CIBMTR Reporting Implementation Guide
0.1.11 - Trial Use 1

This page is part of the CIBMTR Reporting Implementation Guide (v0.1.11: Release) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Resource Profile: CIBMTR Patient Profile (us-core)

Official URL: http://fhir.nmdp.org/ig/cibmtr-reporting/StructureDefinition/cibmtr-patient Version: 0.1.11
Draft as of 2026-06-25 Computable Name: CIBMTRPatient

Overview

The CIBMTR Patient Profile (us-core) inherits from the US Core Patient Profile, which in turn inherits from the base FHIR Patient resource. This profile meets the requirements of the U.S. Core Data for Interoperability (USCDI) Patient Demographics/Information Data Class and sets minimum expectations for representing, searching, and retrieving patient demographic and administrative information for CIBMTR use cases. It specifies the required elements, extensions, and identifier slices, and defines how they SHALL be used to support standardized reporting to CIBMTR.

Mandatory and Must Support Data Elements

The following data elements must always be present (Must Have) or must be supported if the data is present in the sending system (Must Support).

Each Patient Must Have:

  • security label
  • CCN (5digit)
  • first name
  • last name
  • birthdate (YYYY-MM-DD)
  • gender (M/F)

Each Patient Must Support:

  • address
  • communication
  • link

Profile-specific Implementation Guidance (CIBMTR)

Security label requirement (meta.security)
The CIBMTR Patient profile requires a meta.security label identifying the Transplant Center context (e.g., rc_<CCN>). This security tag is used as part of the query pattern for searching and for access scoping.

CCN
The patient identifier MUST include a 5-digit CCN identifying the transplant center.

Patient Name
The patient record MUST include both a first name and last name. Previous or historical names may be represented using Patient.name.use = "old" and/or an end date in Patient.name.period.

Birth Date
Birth date MUST be represented using the YYYY-MM-DD format

Gender
Gender MUST be represented using supported values such as M or F.

Patient Address
Previous or historical addresses may be represented using Patient.address.use = "old" and/or an end date in Patient.address.period.

