Implementation Guide
ePA Basisfunktionalitäten
Version 1.1.5 - release

Resource Profile: EPAPatient - Detailed Descriptions

Active as of 2025-05-28

Definitions for the epa-patient resource profile.

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

0. Patient
Definition

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

ShortInformation about an individual or animal receiving health care services
Control0..*
Is Modifierfalse
Summaryfalse
Alternate NamesSubjectOfCare Client Resident
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
pat-de-1: Die amtliche Differenzierung der Geschlechtsangabe 'other' darf nur gefüllt sein, wenn das Geschlecht 'other' angegeben ist (gender.exists() and gender='other' implies gender.extension('http://fhir.de/StructureDefinition/gender-amtlich-de').exists())
2. Patient.id
Definition

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

ShortLogical id of this artifact
Comments

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

Control0..1
Typeidstring
Is Modifierfalse
Must Supporttrue
Summarytrue
4. Patient.meta
Definition

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

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

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

ShortVersion specific identifier
Comments

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

Control0..1
Typeid
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. Patient.meta.lastUpdated
Definition

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

ShortWhen the resource version last changed
Comments

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

Control0..1
Typeinstant
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. 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()))
12. 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())
14. Patient.identifier
Definition

An identifier for this patient.

ShortAn identifier for this patient
NoteThis is a business identifier, not a resource identifier (see discussion)
Control10..*
TypeIdentifier
Is Modifierfalse
Must Supporttrue
Summarytrue
Requirements

Patients are almost always assigned specific numerical identifiers.

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

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


    An identifier for this patient.

    ShortAn identifier intended for computationAn identifier for this patient
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control10..1*
    This element is affected by the following invariants: ele-1
    TypeIdentifier(Identifier-Profil für die 10-stellige Krankenversichertennummer)
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    Patients are almost always assigned specific numerical identifiers.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    18. 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
    Must Supporttrue
    Summarytrue
    Requirements

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

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

    A name associated with the individual.

    ShortA name associated with the patient
    Comments

    Um die Unterscheidung der Namensbestandteile gemäß dem VSDM-Datensatz beizubehalten oder Präfixe als akademische Titel zu qualifizieren, können Anbieter die im deutschen HumanName-Basisprofil spezifizierten Erweiterungen unterstützen: HumanName DE Basis (https://simplifier.net/basisprofil-de-r4/humannamedebasis).

    Dies ist jedoch nicht verpflichtend im Rahmen dieser Spezifikation.


    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..*
    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()))
    SlicingThis element introduces a set of slices on Patient.name. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ $this
    • 22. Patient.name:Name
      Slice NameName
      Definition

      Personenname mit in Deutschland üblichen Erweiterungen


      A name associated with the individual.

      ShortPersonennameA name associated with the patient
      Comments

      Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts may or may not be imbued with some implicit meaning; various cultures associate different importance with the name parts and the degree to which systems must care about name parts around the world varies widely.


      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*
      This element is affected by the following invariants: ele-1
      TypeHumanName(HumanName, deutsches Basisprofil)
      Is Modifierfalse
      Must Supporttrue
      Standard StatusNormative (from Normative)
      Summarytrue
      Requirements

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

      Pattern Value{
        "use" : "official"
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      hum-1: Wenn die Extension 'namenszusatz' verwendet wird, dann muss der vollständige Name im Attribut 'family' angegeben werden (family.extension('http://fhir.de/StructureDefinition/humanname-namenszusatz').empty() or family.hasValue())
      hum-2: Wenn die Extension 'nachname' verwendet wird, dann muss der vollständige Name im Attribut 'family' angegeben werden (family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-name').empty() or family.hasValue())
      hum-3: Wenn die Extension 'vorsatzwort' verwendet wird, dann muss der vollständige Name im Attribut 'family' angegeben werden (family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-prefix').empty() or family.hasValue())
      hum-4: Wenn die Extension 'prefix-qualifier' verwendet wird, dann muss ein Namenspräfix im Attribut 'prefix' angegeben werden (prefix.all($this.extension('http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier').empty() or $this.hasValue()))
      24. Patient.name:Name.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
      Must Supporttrue
      Summarytrue
      Requirements

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

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

      Der vollständige Familienname, einschließlich aller Vorsatz- und Zusatzwörter, mit Leerzeichen getrennt.


      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.

