Generated Narrative: StructureDefinition epa-patient Name Flags Card. Type Description & Constraints Patient 0..* TIPatient Information about an individual or animal receiving health care services #xD; id S 0..1 id Logical id of this artifact #xD; meta S 0..1 Meta Metadata about the resource #xD; versionId S 0..1 id Version specific identifier #xD; lastUpdated S 0..1 instant When the resource version last changed #xD; identifier 1..* Identifier An identifier for this patient #xD; Slices for identifier Content/Rules for all slices #xD; identifier:KVNR 1..1 IdentifierKvid10 An identifier intended for computation #xD; active 0..0 Whether this patient's record is in active use #xD; Documentation for this format
gematik GmbH / Dieses Artefakt ist lizenziert unter [Apache License](./license.html), Version 2.0.
Information about an individual or animal receiving health care services
Demographics and other administrative information about an individual or animal receiving care or other health-related services.
If the resource is contained in another resource, it SHALL NOT contain nested Resources
not(parent::f:contained and f:contained)
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()
not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))
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()
not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
If a resource is contained in another resource, it SHALL NOT have a security label
When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time.
A resource should have narrative for robust management
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()
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
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.
All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Extensions are always sliced by (at least) url
Additional content defined by implementations
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.
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.
Must have either extensions or value[x], not both
exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
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.
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.
When the resource last changed - e.g. when the version changed.
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](http://hl7.org/fhir/R4/http.html#read) interaction.
Identifies where the resource comes from
A uri that identifies the source system of the resource. This provides a minimal amount of [Provenance](http://hl7.org/fhir/R4/provenance.html#) 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.
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.
Profiles this resource claims to conform to
A list of profiles (references to [StructureDefinition](http://hl7.org/fhir/R4/structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](http://hl7.org/fhir/R4/structuredefinition-definitions.html#StructureDefinition.url).
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.
Security Labels applied to this resource
Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.
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.
Security Labels from the Healthcare Privacy and Security Classification System.
CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
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.
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.
Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
A set of rules under which this content was created
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.
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.
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
The base language in which the resource is written.
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).
Text summary of the resource, for human interpretation
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.
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.
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.
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.
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.
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).
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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Patients are almost always assigned specific numerical identifiers.
CX / EI (occasionally, more often EI maps to a resource id or a URL)
II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.
Whether this patient's record is in active use
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.
If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient.
Need to be able to mark a patient record as not to be used because it was created in error.
This resource is generally assumed to be active if no value is provided for the active element
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
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.
Need to be able to track the patient by multiple names. Examples are your official name and a partner name.
Personenname mit in Deutschland üblichen Erweiterungen
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.
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()
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()
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()
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())
usual | official | temp | nickname | anonymous | old | maiden
Applications can assume that a name is current unless it explicitly says that it is temporary or old.
Allows the appropriate name for a particular context of use to be selected from among a set of names.
This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one
XPN.7, but often indicated by which field contains the name
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.
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.
Der vollständige Familienname, einschließlich aller Vorsatz- und Zusatzwörter, mit Leerzeichen getrennt.
Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).
Namenszusatz gemäß VSDM (Versichertenstammdatenmanagement, "eGK")
Namenszusatz als Bestandteil das Nachnamens, wie in VSDM (Versichertenstammdatenmanagement, "eGK") definiert. Beispiele: Gräfin, Prinz oder Fürst
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.
exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
Nachname ohne Vor- und Zusätze. Dient z.B. der alphabetischen Einordnung des Namens.
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".
Vorsatzwort wie z.B.: von, van, zu Vgl. auch VSDM-Spezifikation der Gematik (Versichertenstammdatenmanagement, "eGK")
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.
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.
Given Names appear in the correct order for presenting the name
Namensteile vor dem Vornamen, z.B. akademischer Titel.
Note that FHIR strings SHALL NOT exceed 1MB in size
Prefixes appear in the correct order for presenting the name
LS | AC | NB | PR | HON | BR | AD | SP | MID | CL | IN | VV
Spezialisierung der Art des Präfixes, z.B. "AC" für Akademische Titel
Used to indicate additional information about the name part and how it should be used.
Source of the definition for the extension code - a logical name or a URL.
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.
Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).
A set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type.
Suffixes appear in the correct order for presenting the name
Indicates the period of time when this name was valid for the named person.