SSN caution
SSNs SHOULD NOT be used as a patient identifier (Patient.identifier.value) due to identity theft and filtering concerns.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Patient 0..* USCorePatientProfile(8.0.0) Information about an individual or animal receiving health care services
... meta Σ 0..1 Meta Metadata about the resource
.... Slices for security Σ 1..* Coding Security Labels applied to this resource
Slice: Unordered, Open by pattern:system
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
..... security:TransplantCenter SΣ 1..1 Coding Security Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
...... system Σ 1..1 uri Identity of the terminology system
Required Pattern: http://terminology.cibmtr.org/codesystem/transplant-center
...... code ΣC 1..1 code Symbol in syntax defined by the system
Constraints: sec-rc
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension Content/Rules for all slices
.... extension:race C 0..1 (Complex) 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Race Extension. (multiple races are supported in the extension)
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-race
Constraints: us-core-23
.... extension:ethnicity 0..1 (Complex) 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core ethnicity Extension (multiple ethnicities are supported in the extension)
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity
.... extension:tribalAffiliation 0..* (Complex) 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Tribal Affiliation Extension
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-tribal-affiliation
.... extension:sex 0..1 Coding 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Sex Extension
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-sex
Binding: Federal Administrative Sex . (extensible): Federal Administrative Sex
.... extension:interpreterRequired 0..1 Coding 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Whether the patient needs an interpreter
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-interpreter-needed
Binding: Answer Set with Yes No and Unknowns . (required): Answer Set with Yes No and Unknowns
.... extension:MaidenNameExt S 0..1 string Mother's Maiden name
URL: http://hl7.org/fhir/StructureDefinition/patient-mothersMaidenName
.... extension:PatBirthPlaceExt S 0..1 Address Place of Birth for patient
URL: http://hl7.org/fhir/StructureDefinition/patient-birthPlace
... Slices for identifier SΣ 1..* Identifier An identifier for this patient
Slice: Unordered, Open by pattern:system
.... identifier:All Slices Content/Rules for all slices
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... system SΣ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value SΣ 1..1 string The value that is unique within the system.
Example General: 123456
.... identifier:CRID SΣ 0..1 Identifier An identifier for this patient
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... system SΣ 1..1 uri The namespace for the identifier value
Required Pattern: http://terminology.cibmtr.org/identifier/CRID
..... value SΣ 1..1 string The value that is unique within the system.
Example General: 123456
.... identifier:GRID SΣ 0..1 Identifier An identifier for this patient
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... system SΣ 1..1 uri The namespace for the identifier value
Required Pattern: http://www.isbt128.org/uri/GRID
..... value SΣ 1..1 string The value that is unique within the system.
Example General: 123456
.... identifier:NMDPRecipient SΣ 0..1 Identifier An identifier for this patient
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... system SΣ 1..1 uri The namespace for the identifier value
Required Pattern: http://terminology.nmdp.org/identifier/recipient
..... value SΣ 1..1 string The value that is unique within the system.
Example General: 123456
.... identifier:CIBMTR-non-NMDP-donor SΣ 0..1 Identifier An identifier for this patient
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... system SΣ 1..1 uri The namespace for the identifier value
Required Pattern: http://terminology.cibmtr.org/identifier/non-nmdp-donor
..... value SΣ 1..1 string The value that is unique within the system.
Example General: 123456
.... identifier:SSN SΣ 0..1 Identifier An identifier for this patient
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... system SΣ 1..1 uri The namespace for the identifier value
Required Pattern: http://hl7.org/fhir/sid/us-ssn
..... value SΣ 1..1 string The value that is unique within the system.
Example General: 123456
... active ?!Σ 0..1 boolean Whether this patient's record is in active use
... name SΣC 1..* HumanName A name associated with the patient
Constraints: us-core-6
.... use ?!Σ 0..1 code 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: usual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required): The use of a human name.
.... family SΣC 0..1 string Family name (often called 'Surname')
.... given SΣC 0..* string Given names (not always 'first'). Includes middle names
This repeating element order: Given Names appear in the correct order for presenting the name
... telecom Σ 0..* ContactPoint 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: A contact detail for the individual
.... system SΣC 1..1 code phone | fax | email | pager | url | sms | other
Binding: ContactPointSystem (required): Telecommunications form for contact point.
.... value SΣ 1..1 string The actual contact point details
.... use ?!SΣ 0..1 code home | work | temp | old | mobile - purpose of this contact point
Binding: ContactPointUse (required)
... birthDate SΣ 0..1 date The date of birth for the individual
... deceased[x] ?!Σ 0..1 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Indicates if the individual is deceased or not
.... deceasedBoolean boolean
.... deceasedDateTime dateTime
... address SΣ 0..* Address An address for the individual
.... use ?!Σ 0..1 code 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: home | work | temp | old | billing - purpose of this address
Binding: AddressUse (required): The use of an address.
Example General: home
.... line SΣ 0..* string Street name, number, direction & P.O. Box etc.
This repeating element order: The order in which lines should appear in an address label
Example General: 137 Nowhere Street
Example US Core: 49 MEADOW ST
.... city SΣ 0..1 string Name of city, town etc.
Example General: Erewhon
Example US Core: EVERYTOWN
.... state SΣ 0..1 string Sub-unit of country (abbreviations ok)
Binding: USPS Two Letter Alphabetic Codes (extensible): Two Letter USPS alphabetic codes.
Example US Core: OK
.... postalCode SΣ 0..1 string US Zip Codes
Example General: 9132
Example US Core: 74047
... communication 0..* BackboneElement 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: A language which may be used to communicate with the patient about his or her health
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... language S 1..1 CodeableConcept The language which can be used to communicate with the patient about his or her health
Binding: Languages (extensible)
... link ?!Σ 0..* BackboneElement Link to another patient resource that concerns the same actual person
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... other Σ 1..1 Reference(Patient | RelatedPerson) The other patient or related person resource that the link refers to
.... type Σ 1..1 code replaced-by | replaces | refer | seealso
Binding: LinkType (required): The type of link between this patient resource and another patient resource.