      ShortFamiliennameFamily 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()))
      28. Patient.name:Name.family.extension:namenszusatz
      Slice Namenamenszusatz
      Definition

      Namenszusatz als Bestandteil das Nachnamens, wie in VSDM (Versichertenstammdatenmanagement, "eGK") definiert. Beispiele: Gräfin, Prinz oder Fürst

      ShortNamenszusatz gemäß VSDM (Versichertenstammdatenmanagement, "eGK")
      Comments

      Die Extension wurde erstellt aufgrund der Anforderung, die auf der eGK vorhandenen Patientenstammdaten in FHIR abbilden zu können. Auf der eGK werden die Namensbestandteile "Namenszusatz" und "Vorsatzwort" getrennt vom Nachnamen gespeichert. Anhand der Liste der zulässigen Namenszusätze ist deutlich erkennbar, dass es sich hierbei sinngemäß um Adelstitel handelt. Das Vorsatzwort kann durch die Core-Extension own-prefix (Canonical: http://hl7.org/fhir/StructureDefinition/humanname-own-prefix) abgebildet werden, für den Namenszusatz ergibt sich jedoch die Notwendikeit einer nationalen Extension, da in andern Ländern Adelstitel entweder gar nicht oder als reguläres Namenspräfix erfasst werden.

      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(Extension zur Erfassung der VSDM Namensbestandteile) (Extension Type: string)
      Is Modifierfalse
      Must Supporttrue
      Standard StatusNormative (from Normative)
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      30. Patient.name:Name.family.extension:nachname
      Slice Namenachname
      Definition

      Nachname ohne Vor- und Zusätze. Dient z.B. der alphabetischen Einordnung des Namens.

      ShortNachname ohne Vor- und Zusätze
      Comments

      If the person's surname has legally changed to become (or incorporate) the surname of the person's partner or spouse, this is the person's surname immediately prior to such change. Often this is the person's "maiden name".

      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(Own Name) (Extension Type: string)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      32. Patient.name:Name.family.extension:vorsatzwort
      Slice Namevorsatzwort
      Definition

      Vorsatzwort wie z.B.: von, van, zu Vgl. auch VSDM-Spezifikation der Gematik (Versichertenstammdatenmanagement, "eGK")

      ShortVorsatzwort
      Comments

      An example of a voorvoegsel is the "van" in "Ludwig van Beethoven". Since the voorvoegsel doesn't sort completely alphabetically, it is reasonable to specify it as a separate sub-component.

      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(Own Prefix) (Extension Type: string)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      34. Patient.name:Name.given
      Definition

      Vorname der Person


      Given name.

      ShortVornameGiven 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()))
      36. Patient.name:Name.prefix
      Definition

      Namensteile vor dem Vornamen, z.B. akademischer Titel.


      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.

      ShortNamensteile vor dem VornamenParts that come before the name
      Control0..*
      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()))
      38. Patient.name:Name.prefix.extension:prefix-qualifier
      Slice Nameprefix-qualifier
      Definition

      Spezialisierung der Art des Präfixes, z.B. "AC" für Akademische Titel

      ShortLS | AC | NB | PR | HON | BR | AD | SP | MID | CL | IN | VV
      Comments

      Used to indicate additional information about the name part and how it should be used.

      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(EN Qualifier) (Extension Type: code)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      40. Patient.name:Name.prefix.extension:prefix-qualifier.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.name.prefix.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 42. Patient.name:Name.prefix.extension:prefix-qualifier.url
        Definition

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

        Shortidentifies the meaning of the extension
        Comments

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

        Control1..1
        Typeuri
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        Fixed Valuehttp://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier
        44. Patient.name:Name.prefix.extension:prefix-qualifier.value[x]
        Definition

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


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

        ShortValue of extension
        Control10..1
        BindingThe codes SHALL be taken from For codes, see EntityNamePartQualifier
        (required to http://hl7.org/fhir/ValueSet/name-part-qualifier|4.0.1)

        A set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type.

        Typecode, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Fixed ValueAC
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        46. Patient.name:Geburtsname
        Slice NameGeburtsname
        Definition

        Personenname mit in Deutschland üblichen Erweiterungen


        A name associated with the individual.

        ShortPersonennameA name associated with the patient
        Comments

        Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts may or may not be imbued with some implicit meaning; various cultures associate different importance with the name parts and the degree to which systems must care about name parts around the world varies widely.


