1.7.1 - release

SHINNYHRSN - Local Development build (v1.7.1) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

## Resource Profile: SHINNY Patient Profile

Official URL: http://test.shinny.org/us/ny/hrsn/StructureDefinition/shinny-patient | Version: 1.7.1
Active as of 2025-12-09 | Computable Name: SHINNYPatientProfile

- SHINNY HRSN: Needed for all bundles.
- Profiled off of the USCore Patient: This profile sets minimum expectations for the Patient resource to record, search, and fetch basic demographics and other administrative information about an individual patient. It identifies which core elements, extensions, vocabularies and value sets SHALL be present in the resource when using this profile.

### Purpose

The SHINNY Patient Profile inherits from the US Core Patient profile. It sets minimum expectations for the Patient resource. It identifies which core elements, extensions, vocabularies and value sets SHALL be present in the resource when using this profile.

### Usage

The patient profile is required for all SHINNY HRSN bundles.

An extension is included for both patient pronouns and gender identity with SHINNY valuesets defined for each of these. In addition, an extension has been added to explicitly capture the patient's middle name.

Three patient identifiers are defined using slices. These include the medical record number MR (MR), the Medicare identifier CMS (MA), and the social security number SSN (SS).

#### Parent Child Relationships

Within the PatientExample instance, an example of a relationship between a parent and a child is shown using the contact.relationship element. This example can be used for situations where two members of the same family are receiving a service. The FHIR valueset is extensible and in this example we are using the HL7 Terminology CodeSystem: relationship.

#### Race and Ethnicity

Due to the values defined by US Core for Ethnicity and Race, the situation where this information is unknown for a patient must be handled differently for each of these elements, as described below.

The values for Ethnicity found here do not include an option for "unknown", so a value should not be included when this information is unknown.

Conversely, the values for Race found here include both "Unknown" and "Asked but no answer", so either of these values can be used when appropriate.

#### Language

Note that within the SHINNYLanguageVS value set there are two different links to language standards. Within the FHIR documentation, currently there is no way of navitaging directly to the complete list of "All Languages", which can be found here.

It's also important to note there are two language attributes within the patient resource. The "language" attribute within all resources describes the language of the FHIR IG itself. For the SHIN-NY IG, this should always be "en" for English. The communication.language is described as, "The language which can be used to communicate with the patient about his or her health." For this attribute, any of the languages found in the list of "All Languages", referenced above, can be used.

Usages:

- Refer to this Profile: SHINNY Encounter Profile
- Examples for this Profile: Patient/CBOPatientExample, Patient/NullFlavorRacePatientExample, Patient/PatientExample and Patient/PatientExampleExtendedLanguages