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Patient.meta.security Base extensible SecurityLabels 📍4.0.1 FHIR Std.
Patient.meta.security:TransplantCenter Base extensible SecurityLabels 📍4.0.1 FHIR Std.
Patient.identifier.use Base required IdentifierUse 📍4.0.1 FHIR Std.
Patient.identifier:CRID.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
Patient.identifier:GRID.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
Patient.identifier:NMDPRecipient.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
Patient.identifier:CIBMTR-non-NMDP-donor.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
Patient.identifier:SSN.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
Patient.name.use Base required NameUse 📍4.0.1 FHIR Std.
Patient.telecom.system Base required ContactPointSystem 📦4.0.1 FHIR Std.
Patient.telecom.use Base required ContactPointUse 📦4.0.1 FHIR Std.
Patient.address.use Base required AddressUse 📍4.0.1 FHIR Std.
Patient.address.state Base extensible USPS Two Letter Alphabetic Codes 📦2.0.0 THO v7.2
Patient.communication.​language Base extensible Languages 📦1.0.0 THO v7.2
Patient.link.type Base required LinkType 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Patient If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Patient If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Patient If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Patient If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Patient A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
sec-rc error Patient.meta.security:TransplantCenter.code Use transplant center identifier for security tag matches('^rc_[0-9]{5}$')
us-core-6 error Patient.name At least name.given and/or name.family are present or, if neither is available, the Data Absent Reason Extension is present. (family.exists() or given.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()
us-core-23 error Patient.extension:race If "ASKU" or "UNK" are present, then no other OMB race categories can be present. extension.where(url = 'ombCategory').value.where(code in 'ASKU'|'UNK').exists() implies extension.where(url = 'ombCategory').count() = 1

This structure is derived from USCorePatientProfile

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Patient 0..* USCorePatientProfile(8.0.0) Information about an individual or animal receiving health care services
... meta
.... Slices for security 1..* Coding Security Labels applied to this resource
Slice: Unordered, Open by pattern:system
..... security:TransplantCenter S 1..1 Coding Security Labels applied to this resource
...... system 1..1 uri Identity of the terminology system
Required Pattern: http://terminology.cibmtr.org/codesystem/transplant-center
...... code C 1..1 code Symbol in syntax defined by the system
Constraints: sec-rc
... Slices for extension Content/Rules for all slices
.... extension:MaidenNameExt S 0..1 string Mother's Maiden name
URL: http://hl7.org/fhir/StructureDefinition/patient-mothersMaidenName
.... extension:PatBirthPlaceExt S 0..1 Address Place of Birth for patient
URL: http://hl7.org/fhir/StructureDefinition/patient-birthPlace
... Slices for identifier 1..* Identifier An identifier for this patient
Slice: Unordered, Open by pattern:system
.... identifier:CRID S 0..1 Identifier An identifier for this patient
..... system 1..1 uri The namespace for the identifier value
Required Pattern: http://terminology.cibmtr.org/identifier/CRID
.... identifier:GRID S 0..1 Identifier An identifier for this patient
..... type
...... coding
....... system 0..1 uri Identity of the terminology system
Required Pattern: https://www.hl7.org/fhir/v2/0203/index.html
....... code 0..1 code Symbol in syntax defined by the system
Required Pattern: DR
..... system 1..1 uri The namespace for the identifier value
Required Pattern: http://www.isbt128.org/uri/GRID
.... identifier:NMDPRecipient S 0..1 Identifier An identifier for this patient
..... system 1..1 uri The namespace for the identifier value
Required Pattern: http://terminology.nmdp.org/identifier/recipient
.... identifier:CIBMTR-non-NMDP-donor 0..1 Identifier An identifier for this patient
..... system 1..1 uri The namespace for the identifier value
Required Pattern: http://terminology.cibmtr.org/identifier/non-nmdp-donor
.... identifier:SSN S 0..1 Identifier An identifier for this patient
..... system 1..1 uri The namespace for the identifier value
Required Pattern: http://hl7.org/fhir/sid/us-ssn