        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*
        This element is affected by the following invariants: ele-1
        TypeHumanName(HumanName, deutsches Basisprofil)
        Is Modifierfalse
        Must Supporttrue
        Standard StatusNormative (from Normative)
        Summarytrue
        Requirements

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

        Pattern Value{
          "use" : "maiden"
        }
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        hum-1: Wenn die Extension 'namenszusatz' verwendet wird, dann muss der vollständige Name im Attribut 'family' angegeben werden (family.extension('http://fhir.de/StructureDefinition/humanname-namenszusatz').empty() or family.hasValue())
        hum-2: Wenn die Extension 'nachname' verwendet wird, dann muss der vollständige Name im Attribut 'family' angegeben werden (family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-name').empty() or family.hasValue())
        hum-3: Wenn die Extension 'vorsatzwort' verwendet wird, dann muss der vollständige Name im Attribut 'family' angegeben werden (family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-prefix').empty() or family.hasValue())
        hum-4: Wenn die Extension 'prefix-qualifier' verwendet wird, dann muss ein Namenspräfix im Attribut 'prefix' angegeben werden (prefix.all($this.extension('http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier').empty() or $this.hasValue()))
        48. Patient.name:Geburtsname.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
        Must Supporttrue
        Summarytrue
        Requirements

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

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

        Der vollständige Familienname, einschließlich aller Vorsatz- und Zusatzwörter, mit Leerzeichen getrennt.


        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.

        ShortFamiliennameFamily 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()))
        52. Patient.name:Geburtsname.family.extension:namenszusatz
        Slice Namenamenszusatz
        Definition

        Namenszusatz als Bestandteil das Nachnamens, wie in VSDM (Versichertenstammdatenmanagement, "eGK") definiert. Beispiele: Gräfin, Prinz oder Fürst

        ShortNamenszusatz gemäß VSDM (Versichertenstammdatenmanagement, "eGK")
        Comments

        Die Extension wurde erstellt aufgrund der Anforderung, die auf der eGK vorhandenen Patientenstammdaten in FHIR abbilden zu können. Auf der eGK werden die Namensbestandteile "Namenszusatz" und "Vorsatzwort" getrennt vom Nachnamen gespeichert. Anhand der Liste der zulässigen Namenszusätze ist deutlich erkennbar, dass es sich hierbei sinngemäß um Adelstitel handelt. Das Vorsatzwort kann durch die Core-Extension own-prefix (Canonical: http://hl7.org/fhir/StructureDefinition/humanname-own-prefix) abgebildet werden, für den Namenszusatz ergibt sich jedoch die Notwendikeit einer nationalen Extension, da in andern Ländern Adelstitel entweder gar nicht oder als reguläres Namenspräfix erfasst werden.

        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(Extension zur Erfassung der VSDM Namensbestandteile) (Extension Type: string)
        Is Modifierfalse
        Must Supporttrue
        Standard StatusNormative (from Normative)
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        54. Patient.name:Geburtsname.family.extension:nachname
        Slice Namenachname
        Definition

        Nachname ohne Vor- und Zusätze. Dient z.B. der alphabetischen Einordnung des Namens.

        ShortNachname ohne Vor- und Zusätze
        Comments

        If the person's surname has legally changed to become (or incorporate) the surname of the person's partner or spouse, this is the person's surname immediately prior to such change. Often this is the person's "maiden name".

        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(Own Name) (Extension Type: string)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        56. Patient.name:Geburtsname.family.extension:vorsatzwort
        Slice Namevorsatzwort
        Definition

        Vorsatzwort wie z.B.: von, van, zu Vgl. auch VSDM-Spezifikation der Gematik (Versichertenstammdatenmanagement, "eGK")

        ShortVorsatzwort
        Comments

        An example of a voorvoegsel is the "van" in "Ludwig van Beethoven". Since the voorvoegsel doesn't sort completely alphabetically, it is reasonable to specify it as a separate sub-component.

        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(Own Prefix) (Extension Type: string)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        58. Patient.name:Geburtsname.given
        Definition

        Vorname der Person


        Given name.

        ShortVornameGiven 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.

        Control0..0*
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Alternate Namesfirst name, middle name
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        60. Patient.name:Geburtsname.prefix
        Definition

        Namensteile vor dem Vornamen, z.B. akademischer Titel.


        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.

        ShortNamensteile vor dem VornamenParts that come before the name
        Control0..0*
        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()))
        63. Patient.name:Geburtsname.suffix
        Definition

        Namensteile nach dem Nachnamen


        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.

        ShortNamensteile nach dem NachnamenParts that come after the name
        Control0..0*
        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()))
        65. 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 AdministrativeGenderhttp://hl7.org/fhir/ValueSet/administrative-gender|4.0.1
        (required to http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1)

        The gender of a person used for administrative purposes.