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Patient |  | 0..* | USCorePatientProfile | Information about an individual or animal receiving health care services
id | S Σ | 1..1 | id | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
meta | S Σ | 1..1 | SHINNYMeta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: SHINNYLanguageVS (preferred)
Slices for extension |  |  |  | Content/Rules for all slices
extension:race | S | 0..1 | (Complex) | US Core Race Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-race
extension:ethnicity | S | 0..1 | (Complex) | US Core ethnicity Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity
extension:birthsex | S | 0..1 | code | Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex Binding: Birth Sex (required): Code for sex assigned at birth
extension:pronouns |  | 0..* | CodeableConcept | SHINNY Personal Pronouns URL: http://test.shinny.org/us/ny/hrsn/StructureDefinition/shinny-personal-pronouns Binding: SHINNYPersonalPronounsVS (preferred): PersonalPronouns
extension:genderIdentity |  | 0..* | CodeableConcept | SHINNYGenderIdentityExtension URL: http://test.shinny.org/us/ny/hrsn/StructureDefinition/shinny-gender-identity Binding: Gender Identity (extensible): GenderIdentity
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for identifier | S Σ | 2..* | Identifier | An identifier for this patient Slice: Unordered, Open by pattern:type
identifier:All Slices |  |  |  | Content/Rules for all slices
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | S Σ | 1..1 | CodeableConcept | Description of identifier. It MUST contain a single instance of MR (Medical record number) Binding: SHINNYIdentiferTypeVS (extensible)
system | S Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique within the system. Example General: 123456
identifier:MR | S Σ | 1..1 | Identifier | An identifier for this patient
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | S Σ | 1..1 | CodeableConcept | Description of identifier. It MUST contain a single instance of MR (Medical record number) Binding: SHINNYIdentiferTypeVS (extensible) Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: MR
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
system | S Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique within the system. Example General: 123456
assigner | S Σ | 1..1 | Reference(Organization) | Organization that issued id (may be just text)
identifier:CMS | S Σ | 1..1 | Identifier | An identifier for this patient
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | S Σ | 1..1 | CodeableConcept | Description of identifier. It MUST contain a single instance of MR (Medical record number) Binding: SHINNYIdentiferTypeVS (extensible) Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: MA
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
system | S Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique within the system. Example General: 123456
identifier:SSN | S Σ | 0..1 | Identifier | An identifier for this patient
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | S Σ | 1..1 | CodeableConcept | Description of identifier. It MUST contain a single instance of MR (Medical record number) Binding: SHINNYIdentiferTypeVS (extensible) Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: SS
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
system | S Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique within the system. Example General: 123456
active | ?!Σ | 0..1 | boolean | Whether this patient's record is in active use
name | S Σ C | 1..1 | HumanName | A name associated with the patient Constraints: us-core-8
Slices for extension |  |  |  | Content/Rules for all slices
extension:middle-name |  | 0..1 | string | SHINNY Name Extension URL: http://test.shinny.org/us/ny/hrsn/StructureDefinition/middle-name Binding Description: (extensible) ⚠: middle name
use | ?!Σ | 0..1 | code | usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
family | S Σ C | 1..1 | string | Family name (often called 'Surname')
given | S Σ C | 1..1 | string | Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name
telecom | S Σ | 0..* | ContactPoint | A contact detail for the individual
system | S Σ C | 1..1 | code | phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value | S Σ | 1..1 | string | The actual contact point details
use | ?!S Σ | 0..1 | code | home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required)
gender | S Σ | 1..1 | code | male | female | other | unknown Binding: AdministrativeGender (required)
birthDate | S Σ | 1..1 | date | The date of birth for the individual
deceased[x] | ?!Σ | 0..1 |  | Indicates if the individual is deceased or not
deceasedBoolean |  |  | boolean |
deceasedDateTime |  |  | dateTime |
address | S Σ | 0..* | Address | An address for the individual
use | ?!Σ | 0..1 | code | home | work | temp | old | billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
line | S Σ | 0..* | string | Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label Example General: 137 Nowhere Street
city | S Σ | 0..1 | string | Name of city, town etc. Example General: Erewhon
state | S Σ | 0..1 | string | Sub-unit of country (abbreviations ok) Binding: USPS Two Letter Alphabetic Codes (extensible): Two Letter USPS alphabetic codes.
postalCode | S Σ | 0..1 | string | US Zip Codes Example General: 9132
period | S Σ | 0..1 | Period | Time period when address was/is in use Example General: {"start":"2010-03-23","end":"2010-07-01"}
communication | S | 0..* | BackboneElement | A language which may be used to communicate with the patient about his or her health
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
language | S | 1..1 | CodeableConcept | The language which can be used to communicate with the patient about his or her health Binding: Language codes with language and optionally a region modifier (extensible)
Slices for extension |  |  |  | Content/Rules for all slices
extension:language |  | 0..1 | code | SHINNY Languages URL: http://test.shinny.org/us/ny/hrsn/StructureDefinition/language Binding: SHINNYLanguageVS (preferred): language
link | ?!Σ | 0..* | BackboneElement | Link to another patient resource that concerns the same actual person
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
other | Σ | 1..1 | Reference(Patient | RelatedPerson) | The other patient or related person resource that the link refers to
type | Σ | 1..1 | code | replaced-by | replaces | refer | seealso Binding: LinkType (required): The type of link between this patient resource and another patient resource.
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
Patient.language | preferred | SHINNYLanguageVS `http://test.shinny.org/us/ny/hrsn/ValueSet/SHINNYLanguageVS` From this IG
Patient.identifier.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` From the FHIR Standard
Patient.identifier.type | extensible | SHINNYIdentiferTypeVS `http://test.shinny.org/us/ny/hrsn/ValueSet/SHINNYIdentiferTypeVS` From this IG
Patient.identifier:MR.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` From the FHIR Standard
Patient.identifier:MR.type | extensible | Pattern Value: MR `http://test.shinny.org/us/ny/hrsn/ValueSet/SHINNYIdentiferTypeVS` From this IG
Patient.identifier:CMS.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` From the FHIR Standard
Patient.identifier:CMS.type | extensible | Pattern Value: MA `http://test.shinny.org/us/ny/hrsn/ValueSet/SHINNYIdentiferTypeVS` From this IG
Patient.identifier:SSN.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` From the FHIR Standard
Patient.identifier:SSN.type | extensible | Pattern Value: SS `http://test.shinny.org/us/ny/hrsn/ValueSet/SHINNYIdentiferTypeVS` From this IG
Patient.name.use | required | NameUse `http://hl7.org/fhir/ValueSet/name-use|4.0.1` From the FHIR Standard
Patient.telecom.system | required | ContactPointSystem `http://hl7.org/fhir/ValueSet/contact-point-system` From the FHIR Standard
Patient.telecom.use | required | ContactPointUse `http://hl7.org/fhir/ValueSet/contact-point-use` From the FHIR Standard
Patient.gender | required | AdministrativeGender `http://hl7.org/fhir/ValueSet/administrative-gender` From the FHIR Standard
Patient.address.use | required | AddressUse `http://hl7.org/fhir/ValueSet/address-use|4.0.1` From the FHIR Standard
Patient.address.state | extensible | UspsTwoLetterAlphabeticCodes `http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state`
Patient.communication.language | extensible | LanguageCodesWithLanguageAndOptionallyARegionModifier `http://hl7.org/fhir/us/core/ValueSet/simple-language`
Patient.link.type | required | LinkType `http://hl7.org/fhir/ValueSet/link-type|4.0.1` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | Patient | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Patient | 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 | error | Patient | 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 | error | Patient | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Patient | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
us-core-8 | error | Patient.name | Either Patient.name.given and/or Patient.name.family SHALL be present or a Data Absent Reason Extension SHALL be present. : (family.exists() or given.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists() |