doco Documentation for this format

Constraints

Id Grade Path(s) Description Expression
sec-rc error Patient.meta.security:TransplantCenter.code Use transplant center identifier for security tag matches('^rc_[0-9]{5}$')
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Patient 0..* USCorePatientProfile(8.0.0) Information about an individual or animal receiving health care services
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ 0..1 id Version specific identifier
.... lastUpdated Σ 0..1 instant When the resource version last changed
.... source Σ 0..1 uri Identifies where the resource comes from
.... profile Σ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
.... Slices for security Σ 1..* Coding Security Labels applied to this resource
Slice: Unordered, Open by pattern:system
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
..... security:TransplantCenter SΣ 1..1 Coding Security Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Required Pattern: http://terminology.cibmtr.org/codesystem/transplant-center
...... version Σ 0..1 string Version of the system - if relevant
...... code ΣC 1..1 code Symbol in syntax defined by the system
Constraints: sec-rc
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... tag Σ 0..* Coding Tags applied to this resource
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:race C 0..1 (Complex) 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Race Extension. (multiple races are supported in the extension)
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-race
Constraints: us-core-23
.... extension:ethnicity 0..1 (Complex) 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core ethnicity Extension (multiple ethnicities are supported in the extension)
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity
.... extension:tribalAffiliation 0..* (Complex) 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Tribal Affiliation Extension
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-tribal-affiliation
.... extension:sex 0..1 Coding 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Sex Extension
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-sex
Binding: Federal Administrative Sex . (extensible): Federal Administrative Sex
.... extension:interpreterRequired 0..1 Coding 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Whether the patient needs an interpreter
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-interpreter-needed
Binding: Answer Set with Yes No and Unknowns . (required): Answer Set with Yes No and Unknowns
.... extension:MaidenNameExt S 0..1 string Mother's Maiden name
URL: http://hl7.org/fhir/StructureDefinition/patient-mothersMaidenName
.... extension:PatBirthPlaceExt S 0..1 Address Place of Birth for patient
URL: http://hl7.org/fhir/StructureDefinition/patient-birthPlace
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... Slices for identifier SΣ 1..* Identifier An identifier for this patient
Slice: Unordered, Open by pattern:system
.... identifier:All Slices Content/Rules for all slices
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
..... system SΣ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value SΣ 1..1 string The value that is unique within the system.
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
.... identifier:CRID SΣ 0..1 Identifier An identifier for this patient
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
..... system SΣ 1..1 uri The namespace for the identifier value
Required Pattern: http://terminology.cibmtr.org/identifier/CRID
..... value SΣ 1..1 string The value that is unique within the system.
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
.... identifier:GRID SΣ 0..1 Identifier An identifier for this patient
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... coding Σ 0..* Coding Code defined by a terminology system
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 0..1 uri Identity of the terminology system
Required Pattern: https://www.hl7.org/fhir/v2/0203/index.html
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 0..1 code Symbol in syntax defined by the system
Required Pattern: DR
....... display Σ 0..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... system SΣ 1..1 uri The namespace for the identifier value
Required Pattern: http://www.isbt128.org/uri/GRID
..... value SΣ 1..1 string The value that is unique within the system.
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
.... identifier:NMDPRecipient SΣ 0..1 Identifier An identifier for this patient
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
..... system SΣ 1..1 uri The namespace for the identifier value
Required Pattern: http://terminology.nmdp.org/identifier/recipient
..... value SΣ 1..1 string The value that is unique within the system.
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
.... identifier:CIBMTR-non-NMDP-donor SΣ 0..1 Identifier An identifier for this patient
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
..... system SΣ 1..1 uri The namespace for the identifier value
Required Pattern: http://terminology.cibmtr.org/identifier/non-nmdp-donor
..... value SΣ 1..1 string The value that is unique within the system.
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
.... identifier:SSN SΣ 0..1 Identifier An identifier for this patient
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
..... system SΣ 1..1 uri The namespace for the identifier value
Required Pattern: http://hl7.org/fhir/sid/us-ssn
..... value SΣ 1..1 string The value that is unique within the system.
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... active ?!Σ 0..1 boolean Whether this patient's record is in active use
... name SΣC 1..* HumanName A name associated with the patient
Constraints: us-core-6