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

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

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        67. Patient.gender.extension:other-amtlich
        Slice Nameother-amtlich
        Definition

        Optional Extension Element - found in all resources.

        ShortOptional Extensions Element
        Comments

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

        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(Differenzierung des administrativen Geschlechts 'other') (Extension Type: Coding)
        Is Modifierfalse
        Standard StatusNormative (from Normative)
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        69. Patient.birthDate
        Definition

        The date of birth for the individual.

        ShortThe 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.

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

        Indicates if the individual is deceased or not.

        ShortIndicates if the individual is deceased or not
        Comments

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

        Control0..1
        TypeChoice of: boolean, dateTime
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifiertrue because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

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

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

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

        ShortLink to another patient resource that concerns the same actual person
        Comments

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

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

        There are multiple use cases:

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

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

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

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

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

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

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

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

        The other patient resource that the link refers to.

        ShortThe other patient or related person resource that the link refers to
        Comments

        Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.

        Control1..1
        TypeReference(Patient, RelatedPerson)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        79. Patient.link.type
        Definition

        The type of link between this patient resource and another patient resource.

        Shortreplaced-by | replaces | refer | seealso
        Control1..1
        BindingThe codes SHALL be taken from LinkTypehttp://hl7.org/fhir/ValueSet/link-type|4.0.1
        (required to http://hl7.org/fhir/ValueSet/link-type|4.0.1)

        The type of link between this patient resource and another patient resource.

        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

        0. Patient
        2. Patient.identifier
        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control1..?
        4. Patient.identifier:KVNR
        Slice NameKVNR
        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control1..?

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

        0. Patient
        Definition

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

        ShortInformation about an individual or animal receiving health care services
        Control0..*
        Is Modifierfalse
        Summaryfalse
        Alternate NamesSubjectOfCare Client Resident
        Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
        dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
        dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
        dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
        dom-6: A resource should have narrative for robust management (text.`div`.exists())
        pat-de-1: Die amtliche Differenzierung der Geschlechtsangabe 'other' darf nur gefüllt sein, wenn das Geschlecht 'other' angegeben ist (gender.exists() and gender='other' implies gender.extension('http://fhir.de/StructureDefinition/gender-amtlich-de').exists())
        2. Patient.id
        Definition

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

        ShortLogical id of this artifact
        Comments

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

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

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

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

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

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

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

        ShortAdditional content defined by implementations
        Comments

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

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

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

          ShortVersion specific identifier
          Comments

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

          Control0..1
          Typeid
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          12. Patient.meta.lastUpdated
          Definition

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

          ShortWhen the resource version last changed
          Comments

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

          Control0..1
          Typeinstant
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          14. Patient.meta.source
          Definition

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

          ShortIdentifies where the resource comes from
          Comments

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

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

          Control0..1
          Typeuri
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          16. Patient.meta.profile
          Definition

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

          ShortProfiles this resource claims to conform to
          Comments

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

          Control0..*
          Typecanonical(StructureDefinition)
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          18. Patient.meta.security
          Definition

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

          ShortSecurity Labels applied to this resource
          Comments

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

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

          Security Labels from the Healthcare Privacy and Security Classification System.

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

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

          ShortTags applied to this resource
          Comments

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

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

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

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

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

          ShortA set of rules under which this content was created
          Comments

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

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

          The base language in which the resource is written.

          ShortLanguage of the resource content
          Comments

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

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

          A human language.

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

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

          ShortText summary of the resource, for human interpretation
          Comments

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

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

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

          ShortContained, inline Resources
          Comments

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

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

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

          ShortAdditional content defined by implementations
          Comments

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

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

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

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

          ShortExtensions that cannot be ignored
          Comments

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

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

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

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

          An identifier for this patient.

          ShortAn identifier for this patient
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control1..*
          TypeIdentifier
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Requirements

          Patients are almost always assigned specific numerical identifiers.

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

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

            ShortAn identifier intended for computation
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control1..1
            This element is affected by the following invariants: ele-1
            TypeIdentifier(Identifier-Profil für die 10-stellige Krankenversichertennummer)
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Patients are almost always assigned specific numerical identifiers.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            38. 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
            Must Supporttrue
            Summarytrue
            Requirements

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

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

            A name associated with the individual.

            ShortA name associated with the patient
            Comments

            Um die Unterscheidung der Namensbestandteile gemäß dem VSDM-Datensatz beizubehalten oder Präfixe als akademische Titel zu qualifizieren, können Anbieter die im deutschen HumanName-Basisprofil spezifizierten Erweiterungen unterstützen: HumanName DE Basis (https://simplifier.net/basisprofil-de-r4/humannamedebasis).