This structure is derived from USCorePatientProfile

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Patient |  |  | USCorePatientProfile |
id | S | 1..1 | id | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
meta | S | 1..1 | SHINNYMeta | Metadata about the resource
language |  | 0..1 | code | Language of the resource content Binding: SHINNYLanguageVS (preferred)
Slices for extension |  |  |  | Content/Rules for all slices
extension:pronouns |  | 0..* | CodeableConcept | SHINNY Personal Pronouns URL: http://test.shinny.org/us/ny/hrsn/StructureDefinition/shinny-personal-pronouns Binding: SHINNYPersonalPronounsVS (preferred): PersonalPronouns
extension:genderIdentity |  | 0..* | CodeableConcept | SHINNYGenderIdentityExtension URL: http://test.shinny.org/us/ny/hrsn/StructureDefinition/shinny-gender-identity Binding: Gender Identity (extensible): GenderIdentity
Slices for identifier |  | 2..* | Identifier | An identifier for this patient Slice: Unordered, Open by pattern:type
identifier:All Slices |  |  |  | Content/Rules for all slices
type | S | 1..1 | CodeableConcept | Description of identifier. It MUST contain a single instance of MR (Medical record number) Binding: SHINNYIdentiferTypeVS (extensible)
identifier:MR |  | 1..1 | Identifier | An identifier for this patient
type |  | 1..1 | CodeableConcept | Description of identifier. It MUST contain a single instance of MR (Medical record number) Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: MR
assigner | S | 1..1 | Reference(Organization) | Organization that issued id (may be just text)
identifier:CMS |  | 1..1 | Identifier | An identifier for this patient
type |  | 1..1 | CodeableConcept | Description of identifier. It MUST contain a single instance of MR (Medical record number) Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: MA
identifier:SSN |  | 0..1 | Identifier | An identifier for this patient
type |  | 1..1 | CodeableConcept | Description of identifier. It MUST contain a single instance of MR (Medical record number) Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: SS
name |  | 1..1 | HumanName | A name associated with the patient
Slices for extension |  |  |  | Content/Rules for all slices
extension:middle-name |  | 0..1 | string | SHINNY Name Extension URL: http://test.shinny.org/us/ny/hrsn/StructureDefinition/middle-name Binding Description: (extensible) ⚠: middle name
family |  | 1..1 | string | Family name (often called 'Surname')
given |  | 1..1 | string | Given names (not always 'first'). Includes middle names
birthDate |  | 1..1 | date | The date of birth for the individual
contact |  |  |  |
relationship |  | 0..* | CodeableConcept | The kind of relationship Binding: SHINNYRelationshipVS (extensible)
communication |  |  |  |
language |  |  |  |
Slices for extension |  |  |  | Content/Rules for all slices
extension:language |  | 0..* | code | SHINNY Languages URL: http://test.shinny.org/us/ny/hrsn/StructureDefinition/language Binding: SHINNYLanguageVS (preferred): language
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
Patient.language | preferred | SHINNYLanguageVS `http://test.shinny.org/us/ny/hrsn/ValueSet/SHINNYLanguageVS` From this IG
Patient.identifier.type | extensible | SHINNYIdentiferTypeVS `http://test.shinny.org/us/ny/hrsn/ValueSet/SHINNYIdentiferTypeVS` From this IG
Patient.contact.relationship | extensible | SHINNYRelationshipVS `http://test.shinny.org/us/ny/hrsn/ValueSet/SHINNYRelationshipVS` From this IG

