtension(genderIdentity) (Extension Type: CodeableConcept)
                Is Modifierfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                35. Patient.extension:sexAtBirth
                Slice NamesexAtBirth
                Definition

                Patient Resource - Patient Sex at Birth

                ShortExtension
                Control1..1
                TypeExtension(Sex at Birth extension) (Extension Type: CodeableConcept)
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                37. Patient.extension:patientRegistrationStatus
                Slice NamepatientRegistrationStatus
                Definition

                Patient Resource - Registration Status (Patient Register Screen)

                ShortExtension
                Control0..1
                TypeExtension(Patient Registration status extension) (Extension Type: CodeableConcept)
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                39. Patient.extension:patientLocation
                Slice NamepatientLocation
                Definition

                Patient Resource - Patient Location by Reference

                ShortExtension
                Control0..1
                TypeExtension(Patient Location extension) (Extension Type: Reference)
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                41. Patient.extension:patientEthnicity
                Slice NamepatientEthnicity
                Definition

                Patient Resource - Ethnicity

                ShortExtension
                Control0..1
                TypeExtension(Patient ethnicity extension) (Extension Type: CodeableConcept)
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                43. Patient.extension:isAccountHolder
                Slice NameisAccountHolder
                Definition

                Patient Resource - Patient Account Holder status (Patient Register Screen)

                ShortExtension
                Control0..1
                TypeExtension(Account Holder extension) (Extension Type: boolean)
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                45. Patient.extension:accountGroup
                Slice NameaccountGroup
                Definition

                Patient Resource - Patient Account Group

                ShortExtension
                Control0..1
                TypeExtension(Patient Account Group extension) (Extension Type: CodeableConcept)
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                47. Patient.extension:accountHeldBy
                Slice NameaccountHeldBy
                Definition

                Patient Resource - Patient Account Held By Reference (Patient Register Screen)

                ShortExtension
                Control0..1
                TypeExtension(Account Held By extension) (Extension Type: Reference)
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                49. Patient.modifierExtension
                Definition

                May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                ShortExtensions that cannot be ignored
                Comments

                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

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

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

                An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.

                ShortIdentifies this patient across multiple systems
                NoteThis is a business identifier, not a resource identifier (see discussion)
                Control0..*
                This element is affected by the following invariants: ele-1, au-core-pat-01
                TypeIdentifier(AU IHI, AU Medicare Card Number, AU DVA Number, AU Health Care Card Number, AU Pensioner Concession Card Number, AU Commonwealth Seniors Health Card Number)
                Is Modifierfalse
                Must Supporttrue
                Must Support TypesNo must-support rules about the choice of types/profiles
                Requirements

                Patients are almost always assigned specific numerical identifiers.

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

                  An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.

                  ShortIdentifies this patient across multiple systems
                  NoteThis is a business identifier, not a resource identifier (see discussion)
                  Control0..*
                  This element is affected by the following invariants: ele-1
                  TypeIdentifier(AU IHI)
                  Is Modifierfalse
                  Must Supporttrue
                  Requirements

                  Patients are almost always assigned specific numerical identifiers.

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

                  An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.

                  ShortIdentifies this patient across multiple systems
                  NoteThis is a business identifier, not a resource identifier (see discussion)
                  Control0..*
                  This element is affected by the following invariants: ele-1
                  TypeIdentifier(AU Medicare Card Number)
                  Is Modifierfalse
                  Must Supporttrue
                  Requirements

                  Patients are almost always assigned specific numerical identifiers.

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

                  An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.

                  ShortIdentifies this patient across multiple systems
                  NoteThis is a business identifier, not a resource identifier (see discussion)
                  Control0..*
                  This element is affected by the following invariants: ele-1
                  TypeIdentifier(AU DVA Number)
                  Is Modifierfalse
                  Must Supporttrue
                  Requirements

                  Patients are almost always assigned specific numerical identifiers.

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

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

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

                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                  ShortAdditional content defined by implementations
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                    The purpose of this identifier.

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

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

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

                    Identifies the purpose for this identifier, if known .

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

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

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

                    Entitlement type associated with a DVA issued Veteran Card.

                    ShortDescription of identifier
                    Comments

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

                    Control1..1
                    BindingThe codes SHALL be taken from The DVA Entitlement for Patient
                    (required to https://alexapi.medtechglobal.com.au/fhir/ValueSet/patient-dva-entitlement)
                    TypeCodeableConcept
                    Is Modifierfalse
                    Summarytrue
                    Requirements

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

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

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

                    ShortThe namespace for the identifier value
                    Comments

                    Identifier.system is always case sensitive.

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

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

                    Fixed Valuehttp://ns.electronichealth.net.au/id/dva
                    Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    69. Patient.identifier:dva.value
                    Definition

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

                    ShortDVA number
                    Comments

                    This concept is equivalent to Australian Institute of Health and Welfare data element 339127 Person—government funding identifier, Department of Veterans' Affairs file number AAXXNNNNA.

                    Control1..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Max Length:9
                    Example<br/><b>General</b>:123456 <br/><b>DVA number</b>:NBUR9080
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    71. Patient.identifier:dva.period
                    Definition

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

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

                    Organization that issued/manages the identifier.