            Dies ist jedoch nicht verpflichtend im Rahmen dieser Spezifikation.

            Control1..*
            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()))
            SlicingThis element introduces a set of slices on Patient.name. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ $this
            • 42. Patient.name:Name
              Slice NameName
              Definition

              Personenname mit in Deutschland üblichen Erweiterungen

              ShortPersonenname
              Comments

              Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts may or may not be imbued with some implicit meaning; various cultures associate different importance with the name parts and the degree to which systems must care about name parts around the world varies widely.

              Control1..1
              This element is affected by the following invariants: ele-1
              TypeHumanName(HumanName, deutsches Basisprofil)
              Is Modifierfalse
              Must Supporttrue
              Standard StatusNormative (from Normative)
              Summarytrue
              Requirements

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

              Pattern Value{
                "use" : "official"
              }
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              hum-1: Wenn die Extension 'namenszusatz' verwendet wird, dann muss der vollständige Name im Attribut 'family' angegeben werden (family.extension('http://fhir.de/StructureDefinition/humanname-namenszusatz').empty() or family.hasValue())
              hum-2: Wenn die Extension 'nachname' verwendet wird, dann muss der vollständige Name im Attribut 'family' angegeben werden (family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-name').empty() or family.hasValue())
              hum-3: Wenn die Extension 'vorsatzwort' verwendet wird, dann muss der vollständige Name im Attribut 'family' angegeben werden (family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-prefix').empty() or family.hasValue())
              hum-4: Wenn die Extension 'prefix-qualifier' verwendet wird, dann muss ein Namenspräfix im Attribut 'prefix' angegeben werden (prefix.all($this.extension('http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier').empty() or $this.hasValue()))
              44. Patient.name:Name.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
              46. Patient.name:Name.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
              • 48. Patient.name:Name.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
                Must Supporttrue
                Summarytrue
                Requirements

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

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

                Der vollständige Familienname, einschließlich aller Vorsatz- und Zusatzwörter, mit Leerzeichen getrennt.

                ShortFamilienname
                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()))
                54. Patient.name:Name.family.id
                Definition

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

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

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

                ShortAdditional content defined by implementations
                Comments

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

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

                  Namenszusatz als Bestandteil das Nachnamens, wie in VSDM (Versichertenstammdatenmanagement, "eGK") definiert. Beispiele: Gräfin, Prinz oder Fürst

                  ShortNamenszusatz gemäß VSDM (Versichertenstammdatenmanagement, "eGK")
                  Comments

                  Die Extension wurde erstellt aufgrund der Anforderung, die auf der eGK vorhandenen Patientenstammdaten in FHIR abbilden zu können. Auf der eGK werden die Namensbestandteile "Namenszusatz" und "Vorsatzwort" getrennt vom Nachnamen gespeichert. Anhand der Liste der zulässigen Namenszusätze ist deutlich erkennbar, dass es sich hierbei sinngemäß um Adelstitel handelt. Das Vorsatzwort kann durch die Core-Extension own-prefix (Canonical: http://hl7.org/fhir/StructureDefinition/humanname-own-prefix) abgebildet werden, für den Namenszusatz ergibt sich jedoch die Notwendikeit einer nationalen Extension, da in andern Ländern Adelstitel entweder gar nicht oder als reguläres Namenspräfix erfasst werden.

                  Control0..1
                  This element is affected by the following invariants: ele-1
                  TypeExtension(Extension zur Erfassung der VSDM Namensbestandteile) (Extension Type: string)
                  Is Modifierfalse
                  Must Supporttrue
                  Standard StatusNormative (from Normative)
                  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())
                  60. Patient.name:Name.family.extension:nachname
                  Slice Namenachname
                  Definition

                  Nachname ohne Vor- und Zusätze. Dient z.B. der alphabetischen Einordnung des Namens.

                  ShortNachname ohne Vor- und Zusätze
                  Comments

                  If the person's surname has legally changed to become (or incorporate) the surname of the person's partner or spouse, this is the person's surname immediately prior to such change. Often this is the person's "maiden name".