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Patient |  | 0..* | USCorePatientProfile | Information about an individual or animal receiving health care services
id | S Σ | 1..1 | id | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
meta | S Σ | 1..1 | SHINNYMeta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: SHINNYLanguageVS (preferred)
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:race | S | 0..1 | (Complex) | US Core Race Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-race
extension:ethnicity | S | 0..1 | (Complex) | US Core ethnicity Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity
extension:birthsex | S | 0..1 | code | Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex Binding: Birth Sex (required): Code for sex assigned at birth
extension:pronouns |  | 0..* | CodeableConcept | SHINNY Personal Pronouns URL: http://test.shinny.org/us/ny/hrsn/StructureDefinition/shinny-personal-pronouns Binding: SHINNYPersonalPronounsVS (preferred): PersonalPronouns
extension:genderIdentity |  | 0..* | CodeableConcept | SHINNYGenderIdentityExtension URL: http://test.shinny.org/us/ny/hrsn/StructureDefinition/shinny-gender-identity Binding: Gender Identity (extensible): GenderIdentity
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for identifier | S Σ | 2..* | Identifier | An identifier for this patient Slice: Unordered, Open by pattern:type
identifier:All Slices |  |  |  | Content/Rules for all slices
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | S Σ | 1..1 | CodeableConcept | Description of identifier. It MUST contain a single instance of MR (Medical record number) Binding: SHINNYIdentiferTypeVS (extensible)
system | S Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique within the system. Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
identifier:MR | S Σ | 1..1 | Identifier | An identifier for this patient
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | S Σ | 1..1 | CodeableConcept | Description of identifier. It MUST contain a single instance of MR (Medical record number) Binding: SHINNYIdentiferTypeVS (extensible) Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: MR
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
system | S Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique within the system. Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | S Σ | 1..1 | Reference(Organization) | Organization that issued id (may be just text)
identifier:CMS | S Σ | 1..1 | Identifier | An identifier for this patient
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | S Σ | 1..1 | CodeableConcept | Description of identifier. It MUST contain a single instance of MR (Medical record number) Binding: SHINNYIdentiferTypeVS (extensible) Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: MA
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
system | S Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique within the system. Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
identifier:SSN | S Σ | 0..1 | Identifier | An identifier for this patient
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | S Σ | 1..1 | CodeableConcept | Description of identifier. It MUST contain a single instance of MR (Medical record number) Binding: SHINNYIdentiferTypeVS (extensible) Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: SS
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
system | S Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique within the system. Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
active | ?!Σ | 0..1 | boolean | Whether this patient's record is in active use
name | S Σ C | 1..1 | HumanName | A name associated with the patient Constraints: us-core-8
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:middle-name |  | 0..1 | string | SHINNY Name Extension URL: http://test.shinny.org/us/ny/hrsn/StructureDefinition/middle-name Binding Description: (extensible) ⚠: middle name
use | ?!Σ | 0..1 | code | usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
text | Σ | 0..1 | string | Text representation of the full name
family | S Σ C | 1..1 | string | Family name (often called 'Surname')
given | S Σ C | 1..1 | string | Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name
prefix | Σ | 0..* | string | Parts that come before the name This repeating element order: Prefixes appear in the correct order for presenting the name
suffix | Σ | 0..* | string | Parts that come after the name This repeating element order: Suffixes appear in the correct order for presenting the name
period | Σ | 0..1 | Period | Time period when name was/is in use
telecom | S Σ | 0..* | ContactPoint | A contact detail for the individual
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | S Σ C | 1..1 | code | phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value | S Σ | 1..1 | string | The actual contact point details
use | ?!S Σ | 0..1 | code | home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required)
rank | Σ | 0..1 | positiveInt | Specify preferred order of use (1 = highest)
period | Σ | 0..1 | Period | Time period when the contact point was/is in use
gender | S Σ | 1..1 | code | male | female | other | unknown Binding: AdministrativeGender (required)
birthDate | S Σ | 1..1 | date | The date of birth for the individual
deceased[x] | ?!Σ | 0..1 |  | Indicates if the individual is deceased or not
deceasedBoolean |  |  | boolean |
deceasedDateTime |  |  | dateTime |
address | S Σ | 0..* | Address | An address for the individual
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | home | work | temp | old | billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
type | Σ | 0..1 | code | postal | physical | both Binding: AddressType (required): The type of an address (physical / postal). Example General: both
text | Σ | 0..1 | string | Text representation of the address Example General: 137 Nowhere Street, Erewhon 9132
line | S Σ | 0..* | string | Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label Example General: 137 Nowhere Street
city | S Σ | 0..1 | string | Name of city, town etc. Example General: Erewhon
district | Σ | 0..1 | string | District name (aka county) Example General: Madison
state | S Σ | 0..1 | string | Sub-unit of country (abbreviations ok) Binding: USPS Two Letter Alphabetic Codes (extensible): Two Letter USPS alphabetic codes.
postalCode | S Σ | 0..1 | string | US Zip Codes Example General: 9132
country | Σ | 0..1 | string | Country (e.g. can be ISO 3166 2 or 3 letter code)
period | S Σ | 0..1 | Period | Time period when address was/is in use Example General: {"start":"2010-03-23","end":"2010-07-01"}
maritalStatus |  | 0..1 | CodeableConcept | Marital (civil) status of a patient Binding: Marital Status Codes (extensible): The domestic partnership status of a person.
multipleBirth[x] |  | 0..1 |  | Whether patient is part of a multiple birth
multipleBirthBoolean |  |  | boolean |
multipleBirthInteger |  |  | integer |
photo |  | 0..* | Attachment | Image of the patient
contact | C | 0..* | BackboneElement | A contact party (e.g. guardian, partner, friend) for the patient Constraints: pat-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
relationship |  | 0..* | CodeableConcept | The kind of relationship Binding: SHINNYRelationshipVS (extensible)
name |  | 0..1 | HumanName | A name associated with the contact person
telecom |  | 0..* | ContactPoint | A contact detail for the person
address |  | 0..1 | Address | Address for the contact person
gender |  | 0..1 | code | male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
organization | C | 0..1 | Reference(Organization) | Organization that is associated with the contact
period |  | 0..1 | Period | The period during which this contact person or organization is valid to be contacted relating to this patient
communication | S | 0..* | BackboneElement | A language which may be used to communicate with the patient about his or her health
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
language | S | 1..1 | CodeableConcept | The language which can be used to communicate with the patient about his or her health Binding: Language codes with language and optionally a region modifier (extensible)
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:language |  | 0..1 | code | SHINNY Languages URL: http://test.shinny.org/us/ny/hrsn/StructureDefinition/language Binding: SHINNYLanguageVS (preferred): language
coding | Σ | 0..* | Coding | Code defined by a terminology system
text | Σ | 0..1 | string | Plain text representation of the concept
preferred |  | 0..1 | boolean | Language preference indicator
generalPractitioner |  | 0..* | Reference(Organization | Practitioner | PractitionerRole) | Patient's nominated primary care provider
managingOrganization | Σ | 0..1 | Reference(Organization) | Organization that is the custodian of the patient record
link | ?!Σ | 0..* | BackboneElement | Link to another patient resource that concerns the same actual person
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
other | Σ | 1..1 | Reference(Patient | RelatedPerson) | The other patient or related person resource that the link refers to
type | Σ | 1..1 | code | replaced-by | replaces | refer | seealso Binding: LinkType (required): The type of link between this patient resource and another patient resource.
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
Patient.language | preferred | SHINNYLanguageVS `http://test.shinny.org/us/ny/hrsn/ValueSet/SHINNYLanguageVS` From this IG
Patient.identifier.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` From the FHIR Standard
Patient.identifier.type | extensible | SHINNYIdentiferTypeVS `http://test.shinny.org/us/ny/hrsn/ValueSet/SHINNYIdentiferTypeVS` From this IG
Patient.identifier:MR.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` From the FHIR Standard
Patient.identifier:MR.type | extensible | Pattern Value: MR `http://test.shinny.org/us/ny/hrsn/ValueSet/SHINNYIdentiferTypeVS` From this IG
Patient.identifier:CMS.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` From the FHIR Standard
Patient.identifier:CMS.type | extensible | Pattern Value: MA `http://test.shinny.org/us/ny/hrsn/ValueSet/SHINNYIdentiferTypeVS` From this IG
Patient.identifier:SSN.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` From the FHIR Standard
Patient.identifier:SSN.type | extensible | Pattern Value: SS `http://test.shinny.org/us/ny/hrsn/ValueSet/SHINNYIdentiferTypeVS` From this IG
Patient.name.use | required | NameUse `http://hl7.org/fhir/ValueSet/name-use|4.0.1` From the FHIR Standard
Patient.telecom.system | required | ContactPointSystem `http://hl7.org/fhir/ValueSet/contact-point-system` From the FHIR Standard
Patient.telecom.use | required | ContactPointUse `http://hl7.org/fhir/ValueSet/contact-point-use` From the FHIR Standard
Patient.gender | required | AdministrativeGender `http://hl7.org/fhir/ValueSet/administrative-gender` From the FHIR Standard
Patient.address.use | required | AddressUse `http://hl7.org/fhir/ValueSet/address-use|4.0.1` From the FHIR Standard
Patient.address.type | required | AddressType `http://hl7.org/fhir/ValueSet/address-type|4.0.1` From the FHIR Standard
Patient.address.state | extensible | UspsTwoLetterAlphabeticCodes `http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state`
Patient.maritalStatus | extensible | Marital Status Codes `http://hl7.org/fhir/ValueSet/marital-status` From the FHIR Standard
Patient.contact.relationship | extensible | SHINNYRelationshipVS `http://test.shinny.org/us/ny/hrsn/ValueSet/SHINNYRelationshipVS` From this IG
Patient.contact.gender | required | AdministrativeGender `http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1` From the FHIR Standard
Patient.communication.language | extensible | LanguageCodesWithLanguageAndOptionallyARegionModifier `http://hl7.org/fhir/us/core/ValueSet/simple-language`
Patient.link.type | required | LinkType `http://hl7.org/fhir/ValueSet/link-type|4.0.1` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | Patient | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Patient | 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 | error | Patient | 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 | error | Patient | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Patient | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
pat-1 | error | Patient.contact | 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() |
us-core-8 | error | Patient.name | Either Patient.name.given and/or Patient.name.family SHALL be present or a Data Absent Reason Extension SHALL be present. : (family.exists() or given.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists() |

