Medtech ALEX® AU Implementation Guide
1.0.0 - Trial Use International flag

Medtech ALEX® AU Implementation Guide - Local Development build (v1.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: AlexPatient - Detailed Descriptions

Active as of 2025-10-12

Definitions for the alex-patient resource profile.

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

0. Patient
Definition

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


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

ShortA patient in 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(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(Gender Identity) (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)

    ShortPatient registration status (Medtech – required)
    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:patientRegistrationStatus.extension
    Definition

    An Extension


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

    ShortExtensionAdditional content defined by implementations
    Comments

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

    Control0..0*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis element introduces a set of slices on Patient.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 30. Patient.extension:patientRegistrationStatus.url
      Definition

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

      Shortidentifies the meaning of the extension
      Comments

      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

      Control1..1
      Typeuri
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      Fixed Valuehttps://alexapi.medtechglobal.com.au/fhir/StructureDefinition/patient-registration-status
      32. Patient.extension:patientRegistrationStatus.value[x]
      Definition

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

      ShortValue of extension
      Comments

      User-defined codes managed in the PMS; canonical system only; code list not published in this IG.

      Control0..1
      BindingUnless not suitable, these codes SHALL be taken from For codes, see Medtech Patient Registration ValueSet
      (extensible to https://alexapi.medtechglobal.com.au/fhir/ValueSet/patient-registration-status-vs)
      TypeCodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      34. 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())
      36. 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())
      38. 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())
      40. 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())
      42. 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())
      44. Patient.extension:countryOfBirth
      Slice NamecountryOfBirth
      Definition

      Patient Resource - Country of Birth

      ShortExtension
      Control0..1
      TypeExtension(Patient country of 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())
      46. 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())
      48. 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, AU Medical Record 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
      • 50. 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()))
        52. 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()))
        54. 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()))
        56. 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()))
        58. 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|4.0.1
        (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()))
        60. 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
        ExampleGeneral: http://www.acme.com/identifiers/patient
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        62. 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
        ExampleGeneral: 123456
        DVA number: NBUR9080
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        64. 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()))
        66. 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()))
        68. 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()))
        70. Patient.identifier:mrn
        Slice Namemrn
        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 Medical Record 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()))
        72. 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()))
        74. 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
        • 76. 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()))
          78. 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()))
          80. 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()))
          82. 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()))
          84. 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..1*
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          86. 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()))
          88. 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()))
          90. 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()))
          92. 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()))
          94. 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..1*
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          96. 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()))
          98. 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
          100. 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())
          102. 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/Person/RelatedPerson/Practitioner 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())
          104. 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
          • 106. 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()))
            108. 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()))
            111. 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'))
            113. Patient.maritalStatus
            Definition

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

            ShortPatient marital status (Medtech – required)Marital (civil) status of a patient
            Comments

            User-defined codes managed in the PMS; canonical system only; code list not published in this IG.

            Control0..1
            BindingUnless not suitable, these codes SHALL be taken from Medtech Marital Status ValueSethttp://hl7.org/fhir/ValueSet/marital-status|4.0.1
            (extensible to https://alexapi.medtechglobal.com.au/fhir/ValueSet/marital-status)
            TypeCodeableConcept
            Is Modifierfalse
            Must Supporttrue
            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()))
            115. 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()))
            117. 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()))
            119. 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())
            121. 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())
            123. 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, 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()))
            125. 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 foundhere

            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
            ShortPatient registration status (Medtech – required)
            Control0..1
            TypeExtension(Patient Registration Status Extension) (Extension Type: CodeableConcept)
            Must Supporttrue
            22. Patient.extension:patientRegistrationStatus.value[x]
            Comments

            User-defined codes managed in the PMS; canonical system only; code list not published in this IG.