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: usual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required): The use of a human name.
.... text Σ 0..1 string Text representation of the full name
.... family SΣC 0..1 string Family name (often called 'Surname')
.... given SΣC 0..* string Given names (not always 'first'). Includes middle names
This repeating element order: Given Names appear in the correct order for presenting the name
.... prefix Σ 0..* string Parts that come before the name
This repeating element order: Prefixes appear in the correct order for presenting the name
.... suffix Σ 0..* string 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Parts that come after the name
This repeating element order: Suffixes appear in the correct order for presenting the name
.... period Σ 0..1 Period 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Time period when name was/is in use
... telecom Σ 0..* ContactPoint 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: A contact detail for the individual
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... system SΣC 1..1 code phone | fax | email | pager | url | sms | other
Binding: ContactPointSystem (required): Telecommunications form for contact point.
.... value SΣ 1..1 string The actual contact point details
.... use ?!SΣ 0..1 code home | work | temp | old | mobile - purpose of this contact point
Binding: ContactPointUse (required)
.... rank Σ 0..1 positiveInt Specify preferred order of use (1 = highest)
.... period Σ 0..1 Period Time period when the contact point was/is in use
... gender Σ 0..1 code male | female | other | unknown
Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
... birthDate SΣ 0..1 date The date of birth for the individual
... deceased[x] ?!Σ 0..1 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Indicates if the individual is deceased or not
.... deceasedBoolean boolean
.... deceasedDateTime dateTime
... address SΣ 0..* Address An address for the individual
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: home | work | temp | old | billing - purpose of this address
Binding: AddressUse (required): The use of an address.
Example General: home
.... type Σ 0..1 code postal | physical | both
Binding: AddressType (required): The type of an address (physical / postal).
Example General: both
.... text Σ 0..1 string Text representation of the address
Example General: 137 Nowhere Street, Erewhon 9132
.... line SΣ 0..* string Street name, number, direction & P.O. Box etc.
This repeating element order: The order in which lines should appear in an address label
Example General: 137 Nowhere Street
Example US Core: 49 MEADOW ST
.... city SΣ 0..1 string Name of city, town etc.
Example General: Erewhon
Example US Core: EVERYTOWN
.... district Σ 0..1 string District name (aka county)
Example General: Madison
.... state SΣ 0..1 string Sub-unit of country (abbreviations ok)
Binding: USPS Two Letter Alphabetic Codes (extensible): Two Letter USPS alphabetic codes.
Example US Core: OK
.... postalCode SΣ 0..1 string US Zip Codes
Example General: 9132
Example US Core: 74047
.... country Σ 0..1 string Country (e.g. can be ISO 3166 2 or 3 letter code)
.... period Σ 0..1 Period 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Time period when address was/is in use
Example General: {"start":"2010-03-23","end":"2010-07-01"}
... maritalStatus 0..1 CodeableConcept Marital (civil) status of a patient
Binding: Marital Status Codes (extensible): The domestic partnership status of a person.
... multipleBirth[x] 0..1 Whether patient is part of a multiple birth
.... multipleBirthBoolean boolean
.... multipleBirthInteger integer
... photo 0..* Attachment Image of the patient
... contact C 0..* BackboneElement A contact party (e.g. guardian, partner, friend) for the patient
Constraints: pat-1
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... relationship 0..* CodeableConcept The kind of relationship
Binding: PatientContactRelationship (extensible): The nature of the relationship between a patient and a contact person for that patient.
.... name 0..1 HumanName A name associated with the contact person
.... telecom 0..* ContactPoint A contact detail for the person
.... address 0..1 Address Address for the contact person
.... gender 0..1 code male | female | other | unknown
Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
.... organization C 0..1 Reference(Organization) Organization that is associated with the contact
.... period 0..1 Period The period during which this contact person or organization is valid to be contacted relating to this patient
... communication 0..* BackboneElement 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: A language which may be used to communicate with the patient about his or her health
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... language S 1..1 CodeableConcept The language which can be used to communicate with the patient about his or her health
Binding: Languages (extensible)
.... preferred 0..1 boolean Language preference indicator
... generalPractitioner 0..* Reference(Organization | Practitioner | PractitionerRole) Patient's nominated primary care provider
... managingOrganization Σ 0..1 Reference(Organization) Organization that is the custodian of the patient record
... link ?!Σ 0..* BackboneElement Link to another patient resource that concerns the same actual person
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... other Σ 1..1 Reference(Patient | RelatedPerson) The other patient or related person resource that the link refers to
.... type Σ 1..1 code replaced-by | replaces | refer | seealso
Binding: LinkType (required): The type of link between this patient resource and another patient resource.