This structure is derived from USCorePatientProfile

Summary

Mandatory: 9 elements
Must-Support: 4 elements

Structures

This structure refers to these other structures:

- SHINNYMeta (http://test.shinny.org/us/ny/hrsn/StructureDefinition/SHINNYMeta)

Extensions

This structure refers to these extensions:

- http://test.shinny.org/us/ny/hrsn/StructureDefinition/shinny-personal-pronouns
- http://test.shinny.org/us/ny/hrsn/StructureDefinition/shinny-gender-identity
- http://test.shinny.org/us/ny/hrsn/StructureDefinition/middle-name
- http://test.shinny.org/us/ny/hrsn/StructureDefinition/language

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Patient.identifier

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Patient |  | 0..* | USCorePatientProfile | Information about an individual or animal receiving health care services
id | S Σ | 1..1 | id | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
meta | S Σ | 1..1 | SHINNYMeta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: SHINNYLanguageVS (preferred)
Slices for extension |  |  |  | Content/Rules for all slices
extension:race | S | 0..1 | (Complex) | US Core Race Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-race
extension:ethnicity | S | 0..1 | (Complex) | US Core ethnicity Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity
extension:birthsex | S | 0..1 | code | Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex Binding: Birth Sex (required): Code for sex assigned at birth
extension:pronouns |  | 0..* | CodeableConcept | SHINNY Personal Pronouns URL: http://test.shinny.org/us/ny/hrsn/StructureDefinition/shinny-personal-pronouns Binding: SHINNYPersonalPronounsVS (preferred): PersonalPronouns
extension:genderIdentity |  | 0..* | CodeableConcept | SHINNYGenderIdentityExtension URL: http://test.shinny.org/us/ny/hrsn/StructureDefinition/shinny-gender-identity Binding: Gender Identity (extensible): GenderIdentity
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for identifier | S Σ | 2..* | Identifier | An identifier for this patient Slice: Unordered, Open by pattern:type
identifier:All Slices |  |  |  | Content/Rules for all slices
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | S Σ | 1..1 | CodeableConcept | Description of identifier. It MUST contain a single instance of MR (Medical record number) Binding: SHINNYIdentiferTypeVS (extensible)
system | S Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique within the system. Example General: 123456
identifier:MR | S Σ | 1..1 | Identifier | An identifier for this patient
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | S Σ | 1..1 | CodeableConcept | Description of identifier. It MUST contain a single instance of MR (Medical record number) Binding: SHINNYIdentiferTypeVS (extensible) Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: MR
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
system | S Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique within the system. Example General: 123456
assigner | S Σ | 1..1 | Reference(Organization) | Organization that issued id (may be just text)
identifier:CMS | S Σ | 1..1 | Identifier | An identifier for this patient
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | S Σ | 1..1 | CodeableConcept | Description of identifier. It MUST contain a single instance of MR (Medical record number) Binding: SHINNYIdentiferTypeVS (extensible) Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: MA
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
system | S Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique within the system. Example General: 123456
identifier:SSN | S Σ | 0..1 | Identifier | An identifier for this patient
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | S Σ | 1..1 | CodeableConcept | Description of identifier. It MUST contain a single instance of MR (Medical record number) Binding: SHINNYIdentiferTypeVS (extensible) Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: SS
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
system | S Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique within the system. Example General: 123456
active | ?!Σ | 0..1 | boolean | Whether this patient's record is in active use
name | S Σ C | 1..1 | HumanName | A name associated with the patient Constraints: us-core-8
Slices for extension |  |  |  | Content/Rules for all slices
extension:middle-name |  | 0..1 | string | SHINNY Name Extension URL: http://test.shinny.org/us/ny/hrsn/StructureDefinition/middle-name Binding Description: (extensible) ⚠: middle name
use | ?!Σ | 0..1 | code | usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
family | S Σ C | 1..1 | string | Family name (often called 'Surname')
given | S Σ C | 1..1 | string | Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name
telecom | S Σ | 0..* | ContactPoint | A contact detail for the individual
system | S Σ C | 1..1 | code | phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value | S Σ | 1..1 | string | The actual contact point details
use | ?!S Σ | 0..1 | code | home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required)
gender | S Σ | 1..1 | code | male | female | other | unknown Binding: AdministrativeGender (required)
birthDate | S Σ | 1..1 | date | The date of birth for the individual
deceased[x] | ?!Σ | 0..1 |  | Indicates if the individual is deceased or not
deceasedBoolean |  |  | boolean |
deceasedDateTime |  |  | dateTime |
address | S Σ | 0..* | Address | An address for the individual
use | ?!Σ | 0..1 | code | home | work | temp | old | billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
line | S Σ | 0..* | string | Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label Example General: 137 Nowhere Street
city | S Σ | 0..1 | string | Name of city, town etc. Example General: Erewhon
state | S Σ | 0..1 | string | Sub-unit of country (abbreviations ok) Binding: USPS Two Letter Alphabetic Codes (extensible): Two Letter USPS alphabetic codes.
postalCode | S Σ | 0..1 | string | US Zip Codes Example General: 9132
period | S Σ | 0..1 | Period | Time period when address was/is in use Example General: {"start":"2010-03-23","end":"2010-07-01"}
communication | S | 0..* | BackboneElement | A language which may be used to communicate with the patient about his or her health
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
language | S | 1..1 | CodeableConcept | The language which can be used to communicate with the patient about his or her health Binding: Language codes with language and optionally a region modifier (extensible)
Slices for extension |  |  |  | Content/Rules for all slices
extension:language |  | 0..1 | code | SHINNY Languages URL: http://test.shinny.org/us/ny/hrsn/StructureDefinition/language Binding: SHINNYLanguageVS (preferred): language
link | ?!Σ | 0..* | BackboneElement | Link to another patient resource that concerns the same actual person
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
other | Σ | 1..1 | Reference(Patient | RelatedPerson) | The other patient or related person resource that the link refers to
type | Σ | 1..1 | code | replaced-by | replaces | refer | seealso Binding: LinkType (required): The type of link between this patient resource and another patient resource.
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
Patient.language | preferred | SHINNYLanguageVS `http://test.shinny.org/us/ny/hrsn/ValueSet/SHINNYLanguageVS` From this IG
Patient.identifier.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` From the FHIR Standard
Patient.identifier.type | extensible | SHINNYIdentiferTypeVS `http://test.shinny.org/us/ny/hrsn/ValueSet/SHINNYIdentiferTypeVS` From this IG
Patient.identifier:MR.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` From the FHIR Standard
Patient.identifier:MR.type | extensible | Pattern Value: MR `http://test.shinny.org/us/ny/hrsn/ValueSet/SHINNYIdentiferTypeVS` From this IG
Patient.identifier:CMS.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` From the FHIR Standard
Patient.identifier:CMS.type | extensible | Pattern Value: MA `http://test.shinny.org/us/ny/hrsn/ValueSet/SHINNYIdentiferTypeVS` From this IG
Patient.identifier:SSN.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` From the FHIR Standard
Patient.identifier:SSN.type | extensible | Pattern Value: SS `http://test.shinny.org/us/ny/hrsn/ValueSet/SHINNYIdentiferTypeVS` From this IG
Patient.name.use | required | NameUse `http://hl7.org/fhir/ValueSet/name-use|4.0.1` From the FHIR Standard
Patient.telecom.system | required | ContactPointSystem `http://hl7.org/fhir/ValueSet/contact-point-system` From the FHIR Standard
Patient.telecom.use | required | ContactPointUse `http://hl7.org/fhir/ValueSet/contact-point-use` From the FHIR Standard
Patient.gender | required | AdministrativeGender `http://hl7.org/fhir/ValueSet/administrative-gender` From the FHIR Standard
Patient.address.use | required | AddressUse `http://hl7.org/fhir/ValueSet/address-use|4.0.1` From the FHIR Standard
Patient.address.state | extensible | UspsTwoLetterAlphabeticCodes `http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state`
Patient.communication.language | extensible | LanguageCodesWithLanguageAndOptionallyARegionModifier `http://hl7.org/fhir/us/core/ValueSet/simple-language`
Patient.link.type | required | LinkType `http://hl7.org/fhir/ValueSet/link-type|4.0.1` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | Patient | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Patient | 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 | error | Patient | 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 | error | Patient | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Patient | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
us-core-8 | error | Patient.name | Either Patient.name.given and/or Patient.name.family SHALL be present or a Data Absent Reason Extension SHALL be present. : (family.exists() or given.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists() |