            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            24. Patient.extension:patientLocation
            Slice NamepatientLocation
            Control0..1
            TypeExtension(Patient Location extension) (Extension Type: Reference)
            Must Supporttrue
            26. Patient.extension:patientEthnicity
            Slice NamepatientEthnicity
            Control0..1
            TypeExtension(Patient ethnicity extension) (Extension Type: CodeableConcept)
            Must Supporttrue
            28. Patient.extension:isAccountHolder
            Slice NameisAccountHolder
            Control0..1
            TypeExtension(Account Holder extension) (Extension Type: boolean)
            Must Supporttrue
            30. Patient.extension:accountGroup
            Slice NameaccountGroup
            Control0..1
            TypeExtension(Patient Account Group extension) (Extension Type: CodeableConcept)
            Must Supporttrue
            32. Patient.extension:accountHeldBy
            Slice NameaccountHeldBy
            Control0..1
            TypeExtension(Account Held By extension) (Extension Type: Reference)
            Must Supporttrue
            34. Patient.extension:countryOfBirth
            Slice NamecountryOfBirth
            Control0..1
            TypeExtension(Patient country of birth extension) (Extension Type: CodeableConcept)
            Must Supporttrue
            36. 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, AU Medical Record 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
            • 38. Patient.identifier:ihi
              Slice Nameihi
              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control0..*
              TypeIdentifier(AU IHI)
              Must Supporttrue
              40. Patient.identifier:medicare
              Slice Namemedicare
              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control0..*
              TypeIdentifier(AU Medicare Card Number)
              Must Supporttrue
              42. Patient.identifier:dva
              Slice Namedva
              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control0..*
              TypeIdentifier(AU DVA Number)
              Must Supporttrue
              44. 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)
              46. 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
              48. 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
              50. 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
              52. Patient.identifier:mrn
              Slice Namemrn
              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control0..*
              TypeIdentifier(AU Medical Record Number)
              Must Supporttrue
              54. 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
              • 56. Patient.name:official
                Slice Nameofficial
                Control1..1
                Must Supporttrue
                58. Patient.name:official.use
                Control1..?
                Pattern Valueofficial
                60. Patient.name:official.family
                Control1..?
                Must Supporttrue
                62. Patient.name:official.given
                Control1..?
                Must Supporttrue
                64. Patient.name:official.prefix
                Control0..1
                Must Supporttrue
                66. Patient.name:preferred
                Slice Namepreferred
                Control0..1
                Must Supporttrue
                68. Patient.name:preferred.use
                Control1..?
                Pattern Valueusual
                70. Patient.name:preferred.family
                Control0..0
                Must Supporttrue
                72. Patient.name:preferred.given
                Control1..1
                Must Supporttrue
                74. Patient.name:preferred.prefix
                Control0..1
                Must Supporttrue
                76. Patient.telecom
                Must Supporttrue
                78. Patient.birthDate
                Control1..?
                Must Supporttrue
                LOINC Code
                80. Patient.birthDate.extension:accuracyIndicator
                Slice NameaccuracyIndicator
                Control0..0
                82. Patient.birthDate.extension:birthTime
                Slice NamebirthTime
                Control0..0
                84. Patient.deceased[x]
                Control0..0
                86. Patient.deceased[x]:deceasedBoolean
                Slice NamedeceasedBoolean
                Control0..0
                Typeboolean
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                88. Patient.deceased[x]:deceasedDateTime
                Slice NamedeceasedDateTime
                Control0..0
                TypedateTime
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                90. Patient.address
                Control0..2
                TypeAddress(Address)
                Must Supporttrue
                92. Patient.maritalStatus
                ShortPatient marital status (Medtech – required)
                Comments

                User-defined codes managed in the PMS; canonical system only; code list not published in this IG.

                BindingUnless not suitable, these codes SHALL be taken from Medtech Marital Status ValueSet
                (extensible to https://alexapi.medtechglobal.com.au/fhir/ValueSet/marital-status)
                Must Supporttrue
                94. Patient.maritalStatus.coding
                96. Patient.maritalStatus.coding.system
                Pattern Valuehttps://alexapi.medtechglobal.com.au/fhir/CodeSystem/marital-status
                98. Patient.multipleBirth[x]
                Control0..0
                100. Patient.photo
                Control0..0
                102. Patient.contact
                Control0..2
                Must Supporttrue
                104. Patient.generalPractitioner
                Must Supporttrue
                106. Patient.link
                Control0..0

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

                0. Patient
                Definition

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

                ShortA patient in 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(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(Gender Identity) (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)

                  ShortPatient registration status (Medtech – required)
                  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:patientRegistrationStatus.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
                  41. Patient.extension:patientRegistrationStatus.extension
                  Definition

                  An Extension

                  ShortExtension
                  Control0..0
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  SlicingThis element introduces a set of slices on Patient.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 43. Patient.extension:patientRegistrationStatus.url
                    Definition

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

                    Shortidentifies the meaning of the extension
                    Comments

                    The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                    Control1..1
                    Typeuri
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    Fixed Valuehttps://alexapi.medtechglobal.com.au/fhir/StructureDefinition/patient-registration-status
                    45. Patient.extension:patientRegistrationStatus.value[x]
                    Definition

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

                    ShortValue of extension
                    Comments

                    User-defined codes managed in the PMS; canonical system only; code list not published in this IG.

                    Control0..1
                    BindingUnless not suitable, these codes SHALL be taken from Medtech Patient Registration ValueSet
                    (extensible to https://alexapi.medtechglobal.com.au/fhir/ValueSet/patient-registration-status-vs)
                    TypeCodeableConcept
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    47. Patient.extension:patientRegistrationStatus.value[x].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
                    49. Patient.extension:patientRegistrationStatus.value[x].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.extension.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 51. Patient.extension:patientRegistrationStatus.value[x].coding
                      Definition

                      A reference to a code defined by a terminology system.