                  Control0..1
                  This element is affected by the following invariants: ele-1
                  TypeExtension(Own Name) (Extension Type: string)
                  Is Modifierfalse
                  Must Supporttrue
                  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())
                  62. Patient.name:Name.family.extension:vorsatzwort
                  Slice Namevorsatzwort
                  Definition

                  Vorsatzwort wie z.B.: von, van, zu Vgl. auch VSDM-Spezifikation der Gematik (Versichertenstammdatenmanagement, "eGK")

                  ShortVorsatzwort
                  Comments

                  An example of a voorvoegsel is the "van" in "Ludwig van Beethoven". Since the voorvoegsel doesn't sort completely alphabetically, it is reasonable to specify it as a separate sub-component.

                  Control0..1
                  This element is affected by the following invariants: ele-1
                  TypeExtension(Own Prefix) (Extension Type: string)
                  Is Modifierfalse
                  Must Supporttrue
                  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())
                  64. Patient.name:Name.family.value
                  Definition

                  The actual value

                  ShortPrimitive value for string
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  Max Length:1048576
                  66. Patient.name:Name.given
                  Definition

                  Vorname der Person

                  ShortVorname
                  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()))
                  68. Patient.name:Name.prefix
                  Definition

                  Namensteile vor dem Vornamen, z.B. akademischer Titel.

                  ShortNamensteile vor dem Vornamen
                  Control0..*
                  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()))
                  70. Patient.name:Name.prefix.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
                  72. Patient.name:Name.prefix.extension
                  Definition

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

                  ShortAdditional content defined by implementations
                  Comments

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

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

                    Spezialisierung der Art des Präfixes, z.B. "AC" für Akademische Titel

                    ShortLS | AC | NB | PR | HON | BR | AD | SP | MID | CL | IN | VV
                    Comments

                    Used to indicate additional information about the name part and how it should be used.

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeExtension(EN Qualifier) (Extension Type: code)
                    Is Modifierfalse
                    Must Supporttrue
                    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())
                    76. Patient.name:Name.prefix.extension:prefix-qualifier.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
                    78. Patient.name:Name.prefix.extension:prefix-qualifier.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.name.prefix.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 80. Patient.name:Name.prefix.extension:prefix-qualifier.url
                      Definition

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

                      Shortidentifies the meaning of the extension
                      Comments

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

                      Control1..1
                      Typeuri
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      Fixed Valuehttp://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier
                      82. Patient.name:Name.prefix.extension:prefix-qualifier.value[x]
                      Definition

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

                      ShortValue of extension
                      Control1..1
                      BindingThe codes SHALL be taken from EntityNamePartQualifier
                      (required to http://hl7.org/fhir/ValueSet/name-part-qualifier|4.0.1)

                      A set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type.

                      Typecode
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summaryfalse
                      Fixed ValueAC
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      84. Patient.name:Name.prefix.value
                      Definition

                      The actual value

                      ShortPrimitive value for string
                      Control0..1
                      Typestring
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      Max Length:1048576
                      86. Patient.name:Name.suffix
                      Definition

                      Namensteile nach dem Nachnamen

                      ShortNamensteile nach dem Nachnamen
                      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()))
                      88. Patient.name:Name.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()))
                      90. Patient.name:Geburtsname
                      Slice NameGeburtsname
                      Definition

                      Personenname mit in Deutschland üblichen Erweiterungen

                      ShortPersonenname
                      Comments

                      Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts may or may not be imbued with some implicit meaning; various cultures associate different importance with the name parts and the degree to which systems must care about name parts around the world varies widely.

                      Control0..1
                      This element is affected by the following invariants: ele-1
                      TypeHumanName(HumanName, deutsches Basisprofil)
                      Is Modifierfalse
                      Must Supporttrue
                      Standard StatusNormative (from Normative)
                      Summarytrue
                      Requirements

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

                      Pattern Value{
                        "use" : "maiden"
                      }
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      hum-1: Wenn die Extension 'namenszusatz' verwendet wird, dann muss der vollständige Name im Attribut 'family' angegeben werden (family.extension('http://fhir.de/StructureDefinition/humanname-namenszusatz').empty() or family.hasValue())
                      hum-2: Wenn die Extension 'nachname' verwendet wird, dann muss der vollständige Name im Attribut 'family' angegeben werden (family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-name').empty() or family.hasValue())
                      hum-3: Wenn die Extension 'vorsatzwort' verwendet wird, dann muss der vollständige Name im Attribut 'family' angegeben werden (family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-prefix').empty() or family.hasValue())
                      hum-4: Wenn die Extension 'prefix-qualifier' verwendet wird, dann muss ein Namenspräfix im Attribut 'prefix' angegeben werden (prefix.all($this.extension('http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier').empty() or $this.hasValue()))
                      92. Patient.name:Geburtsname.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
                      94. Patient.name:Geburtsname.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
                      • 96. Patient.name:Geburtsname.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
                        Must Supporttrue
                        Summarytrue
                        Requirements

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

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

                        Der vollständige Familienname, einschließlich aller Vorsatz- und Zusatzwörter, mit Leerzeichen getrennt.