Differential View

This structure is derived from USCorePatientProfile

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Patient |  |  | USCorePatientProfile |
id | S | 1..1 | id | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
meta | S | 1..1 | SHINNYMeta | Metadata about the resource
language |  | 0..1 | code | Language of the resource content Binding: SHINNYLanguageVS (preferred)
Slices for extension |  |  |  | Content/Rules for all slices
extension:pronouns |  | 0..* | CodeableConcept | SHINNY Personal Pronouns URL: http://test.shinny.org/us/ny/hrsn/StructureDefinition/shinny-personal-pronouns Binding: SHINNYPersonalPronounsVS (preferred): PersonalPronouns
extension:genderIdentity |  | 0..* | CodeableConcept | SHINNYGenderIdentityExtension URL: http://test.shinny.org/us/ny/hrsn/StructureDefinition/shinny-gender-identity Binding: Gender Identity (extensible): GenderIdentity
Slices for identifier |  | 2..* | Identifier | An identifier for this patient Slice: Unordered, Open by pattern:type
identifier:All Slices |  |  |  | Content/Rules for all slices
type | S | 1..1 | CodeableConcept | Description of identifier. It MUST contain a single instance of MR (Medical record number) Binding: SHINNYIdentiferTypeVS (extensible)
identifier:MR |  | 1..1 | Identifier | An identifier for this patient
type |  | 1..1 | CodeableConcept | Description of identifier. It MUST contain a single instance of MR (Medical record number) Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: MR
assigner | S | 1..1 | Reference(Organization) | Organization that issued id (may be just text)
identifier:CMS |  | 1..1 | Identifier | An identifier for this patient
type |  | 1..1 | CodeableConcept | Description of identifier. It MUST contain a single instance of MR (Medical record number) Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: MA
identifier:SSN |  | 0..1 | Identifier | An identifier for this patient
type |  | 1..1 | CodeableConcept | Description of identifier. It MUST contain a single instance of MR (Medical record number) Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: SS
name |  | 1..1 | HumanName | A name associated with the patient
Slices for extension |  |  |  | Content/Rules for all slices
extension:middle-name |  | 0..1 | string | SHINNY Name Extension URL: http://test.shinny.org/us/ny/hrsn/StructureDefinition/middle-name Binding Description: (extensible) ⚠: middle name
family |  | 1..1 | string | Family name (often called 'Surname')
given |  | 1..1 | string | Given names (not always 'first'). Includes middle names
birthDate |  | 1..1 | date | The date of birth for the individual
contact |  |  |  |
relationship |  | 0..* | CodeableConcept | The kind of relationship Binding: SHINNYRelationshipVS (extensible)
communication |  |  |  |
language |  |  |  |
Slices for extension |  |  |  | Content/Rules for all slices
extension:language |  | 0..* | code | SHINNY Languages URL: http://test.shinny.org/us/ny/hrsn/StructureDefinition/language Binding: SHINNYLanguageVS (preferred): language
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
Patient.language | preferred | SHINNYLanguageVS `http://test.shinny.org/us/ny/hrsn/ValueSet/SHINNYLanguageVS` From this IG
Patient.identifier.type | extensible | SHINNYIdentiferTypeVS `http://test.shinny.org/us/ny/hrsn/ValueSet/SHINNYIdentiferTypeVS` From this IG
Patient.contact.relationship | extensible | SHINNYRelationshipVS `http://test.shinny.org/us/ny/hrsn/ValueSet/SHINNYRelationshipVS` From this IG