                    ShortOrganization that issued id (may be just text)
                    Comments

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

                    Control0..1
                    TypeReference(Organization)
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    75. Patient.identifier:healthcare
                    Slice Namehealthcare
                    Definition

                    An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.

                    ShortIdentifies this patient across multiple systems
                    NoteThis is a business identifier, not a resource identifier (see discussion)
                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeIdentifier(AU Health Care Card Number)
                    Is Modifierfalse
                    Must Supporttrue
                    Requirements

                    Patients are almost always assigned specific numerical identifiers.

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

                    An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.

                    ShortIdentifies this patient across multiple systems
                    NoteThis is a business identifier, not a resource identifier (see discussion)
                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeIdentifier(AU Pensioner Concession Card Number)
                    Is Modifierfalse
                    Must Supporttrue
                    Requirements

                    Patients are almost always assigned specific numerical identifiers.

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

                    An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.

                    ShortIdentifies this patient across multiple systems
                    NoteThis is a business identifier, not a resource identifier (see discussion)
                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeIdentifier(AU Commonwealth Seniors Health Card Number)
                    Is Modifierfalse
                    Must Supporttrue
                    Requirements

                    Patients are almost always assigned specific numerical identifiers.

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

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

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

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

                    ShortWhether this patient's record is in active use
                    Comments

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

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

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

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

                    A name associated with the individual.

                    ShortA name associated with the patient
                    Comments

                    A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.

                    Control1..2
                    TypeHumanName
                    Is Modifierfalse
                    Summarytrue
                    Requirements

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

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

                      A name associated with the individual.

                      ShortA name associated with the patient
                      Comments

                      A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.

                      Control1..1
                      TypeHumanName
                      Is Modifierfalse
                      Must Supporttrue
                      Summarytrue
                      Requirements

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

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

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

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

                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                      ShortAdditional content defined by implementations
                      Comments

                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                        Identifies the purpose for this name.

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

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

                        Control1..1
                        BindingThe codes SHALL be taken from NameUse
                        (required to http://hl7.org/fhir/ValueSet/name-use|4.0.1)

                        The use of a human name.

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

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

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

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

                        ShortText representation of the full name
                        Comments

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

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

                        A renderable, unencoded form.

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

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

                        ShortFamily name (often called 'Surname')
                        Comments

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

                        Control1..1
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        Alternate Namessurname
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        97. Patient.name:official.given
                        Definition

                        Given name.

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

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

                        Control1..*
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        Alternate Namesfirst name, middle name
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        99. Patient.name:official.prefix
                        Definition

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

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

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

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

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

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

                        Allows names to be placed in historical context.

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

                        A name associated with the individual.

                        ShortA name associated with the patient
                        Comments

                        A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.

                        Control0..1
                        TypeHumanName
                        Is Modifierfalse
                        Must Supporttrue
                        Summarytrue
                        Requirements

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

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

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

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

                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                        ShortAdditional content defined by implementations
                        Comments

                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                          Identifies the purpose for this name.

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

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

                          Control1..1
                          BindingThe codes SHALL be taken from NameUse
                          (required to http://hl7.org/fhir/ValueSet/name-use|4.0.1)

                          The use of a human name.

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

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

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

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

                          ShortText representation of the full name
                          Comments

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

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

                          A renderable, unencoded form.

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

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

                          ShortFamily name (often called 'Surname')
                          Comments

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

                          Control0..0
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Alternate Namessurname
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          117. Patient.name:preferred.given
                          Definition

                          Given name.

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

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

                          Control1..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Alternate Namesfirst name, middle name
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          119. Patient.name:preferred.prefix
                          Definition

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

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

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

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

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

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

                          Allows names to be placed in historical context.

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

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

                          ShortA contact detail for the individual
                          Comments

                          A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).

                          Control0..*
                          TypeContactPoint
                          Is Modifierfalse
                          Must Supporttrue
                          Summarytrue
                          Requirements

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

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

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

                          Shortmale | female | other | unknown
                          Comments

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

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

                          The gender of a person used for administrative purposes.

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

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

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

                          The date of birth for the individual.

                          ShortDate of birth extended for time and accuracy indicator
                          Comments

                          At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternity/infant care systems).

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

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

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

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

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

                          An Extension

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

                            General date accuracy indicator coding.

                            ShortDate accuracy indicator
                            Comments

                            In some circumstances, systems may capture date or dateTime data that has unknown or estimated parts. This coding indicates the accuracy of the day, month and year parts. This concept is equivalent to Australian Institute of Health and Welfare data element 294418 Date—accuracy indicator.

                            Control0..0
                            This element is affected by the following invariants: ele-1
                            TypeExtension(Date Accuracy Indicator) (Extension Type: Coding)
                            Is Modifierfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            137. Patient.birthDate.extension:birthTime
                            Slice NamebirthTime
                            Definition

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

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

                            The actual value

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

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

                            ShortIndicates if the individual is deceased or not
                            Comments

                            If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.

                            Control0..0
                            Is Modifiertrue because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
                            Summarytrue
                            Requirements

                            The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.