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Patient.meta.security Base extensible SecurityLabels 📍4.0.1 FHIR Std.
Patient.meta.security:TransplantCenter Base extensible SecurityLabels 📍4.0.1 FHIR Std.
Patient.meta.tag Base example Common Tags 📍4.0.1 FHIR Std.
Patient.language Base preferred Common Languages 📦4.0.1 FHIR Std.
Patient.identifier.use Base required IdentifierUse 📍4.0.1 FHIR Std.
Patient.identifier.type Base extensible IdentifierType 📦4.0.1 FHIR Std.
Patient.identifier:CRID.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
Patient.identifier:CRID.​type Base extensible IdentifierType 📦4.0.1 FHIR Std.
Patient.identifier:GRID.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
Patient.identifier:GRID.​type Base extensible IdentifierType 📦4.0.1 FHIR Std.
Patient.identifier:NMDPRecipient.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
Patient.identifier:NMDPRecipient.​type Base extensible IdentifierType 📦4.0.1 FHIR Std.
Patient.identifier:CIBMTR-non-NMDP-donor.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
Patient.identifier:CIBMTR-non-NMDP-donor.​type Base extensible IdentifierType 📦4.0.1 FHIR Std.
Patient.identifier:SSN.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
Patient.identifier:SSN.​type Base extensible IdentifierType 📦4.0.1 FHIR Std.
Patient.name.use Base required NameUse 📍4.0.1 FHIR Std.
Patient.telecom.system Base required ContactPointSystem 📦4.0.1 FHIR Std.
Patient.telecom.use Base required ContactPointUse 📦4.0.1 FHIR Std.
Patient.gender Base required AdministrativeGender 📍4.0.1 FHIR Std.
Patient.address.use Base required AddressUse 📍4.0.1 FHIR Std.
Patient.address.type Base required AddressType 📍4.0.1 FHIR Std.
Patient.address.state Base extensible USPS Two Letter Alphabetic Codes 📦2.0.0 THO v7.2
Patient.maritalStatus Base extensible MaritalStatus 📦4.0.1 FHIR Std.
Patient.contact.relationship Base extensible Patient Contact Relationship 📦4.0.1 FHIR Std.
Patient.contact.gender Base required AdministrativeGender 📍4.0.1 FHIR Std.
Patient.communication.​language Base extensible Languages 📦1.0.0 THO v7.2
Patient.link.type Base required LinkType 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Patient If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Patient If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Patient If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Patient If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Patient A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
pat-1 error Patient.contact SHALL at least contain a contact's details or a reference to an organization name.exists() or telecom.exists() or address.exists() or organization.exists()
sec-rc error Patient.meta.security:TransplantCenter.code Use transplant center identifier for security tag matches('^rc_[0-9]{5}$')
us-core-6 error Patient.name At least name.given and/or name.family are present or, if neither is available, the Data Absent Reason Extension is present. (family.exists() or given.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()
us-core-23 error Patient.extension:race If "ASKU" or "UNK" are present, then no other OMB race categories can be present. extension.where(url = 'ombCategory').value.where(code in 'ASKU'|'UNK').exists() implies extension.where(url = 'ombCategory').count() = 1