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Patient |  | 0..* | USCorePatientProfile | Information about an individual or animal receiving health care services
id | S Σ | 1..1 | id | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
meta | S Σ | 1..1 | SHINNYMeta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: SHINNYLanguageVS (preferred)
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:race | S | 0..1 | (Complex) | US Core Race Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-race
extension:ethnicity | S | 0..1 | (Complex) | US Core ethnicity Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity
extension:birthsex | S | 0..1 | code | Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex Binding: Birth Sex (required): Code for sex assigned at birth
extension:pronouns |  | 0..* | CodeableConcept | SHINNY Personal Pronouns URL: http://test.shinny.org/us/ny/hrsn/StructureDefinition/shinny-personal-pronouns Binding: SHINNYPersonalPronounsVS (preferred): PersonalPronouns
extension:genderIdentity |  | 0..* | CodeableConcept | SHINNYGenderIdentityExtension URL: http://test.shinny.org/us/ny/hrsn/StructureDefinition/shinny-gender-identity Binding: Gender Identity (extensible): GenderIdentity
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for identifier | S Σ | 2..* | Identifier | An identifier for this patient Slice: Unordered, Open by pattern:type
identifier:All Slices |  |  |  | Content/Rules for all slices
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | S Σ | 1..1 | CodeableConcept | Description of identifier. It MUST contain a single instance of MR (Medical record number) Binding: SHINNYIdentiferTypeVS (extensible)
system | S Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique within the system. Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
identifier:MR | S Σ | 1..1 | Identifier | An identifier for this patient
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | S Σ | 1..1 | CodeableConcept | Description of identifier. It MUST contain a single instance of MR (Medical record number) Binding: SHINNYIdentiferTypeVS (extensible) Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: MR
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
system | S Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique within the system. Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | S Σ | 1..1 | Reference(Organization) | Organization that issued id (may be just text)
identifier:CMS | S Σ | 1..1 | Identifier | An identifier for this patient
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | S Σ | 1..1 | CodeableConcept | Description of identifier. It MUST contain a single instance of MR (Medical record number) Binding: SHINNYIdentiferTypeVS (extensible) Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: MA
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
system | S Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique within the system. Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
identifier:SSN | S Σ | 0..1 | Identifier | An identifier for this patient
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | S Σ | 1..1 | CodeableConcept | Description of identifier. It MUST contain a single instance of MR (Medical record number) Binding: SHINNYIdentiferTypeVS (extensible) Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: SS
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
system | S Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique within the system. Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
active | ?!Σ | 0..1 | boolean | Whether this patient's record is in active use
name | S Σ C | 1..1 | HumanName | A name associated with the patient Constraints: us-core-8
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:middle-name |  | 0..1 | string | SHINNY Name Extension URL: http://test.shinny.org/us/ny/hrsn/StructureDefinition/middle-name Binding Description: (extensible) ⚠: middle name
use | ?!Σ | 0..1 | code | usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
text | Σ | 0..1 | string | Text representation of the full name
family | S Σ C | 1..1 | string | Family name (often called 'Surname')
given | S Σ C | 1..1 | string | Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name
prefix | Σ | 0..* | string | Parts that come before the name This repeating element order: Prefixes appear in the correct order for presenting the name
suffix | Σ | 0..* | string | Parts that come after the name This repeating element order: Suffixes appear in the correct order for presenting the name
period | Σ | 0..1 | Period | Time period when name was/is in use
telecom | S Σ | 0..* | ContactPoint | A contact detail for the individual
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | S Σ C | 1..1 | code | phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value | S Σ | 1..1 | string | The actual contact point details
use | ?!S Σ | 0..1 | code | home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required)
rank | Σ | 0..1 | positiveInt | Specify preferred order of use (1 = highest)
period | Σ | 0..1 | Period | Time period when the contact point was/is in use
gender | S Σ | 1..1 | code | male | female | other | unknown Binding: AdministrativeGender (required)
birthDate | S Σ | 1..1 | date | The date of birth for the individual
deceased[x] | ?!Σ | 0..1 |  | Indicates if the individual is deceased or not
deceasedBoolean |  |  | boolean |
deceasedDateTime |  |  | dateTime |
address | S Σ | 0..* | Address | An address for the individual
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | home | work | temp | old | billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
type | Σ | 0..1 | code | postal | physical | both Binding: AddressType (required): The type of an address (physical / postal). Example General: both
text | Σ | 0..1 | string | Text representation of the address Example General: 137 Nowhere Street, Erewhon 9132
line | S Σ | 0..* | string | Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label Example General: 137 Nowhere Street
city | S Σ | 0..1 | string | Name of city, town etc. Example General: Erewhon
district | Σ | 0..1 | string | District name (aka county) Example General: Madison
state | S Σ | 0..1 | string | Sub-unit of country (abbreviations ok) Binding: USPS Two Letter Alphabetic Codes (extensible): Two Letter USPS alphabetic codes.
postalCode | S Σ | 0..1 | string | US Zip Codes Example General: 9132
country | Σ | 0..1 | string | Country (e.g. can be ISO 3166 2 or 3 letter code)
period | S Σ | 0..1 | Period | Time period when address was/is in use Example General: {"start":"2010-03-23","end":"2010-07-01"}