                        ShortFamilienname
                        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()))
                        102. Patient.name:Geburtsname.family.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
                        104. Patient.name:Geburtsname.family.extension
                        Definition

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

                        ShortAdditional content defined by implementations
                        Comments

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

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

                          Namenszusatz als Bestandteil das Nachnamens, wie in VSDM (Versichertenstammdatenmanagement, "eGK") definiert. Beispiele: Gräfin, Prinz oder Fürst

                          ShortNamenszusatz gemäß VSDM (Versichertenstammdatenmanagement, "eGK")
                          Comments

                          Die Extension wurde erstellt aufgrund der Anforderung, die auf der eGK vorhandenen Patientenstammdaten in FHIR abbilden zu können. Auf der eGK werden die Namensbestandteile "Namenszusatz" und "Vorsatzwort" getrennt vom Nachnamen gespeichert. Anhand der Liste der zulässigen Namenszusätze ist deutlich erkennbar, dass es sich hierbei sinngemäß um Adelstitel handelt. Das Vorsatzwort kann durch die Core-Extension own-prefix (Canonical: http://hl7.org/fhir/StructureDefinition/humanname-own-prefix) abgebildet werden, für den Namenszusatz ergibt sich jedoch die Notwendikeit einer nationalen Extension, da in andern Ländern Adelstitel entweder gar nicht oder als reguläres Namenspräfix erfasst werden.

                          Control0..1
                          This element is affected by the following invariants: ele-1
                          TypeExtension(Extension zur Erfassung der VSDM Namensbestandteile) (Extension Type: string)
                          Is Modifierfalse
                          Must Supporttrue
                          Standard StatusNormative (from Normative)
                          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())
                          108. Patient.name:Geburtsname.family.extension:nachname
                          Slice Namenachname
                          Definition

                          Nachname ohne Vor- und Zusätze. Dient z.B. der alphabetischen Einordnung des Namens.

                          ShortNachname ohne Vor- und Zusätze
                          Comments

                          If the person's surname has legally changed to become (or incorporate) the surname of the person's partner or spouse, this is the person's surname immediately prior to such change. Often this is the person's "maiden name".

                          Control0..1
                          This element is affected by the following invariants: ele-1
                          TypeExtension(Own Name) (Extension Type: string)
                          Is Modifierfalse
                          Must Supporttrue
                          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())
                          110. Patient.name:Geburtsname.family.extension:vorsatzwort
                          Slice Namevorsatzwort
                          Definition

                          Vorsatzwort wie z.B.: von, van, zu Vgl. auch VSDM-Spezifikation der Gematik (Versichertenstammdatenmanagement, "eGK")

                          ShortVorsatzwort
                          Comments

                          An example of a voorvoegsel is the "van" in "Ludwig van Beethoven". Since the voorvoegsel doesn't sort completely alphabetically, it is reasonable to specify it as a separate sub-component.

                          Control0..1
                          This element is affected by the following invariants: ele-1
                          TypeExtension(Own Prefix) (Extension Type: string)
                          Is Modifierfalse
                          Must Supporttrue
                          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())
                          112. Patient.name:Geburtsname.family.value
                          Definition

                          The actual value

                          ShortPrimitive value for string
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          Max Length:1048576
                          114. Patient.name:Geburtsname.given
                          Definition

                          Vorname der Person

                          ShortVorname
                          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.

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

                          Namensteile vor dem Vornamen, z.B. akademischer Titel.

                          ShortNamensteile vor dem Vornamen
                          Control0..0
                          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()))
                          122. Patient.name:Geburtsname.suffix
                          Definition

                          Namensteile nach dem Nachnamen

                          ShortNamensteile nach dem Nachnamen
                          Control0..0
                          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()))
                          124. Patient.name:Geburtsname.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()))
                          126. Patient.telecom
                          Definition

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

                          ShortA contact detail for the individual
                          Comments

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

                          Control0..*
                          TypeContactPoint
                          Is Modifierfalse
                          Summarytrue
                          Requirements

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

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          128. 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
                          Must Supporttrue
                          Summarytrue
                          Requirements

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

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

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

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

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

                          ShortAdditional content defined by implementations
                          Comments

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

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

                            Optional Extension Element - found in all resources.