This structure is derived from USCorePatientProfile

Summary

Mandatory: 0 element(4 nested mandatory elements)
Must-Support: 7 elements

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Patient.meta.security
  • The element 1 is sliced based on the value of Patient.identifier

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Patient 0..* USCorePatientProfile(8.0.0) Information about an individual or animal receiving health care services
... meta Σ 0..1 Meta Metadata about the resource
.... Slices for security Σ 1..* Coding Security Labels applied to this resource
Slice: Unordered, Open by pattern:system
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
..... security:TransplantCenter SΣ 1..1 Coding Security Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
...... system Σ 1..1 uri Identity of the terminology system
Required Pattern: http://terminology.cibmtr.org/codesystem/transplant-center
...... code ΣC 1..1 code Symbol in syntax defined by the system
Constraints: sec-rc
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension Content/Rules for all slices
.... extension:race C 0..1 (Complex) 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Race Extension. (multiple races are supported in the extension)
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-race
Constraints: us-core-23
.... extension:ethnicity 0..1 (Complex) 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core ethnicity Extension (multiple ethnicities are supported in the extension)
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity
.... extension:tribalAffiliation 0..* (Complex) 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Tribal Affiliation Extension
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-tribal-affiliation
.... extension:sex 0..1 Coding 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Sex Extension
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-sex
Binding: Federal Administrative Sex . (extensible): Federal Administrative Sex
.... extension:interpreterRequired 0..1 Coding 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Whether the patient needs an interpreter
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-interpreter-needed
Binding: Answer Set with Yes No and Unknowns . (required): Answer Set with Yes No and Unknowns
.... extension:MaidenNameExt S 0..1 string Mother's Maiden name
URL: http://hl7.org/fhir/StructureDefinition/patient-mothersMaidenName
.... extension:PatBirthPlaceExt S 0..1 Address Place of Birth for patient
URL: http://hl7.org/fhir/StructureDefinition/patient-birthPlace
... Slices for identifier SΣ 1..* Identifier An identifier for this patient
Slice: Unordered, Open by pattern:system
.... identifier:All Slices Content/Rules for all slices
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... system SΣ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value SΣ 1..1 string The value that is unique within the system.
Example General: 123456
.... identifier:CRID SΣ 0..1 Identifier An identifier for this patient
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... system SΣ 1..1 uri The namespace for the identifier value
Required Pattern: http://terminology.cibmtr.org/identifier/CRID
..... value SΣ 1..1 string The value that is unique within the system.
Example General: 123456
.... identifier:GRID SΣ 0..1 Identifier An identifier for this patient
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... system SΣ 1..1 uri The namespace for the identifier value
Required Pattern: http://www.isbt128.org/uri/GRID
..... value SΣ 1..1 string The value that is unique within the system.
Example General: 123456
.... identifier:NMDPRecipient SΣ 0..1 Identifier An identifier for this patient
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... system SΣ 1..1 uri The namespace for the identifier value
Required Pattern: http://terminology.nmdp.org/identifier/recipient
..... value SΣ 1..1 string The value that is unique within the system.
Example General: 123456
.... identifier:CIBMTR-non-NMDP-donor SΣ 0..1 Identifier An identifier for this patient
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... system SΣ 1..1 uri The namespace for the identifier value
Required Pattern: http://terminology.cibmtr.org/identifier/non-nmdp-donor
..... value SΣ 1..1 string The value that is unique within the system.
Example General: 123456
.... identifier:SSN SΣ 0..1 Identifier An identifier for this patient
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... system SΣ 1..1 uri The namespace for the identifier value
Required Pattern: http://hl7.org/fhir/sid/us-ssn
..... value SΣ 1..1 string The value that is unique within the system.
Example General: 123456
... active ?!Σ 0..1 boolean Whether this patient's record is in active use
... name SΣC 1..* HumanName A name associated with the patient
Constraints: us-core-6
.... use ?!Σ 0..1 code 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: usual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required): The use of a human name.
.... family SΣC 0..1 string Family name (often called 'Surname')
.... given SΣC 0..* string Given names (not always 'first'). Includes middle names
This repeating element order: Given Names appear in the correct order for presenting the name
... telecom Σ 0..* ContactPoint 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: A contact detail for the individual
.... system SΣC 1..1 code phone | fax | email | pager | url | sms | other
Binding: ContactPointSystem (required): Telecommunications form for contact point.
.... value SΣ 1..1 string The actual contact point details
.... use ?!SΣ 0..1 code home | work | temp | old | mobile - purpose of this contact point
Binding: ContactPointUse (required)
... birthDate SΣ 0..1 date The date of birth for the individual
... deceased[x] ?!Σ 0..1 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Indicates if the individual is deceased or not
.... deceasedBoolean boolean
.... deceasedDateTime dateTime
... address SΣ 0..* Address An address for the individual
.... use ?!Σ 0..1 code 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: home | work | temp | old | billing - purpose of this address
Binding: AddressUse (required): The use of an address.
Example General: home
.... line SΣ 0..* string Street name, number, direction & P.O. Box etc.
This repeating element order: The order in which lines should appear in an address label
Example General: 137 Nowhere Street
Example US Core: 49 MEADOW ST
.... city SΣ 0..1 string Name of city, town etc.
Example General: Erewhon
Example US Core: EVERYTOWN
.... state SΣ 0..1 string Sub-unit of country (abbreviations ok)
Binding: USPS Two Letter Alphabetic Codes (extensible): Two Letter USPS alphabetic codes.
Example US Core: OK
.... postalCode SΣ 0..1 string US Zip Codes
Example General: 9132
Example US Core: 74047
... communication 0..* BackboneElement 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: A language which may be used to communicate with the patient about his or her health
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... language S 1..1 CodeableConcept The language which can be used to communicate with the patient about his or her health
Binding: Languages (extensible)
... link ?!Σ 0..* BackboneElement Link to another patient resource that concerns the same actual person
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... other Σ 1..1 Reference(Patient | RelatedPerson) The other patient or related person resource that the link refers to
.... type Σ 1..1 code replaced-by | replaces | refer | seealso
Binding: LinkType (required): The type of link between this patient resource and another patient resource.