maritalStatus |  | 0..1 | CodeableConcept | Marital (civil) status of a patient Binding: Marital Status Codes (extensible): The domestic partnership status of a person.
multipleBirth[x] |  | 0..1 |  | Whether patient is part of a multiple birth
multipleBirthBoolean |  |  | boolean |
multipleBirthInteger |  |  | integer |
photo |  | 0..* | Attachment | Image of the patient
contact | C | 0..* | BackboneElement | A contact party (e.g. guardian, partner, friend) for the patient Constraints: pat-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
relationship |  | 0..* | CodeableConcept | The kind of relationship Binding: SHINNYRelationshipVS (extensible)
name |  | 0..1 | HumanName | A name associated with the contact person
telecom |  | 0..* | ContactPoint | A contact detail for the person
address |  | 0..1 | Address | Address for the contact person
gender |  | 0..1 | code | male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
organization | C | 0..1 | Reference(Organization) | Organization that is associated with the contact
period |  | 0..1 | Period | The period during which this contact person or organization is valid to be contacted relating to this patient
communication | S | 0..* | BackboneElement | A language which may be used to communicate with the patient about his or her health
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
language | S | 1..1 | CodeableConcept | The language which can be used to communicate with the patient about his or her health Binding: Language codes with language and optionally a region modifier (extensible)
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:language |  | 0..1 | code | SHINNY Languages URL: http://test.shinny.org/us/ny/hrsn/StructureDefinition/language Binding: SHINNYLanguageVS (preferred): language
coding | Σ | 0..* | Coding | Code defined by a terminology system
text | Σ | 0..1 | string | Plain text representation of the concept
preferred |  | 0..1 | boolean | Language preference indicator
generalPractitioner |  | 0..* | Reference(Organization | Practitioner | PractitionerRole) | Patient's nominated primary care provider
managingOrganization | Σ | 0..1 | Reference(Organization) | Organization that is the custodian of the patient record
link | ?!Σ | 0..* | BackboneElement | Link to another patient resource that concerns the same actual person
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
other | Σ | 1..1 | Reference(Patient | RelatedPerson) | The other patient or related person resource that the link refers to
type | Σ | 1..1 | code | replaced-by | replaces | refer | seealso Binding: LinkType (required): The type of link between this patient resource and another patient resource.
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
Patient.language | preferred | SHINNYLanguageVS `http://test.shinny.org/us/ny/hrsn/ValueSet/SHINNYLanguageVS` From this IG
Patient.identifier.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` From the FHIR Standard
Patient.identifier.type | extensible | SHINNYIdentiferTypeVS `http://test.shinny.org/us/ny/hrsn/ValueSet/SHINNYIdentiferTypeVS` From this IG
Patient.identifier:MR.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` From the FHIR Standard
Patient.identifier:MR.type | extensible | Pattern Value: MR `http://test.shinny.org/us/ny/hrsn/ValueSet/SHINNYIdentiferTypeVS` From this IG
Patient.identifier:CMS.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` From the FHIR Standard
Patient.identifier:CMS.type | extensible | Pattern Value: MA `http://test.shinny.org/us/ny/hrsn/ValueSet/SHINNYIdentiferTypeVS` From this IG
Patient.identifier:SSN.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` From the FHIR Standard
Patient.identifier:SSN.type | extensible | Pattern Value: SS `http://test.shinny.org/us/ny/hrsn/ValueSet/SHINNYIdentiferTypeVS` From this IG
Patient.name.use | required | NameUse `http://hl7.org/fhir/ValueSet/name-use|4.0.1` From the FHIR Standard
Patient.telecom.system | required | ContactPointSystem `http://hl7.org/fhir/ValueSet/contact-point-system` From the FHIR Standard
Patient.telecom.use | required | ContactPointUse `http://hl7.org/fhir/ValueSet/contact-point-use` From the FHIR Standard
Patient.gender | required | AdministrativeGender `http://hl7.org/fhir/ValueSet/administrative-gender` From the FHIR Standard
Patient.address.use | required | AddressUse `http://hl7.org/fhir/ValueSet/address-use|4.0.1` From the FHIR Standard
Patient.address.type | required | AddressType `http://hl7.org/fhir/ValueSet/address-type|4.0.1` From the FHIR Standard
Patient.address.state | extensible | UspsTwoLetterAlphabeticCodes `http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state`
Patient.maritalStatus | extensible | Marital Status Codes `http://hl7.org/fhir/ValueSet/marital-status` From the FHIR Standard
Patient.contact.relationship | extensible | SHINNYRelationshipVS `http://test.shinny.org/us/ny/hrsn/ValueSet/SHINNYRelationshipVS` From this IG
Patient.contact.gender | required | AdministrativeGender `http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1` From the FHIR Standard
Patient.communication.language | extensible | LanguageCodesWithLanguageAndOptionallyARegionModifier `http://hl7.org/fhir/us/core/ValueSet/simple-language`
Patient.link.type | required | LinkType `http://hl7.org/fhir/ValueSet/link-type|4.0.1` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | Patient | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Patient | 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 | error | Patient | 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 | error | Patient | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Patient | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
pat-1 | error | Patient.contact | 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() |
us-core-8 | error | Patient.name | Either Patient.name.given and/or Patient.name.family SHALL be present or a Data Absent Reason Extension SHALL be present. : (family.exists() or given.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists() |

This structure is derived from USCorePatientProfile

Summary

Mandatory: 9 elements
Must-Support: 4 elements

Structures

This structure refers to these other structures:

- SHINNYMeta (http://test.shinny.org/us/ny/hrsn/StructureDefinition/SHINNYMeta)

Extensions

This structure refers to these extensions:

- http://test.shinny.org/us/ny/hrsn/StructureDefinition/shinny-personal-pronouns
- http://test.shinny.org/us/ny/hrsn/StructureDefinition/shinny-gender-identity
- http://test.shinny.org/us/ny/hrsn/StructureDefinition/middle-name
- http://test.shinny.org/us/ny/hrsn/StructureDefinition/language

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Patient.identifier

Other representations of profile: CSV, Excel, Schematron