A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See [Duration](http://hl7.org/fhir/R4/datatypes.html#Duration).
Allows names to be placed in historical context.
If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)
not(exists(f:start/@value)) or not(exists(f:end/@value)) or (xs:dateTime(f:start/@value) <= xs:dateTime(f:end/@value))
IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted.
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).
People have (primary) ways to contact them in some way such as phone, email.
A system is required if a value is provided.
not(exists(f:value)) or exists(f:system)
Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes.
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.
Needed for identification of the individual, in combination with (at least) name and birth date.
The gender of a person used for administrative purposes.
player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender
unique id for the element within a resource (for internal references)
Optional Extension Element - found in all resources.
Das Geburtsjahr ist immer anzugeben. Im Geburtsjahr oder im Geburtstag und im Geburtsmonat ist bei Ausländern '00' bzw. '0000' zulässig. Beispiel: 1990-00-00
Bei Inländern ist immer ein logisch richtiges Geburtsdatum anzugeben. Bei Ausländern gilt folgendes: Zumindest das Geburtsjahr ist immer anzugeben. Im Geburtsjahr oder im Geburtstag und im Geburtsmonat ist bei Ausländern '00' bzw. '0000' zulässig, wenn der Geburtstag und der Geburtsmonat nicht zu ermitteln sind. Das Geburtsdatum muss komplett gefüllt sein. Beispiel: 1990-00-00
Age of the individual drives many clinical processes.
player[classCode=PSN|ANM and determinerCode=INSTANCE]/birthTime
Indicates if the individual is deceased or not
Indicates if the individual is deceased or not.
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.
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.
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.
player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedTime
Patient may have multiple addresses with different uses or applicable periods.
May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.
This field contains a patient's most recent marital (civil) status.
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
The domestic partnership status of a person.
fhir:CodeableConcept rdfs:subClassOf dt:CD
Whether patient is part of a multiple birth
Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer).
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).
For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs.
player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber
Guidelines: * Use id photos, not clinical photos. * Limit dimensions to thumbnail. * Keep byte count low to ease resource updates.
Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too.
If the Attachment has data, it SHALL have a contentType
not(exists(f:data)) or exists(f:contentType)
player[classCode=PSN|ANM and determinerCode=INSTANCE]/desc
A contact party (e.g. guardian, partner, friend) for the patient
A contact party (e.g. guardian, partner, friend) for the patient.
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.
Need to track people you can contact about the patient.
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()
exists(f:name) or exists(f:telecom) or exists(f:address) or exists(f:organization)
player[classCode=PSN|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON]
Extensions that cannot be ignored even if unrecognized
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).
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
The nature of the relationship between the patient and the contact person.
Used to determine which contact person is the most relevant to approach, depending on circumstances.
The nature of the relationship between a patient and a contact person for that patient.
A name associated with the contact person
A name associated with the contact person.
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 might or might 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.
Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person.
A contact detail for the person, e.g. a telephone number or an email address.
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.
Note: address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the [Location](http://hl7.org/fhir/R4/location.html#) resource).
Need to keep track where the contact person can be contacted per postal mail or visited.
Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes.
Organization that is associated with the contact
Organization on behalf of which the contact is acting or for which the contact is working.
References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
For guardians or business related contacts, the organization is relevant.
SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])
The target of a resource reference is a RIM entry point (Act, Role, or Entity)
The period during which this contact person or organization is valid to be contacted relating to this patient
The period during which this contact person or organization is valid to be contacted relating to this patient.
A language which may be used to communicate with the patient about his or her health
A language which may be used to communicate with the patient about his or her health.
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.
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.
The language which can be used to communicate with the patient about his or her health
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.
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.
Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.
player[classCode=PSN|ANM and determinerCode=INSTANCE]/languageCommunication/code
Indicates whether or not the patient prefers this language (over other languages he masters up a certain level).
This language is specifically identified for communicating healthcare information.
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.
Patient's nominated primary care provider
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.
Organization that is the custodian of the patient record
Organization that is the custodian of the patient record.
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).
Need to know who recognizes this patient record, manages and updates it.
Link to another patient resource that concerns the same actual person
Link to another patient resource that concerns the same actual patient.
There is no assumption that linked patient records have mutual links.
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.
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'
The other patient or related person resource that the link refers to
The other patient resource that the link refers to.
Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.
replaced-by | replaces | refer | seealso
The type of link between this patient resource and another patient resource.