                      ShortCode defined by a terminology system
                      Comments

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

                      Control0..*
                      TypeCoding
                      Is Modifierfalse
                      Summarytrue
                      Requirements

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

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      53. Patient.extension:patientRegistrationStatus.value[x].coding.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
                      55. Patient.extension:patientRegistrationStatus.value[x].coding.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.extension.value[x].coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 57. Patient.extension:patientRegistrationStatus.value[x].coding.system
                        Definition

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

                        ShortIdentity of the terminology system
                        Comments

                        The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

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

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

                        Pattern Valuehttps://alexapi.medtechglobal.com.au/fhir/CodeSystem/registration-status-code
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        59. Patient.extension:patientRegistrationStatus.value[x].coding.version
                        Definition

                        The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                        ShortVersion of the system - if relevant
                        Comments

                        Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

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

                        A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

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

                        Need to refer to a particular code in the system.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        63. Patient.extension:patientRegistrationStatus.value[x].coding.display
                        Definition

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

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

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

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        65. Patient.extension:patientRegistrationStatus.value[x].coding.userSelected
                        Definition

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

                        ShortIf this coding was chosen directly by the user
                        Comments

                        Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

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

                        This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

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

                        A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                        ShortPlain text representation of the concept
                        Comments

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

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

                        The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        69. 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())
                        71. 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())
                        73. 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())
                        75. 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())
                        77. 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())
                        79. Patient.extension:countryOfBirth
                        Slice NamecountryOfBirth
                        Definition

                        Patient Resource - Country of Birth

                        ShortExtension
                        Control0..1
                        TypeExtension(Patient country of 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())
                        81. 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())
                        83. 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, AU Medical Record 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
                        • 85. 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()))
                          87. 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()))
                          89. 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()))
                          91. 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
                          93. 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
                          • 95. 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()))
                            97. 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()))
                            99. 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
                            ExampleGeneral: http://www.acme.com/identifiers/patient
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            101. 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
                            ExampleGeneral: 123456
                            DVA number: NBUR9080
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            103. 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()))
                            105. 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()))
                            107. 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()))
                            109. 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()))
                            111. 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()))
                            113. Patient.identifier:mrn
                            Slice Namemrn
                            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 Medical Record 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()))
                            115. 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()))
                            117. 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
                            • 119. 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()))
                              121. 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
                              123. 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
                              • 125. 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()))
                                127. 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()))
                                129. 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()))
                                131. 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()))
                                133. 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..1
                                Typestring
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supporttrue
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                135. 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()))
                                137. 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()))
                                139. 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()))
                                141. 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
                                143. 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
                                • 145. 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()))
                                  147. 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()))
                                  149. 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()))
                                  151. 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()))
                                  153. 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..1
                                  Typestring
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  155. 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()))
                                  157. 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()))
                                  159. 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()))
                                  161. 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()))
                                  163. 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
                                  165. 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
                                  167. 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
                                  • 169. 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())
                                    171. 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/Person/RelatedPerson/Practitioner 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())
                                    173. 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
                                    175. 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
                                    • 177. 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()))
                                      179. 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()))
                                      185. 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'))
                                      187. Patient.maritalStatus
                                      Definition

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

                                      ShortPatient marital status (Medtech – required)
                                      Comments

                                      User-defined codes managed in the PMS; canonical system only; code list not published in this IG.

                                      Control0..1
                                      BindingUnless not suitable, these codes SHALL be taken from Medtech Marital Status ValueSet
                                      (extensible to https://alexapi.medtechglobal.com.au/fhir/ValueSet/marital-status)
                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Must Supporttrue
                                      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()))
                                      189. Patient.maritalStatus.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
                                      191. Patient.maritalStatus.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.maritalStatus.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 193. Patient.maritalStatus.coding
                                        Definition

                                        A reference to a code defined by a terminology system.

                                        ShortCode defined by a terminology system
                                        Comments

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

                                        Control0..*
                                        TypeCoding
                                        Is Modifierfalse
                                        Summarytrue
                                        Requirements

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

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        195. Patient.maritalStatus.coding.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
                                        197. Patient.maritalStatus.coding.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.maritalStatus.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • value @ url
                                        • 199. Patient.maritalStatus.coding.system
                                          Definition

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

                                          ShortIdentity of the terminology system
                                          Comments

                                          The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

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

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

                                          Pattern Valuehttps://alexapi.medtechglobal.com.au/fhir/CodeSystem/marital-status
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          201. Patient.maritalStatus.coding.version
                                          Definition

                                          The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                          ShortVersion of the system - if relevant
                                          Comments

                                          Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                          NoteThis is a business version Id, not a resource version Id (see discussion)
                                          Control0..1
                                          Typestring
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summarytrue
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          203. Patient.maritalStatus.coding.code
                                          Definition

                                          A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

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

                                          Need to refer to a particular code in the system.

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

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

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

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

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

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

                                          ShortIf this coding was chosen directly by the user
                                          Comments

                                          Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

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

                                          This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

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

                                          A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                          ShortPlain text representation of the concept
                                          Comments

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

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

                                          The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          211. 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()))
                                          213. 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()))
                                          215. 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())
                                          217. 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
                                          219. 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())
                                          221. 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())
                                          223. 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()))
                                          225. 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()))
                                          227. 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()))
                                          229. 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()))
                                          231. 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()))
                                          233. 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()))
                                          235. 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()))
                                          237. 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()))
                                          239. 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
                                          241. 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())
                                          243. 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())
                                          245. 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()))
                                          247. 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()))
                                          249. 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()))
                                          251. 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()))
                                          253. 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()))