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

                              Boolean indicator if the individual is deceased or not.

                              ShortDeceased indicator
                              Comments

                              If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.

                              Control0..0
                              Typeboolean
                              Is Modifiertrue because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Requirements

                              The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.

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

                              Individual deceased date-time with optional accuracy indicator.

                              ShortDeceased date time
                              Comments

                              If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.

                              Control0..0
                              TypedateTime
                              Is Modifiertrue because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Requirements

                              The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.

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

                              An Australian address expressed using postal conventions (as opposed to GPS or other location definition formats).

                              ShortAn address for the individual
                              Comments

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

                              Control0..2
                              This element is affected by the following invariants: ele-1
                              TypeAddress(Address)
                              Is Modifierfalse
                              Must Supporttrue
                              Requirements

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

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              inv-add-0: The address shall at least have text or a line (text.exists() or line.exists())
                              inv-add-1: If asserting no fixed address, the type shall be 'physical' (extension('http://hl7.org.au/fhir/StructureDefinition/no-fixed-address').exists() implies type='physical')
                              inv-add-2: If asserting no fixed address, the address text shall begin with 'NO FIXED ADDRESS' (extension('http://hl7.org.au/fhir/StructureDefinition/no-fixed-address').exists() implies text.startsWith('NO FIXED ADDRESS'))
                              153. Patient.maritalStatus
                              Definition

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

                              ShortMarital (civil) status of a patient
                              Control0..0
                              BindingUnless not suitable, these codes SHALL be taken from Marital Status Codes
                              (extensible to http://hl7.org/fhir/ValueSet/marital-status)

                              The domestic partnership status of a person.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Summaryfalse
                              Requirements

                              Most, if not all systems capture it.

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

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

                              ShortWhether patient is part of a multiple birth
                              Comments

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

                              Control0..0
                              TypeChoice of: boolean, integer
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summaryfalse
                              Requirements

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

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

                              Image of the patient.

                              ShortImage of the patient
                              Comments

                              Guidelines:

                              • Use id photos, not clinical photos.
                              • Limit dimensions to thumbnail.
                              • Keep byte count low to ease resource updates.
                              Control0..0
                              TypeAttachment
                              Is Modifierfalse
                              Summaryfalse
                              Requirements

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

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

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

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

                              Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.

                              Control0..2
                              TypeBackboneElement
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              Requirements

                              Need to track people you can contact about the patient.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              pat-1: SHALL at least contain a contact's details or a reference to an organization (name.exists() or telecom.exists() or address.exists() or organization.exists())
                              161. Patient.contact.id
                              Definition

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

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

                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortAdditional content defined by implementations
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Is Modifierfalse
                              Summaryfalse
                              Alternate Namesextensions, user content
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              165. Patient.contact.modifierExtension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                              ShortExtensions that cannot be ignored even if unrecognized
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

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

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

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

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

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

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

                              A name associated with the contact person.

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

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

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

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

                              ShortA contact detail for the person
                              Comments

                              Contact may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification.

                              Control0..*
                              TypeContactPoint
                              Is Modifierfalse
                              Summaryfalse
                              Requirements

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

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

                              An address expressed using postal conventions (as opposed to GPS or other location definition formats). This data type may be used to convey addresses for use in delivering mail as well as for visiting locations which might not be valid for mail delivery. There are a variety of postal address formats defined around the world.

                              ShortAddress for the contact person
                              Comments

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

                              Control0..1
                              This element is affected by the following invariants: ele-1
                              TypeAddress(Address, Australian Address)
                              Is Modifierfalse
                              Requirements

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

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

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

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

                              The gender of a person used for administrative purposes.

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

                              Needed to address the person correctly.

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

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

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

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

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

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

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

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

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

                              If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.

                              Control0..*
                              TypeBackboneElement
                              Is Modifierfalse
                              Summaryfalse
                              Requirements

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

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

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

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

                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortAdditional content defined by implementations
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Is Modifierfalse
                              Summaryfalse
                              Alternate Namesextensions, user content
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              187. Patient.communication.modifierExtension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                              ShortExtensions that cannot be ignored even if unrecognized
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

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

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

                              The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English.

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

                              The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.

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

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

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

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

                              ShortLanguage preference indicator
                              Comments

                              This language is specifically identified for communicating healthcare information.

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

                              People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method.

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

                              Patient's nominated care provider.

                              ShortPatient's nominated primary care provider
                              Comments

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

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

                              Control0..*
                              TypeReference(Organization, Practitioner, PractitionerRole)
                              Is Modifierfalse
                              Must Supporttrue
                              Must Support TypesNo must-support rules about the choice of types/profiles
                              Summaryfalse
                              Alternate NamescareProvider
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              195. Patient.managingOrganization
                              Definition

                              Organization that is the custodian of the patient record.

                              ShortOrganization that is the custodian of the patient record
                              Comments

                              There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association).

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

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

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

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

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

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

                              Control0..0
                              TypeBackboneElement
                              Is Modifiertrue because This element is labeled as a modifier because it might not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'
                              Summarytrue
                              Requirements

                              There are multiple use cases:

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