                            ShortOptional Extensions Element
                            Comments

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

                            Control0..1
                            This element is affected by the following invariants: ele-1
                            TypeExtension(Differenzierung des administrativen Geschlechts 'other') (Extension Type: Coding)
                            Is Modifierfalse
                            Standard StatusNormative (from Normative)
                            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())
                            136. Patient.gender.value
                            Definition

                            Primitive value for code

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

                            The date of birth for the individual.

                            ShortThe 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).

                            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.

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

                            Indicates if the individual is deceased or not.

                            ShortIndicates if the individual is deceased or not
                            Comments

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

                            Control0..1
                            TypeChoice of: boolean, dateTime
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            Is Modifiertrue because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

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

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

                            An address for the individual.

                            ShortAn address for the individual
                            Comments

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

                            Control0..*
                            TypeAddress
                            Is Modifierfalse
                            Summarytrue
                            Requirements

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

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

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

                            ShortMarital (civil) status of a patient
                            Control0..1
                            BindingUnless not suitable, these codes SHALL be taken from Marital Status Codes
                            (extensible to http://hl7.org/fhir/ValueSet/marital-status)

                            The domestic partnership status of a person.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Summaryfalse
                            Requirements

                            Most, if not all systems capture it.

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

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

                            ShortWhether patient is part of a multiple birth
                            Comments

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

                            Control0..1
                            TypeChoice of: boolean, integer
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summaryfalse
                            Requirements

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

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

                            Image of the patient.

                            ShortImage of the patient
                            Comments

                            Guidelines:

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

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

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

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

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

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

                            Control0..*
                            TypeBackboneElement
                            Is Modifierfalse
                            Summaryfalse
                            Requirements

                            Need to track people you can contact about the patient.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            pat-1: SHALL at least contain a contact's details or a reference to an organization (name.exists() or telecom.exists() or address.exists() or organization.exists())
                            152. 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
                            154. 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())
                            156. 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())
                            158. Patient.contact.relationship
                            Definition

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

                            ShortThe kind of relationship
                            Control0..*
                            BindingUnless not suitable, these codes SHALL be taken from PatientContactRelationship
                            (extensible to http://hl7.org/fhir/ValueSet/patient-contactrelationship)

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

                            TypeCodeableConcept
                            Is Modifierfalse
                            Summaryfalse
                            Requirements

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

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            160. 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()))
                            162. 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()))
                            164. Patient.contact.address
                            Definition

                            Address for the contact person.

                            ShortAddress for the contact person
                            Control0..1
                            TypeAddress
                            Is Modifierfalse
                            Summaryfalse
                            Requirements

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

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            166. 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()))
                            168. 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()))
                            170. 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()))
                            172. 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()))
                            174. 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
                            176. 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())
                            178. 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())
                            180. Patient.communication.language
                            Definition

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

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

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

                            Control1..1
                            BindingThe codes SHOULD be taken from CommonLanguages
                            (preferred to http://hl7.org/fhir/ValueSet/languages)

                            A human language.

                            Additional BindingsPurpose
                            AllLanguagesMax Binding
                            TypeCodeableConcept
                            Is Modifierfalse
                            Summaryfalse
                            Requirements

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

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            182. 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()))
                            184. Patient.generalPractitioner
                            Definition

                            Patient's nominated care provider.

                            ShortPatient's nominated primary care provider
                            Comments

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

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

                            Control0..*
                            TypeReference(Organization, Practitioner, PractitionerRole)
                            Is Modifierfalse
                            Summaryfalse
                            Alternate NamescareProvider
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            186. 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()))
                            188. Patient.link
                            Definition

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

                            ShortLink to another patient resource that concerns the same actual person
                            Comments

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

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

                            There are multiple use cases:

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

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

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

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

                            ShortAdditional content defined by implementations
                            Comments

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

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

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

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

                            ShortExtensions that cannot be ignored even if unrecognized
                            Comments

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

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

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

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

                            The other patient resource that the link refers to.

                            ShortThe other patient or related person resource that the link refers to
                            Comments

                            Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.

                            Control1..1
                            TypeReference(Patient, RelatedPerson)
                            Is Modifierfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            198. Patient.link.type
                            Definition

                            The type of link between this patient resource and another patient resource.

                            Shortreplaced-by | replaces | refer | seealso
                            Control1..1
                            BindingThe codes SHALL be taken from LinkType
                            (required to http://hl7.org/fhir/ValueSet/link-type|4.0.1)

                            The type of link between this patient resource and another patient resource.

                            Typecode
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))