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Patient.meta.security Base extensible SecurityLabels 📍4.0.1 FHIR Std.
Patient.meta.security:TransplantCenter Base extensible SecurityLabels 📍4.0.1 FHIR Std.
Patient.identifier.use Base required IdentifierUse 📍4.0.1 FHIR Std.
Patient.identifier:CRID.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
Patient.identifier:GRID.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
Patient.identifier:NMDPRecipient.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
Patient.identifier:CIBMTR-non-NMDP-donor.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
Patient.identifier:SSN.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
Patient.name.use Base required NameUse 📍4.0.1 FHIR Std.
Patient.telecom.system Base required ContactPointSystem 📦4.0.1 FHIR Std.
Patient.telecom.use Base required ContactPointUse 📦4.0.1 FHIR Std.
Patient.address.use Base required AddressUse 📍4.0.1 FHIR Std.
Patient.address.state Base extensible USPS Two Letter Alphabetic Codes 📦2.0.0 THO v7.2
Patient.communication.​language Base extensible Languages 📦1.0.0 THO v7.2
Patient.link.type Base required LinkType 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Patient If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Patient If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Patient If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Patient If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Patient A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
sec-rc error Patient.meta.security:TransplantCenter.code Use transplant center identifier for security tag matches('^rc_[0-9]{5}$')
us-core-6 error Patient.name At least name.given and/or name.family are present or, if neither is available, the Data Absent Reason Extension is present. (family.exists() or given.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()
us-core-23 error Patient.extension:race If "ASKU" or "UNK" are present, then no other OMB race categories can be present. extension.where(url = 'ombCategory').value.where(code in 'ASKU'|'UNK').exists() implies extension.where(url = 'ombCategory').count() = 1

Differential View

This structure is derived from USCorePatientProfile

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Patient 0..* USCorePatientProfile(8.0.0) Information about an individual or animal receiving health care services
... meta
.... Slices for security 1..* Coding Security Labels applied to this resource
Slice: Unordered, Open by pattern:system
..... security:TransplantCenter S 1..1 Coding Security Labels applied to this resource
...... system 1..1 uri Identity of the terminology system
Required Pattern: http://terminology.cibmtr.org/codesystem/transplant-center
...... code C 1..1 code Symbol in syntax defined by the system
Constraints: sec-rc
... Slices for extension Content/Rules for all slices
.... extension:MaidenNameExt S 0..1 string Mother's Maiden name
URL: http://hl7.org/fhir/StructureDefinition/patient-mothersMaidenName
.... extension:PatBirthPlaceExt S 0..1 Address Place of Birth for patient
URL: http://hl7.org/fhir/StructureDefinition/patient-birthPlace
... Slices for identifier 1..* Identifier An identifier for this patient
Slice: Unordered, Open by pattern:system
.... identifier:CRID S 0..1 Identifier An identifier for this patient
..... system 1..1 uri The namespace for the identifier value
Required Pattern: http://terminology.cibmtr.org/identifier/CRID
.... identifier:GRID S 0..1 Identifier An identifier for this patient
..... type
...... coding
....... system 0..1 uri Identity of the terminology system
Required Pattern: https://www.hl7.org/fhir/v2/0203/index.html
....... code 0..1 code Symbol in syntax defined by the system
Required Pattern: DR
..... system 1..1 uri The namespace for the identifier value
Required Pattern: http://www.isbt128.org/uri/GRID
.... identifier:NMDPRecipient S 0..1 Identifier An identifier for this patient
..... system 1..1 uri The namespace for the identifier value
Required Pattern: http://terminology.nmdp.org/identifier/recipient
.... identifier:CIBMTR-non-NMDP-donor 0..1 Identifier An identifier for this patient
..... system 1..1 uri The namespace for the identifier value
Required Pattern: http://terminology.cibmtr.org/identifier/non-nmdp-donor
.... identifier:SSN S 0..1 Identifier An identifier for this patient
..... system 1..1 uri The namespace for the identifier value
Required Pattern: http://hl7.org/fhir/sid/us-ssn

doco Documentation for this format

Constraints

Id Grade Path(s) Description Expression
sec-rc error Patient.meta.security:TransplantCenter.code Use transplant center identifier for security tag matches('^rc_[0-9]{5}$')

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Patient 0..* USCorePatientProfile(8.0.0) Information about an individual or animal receiving health care services
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ 0..1 id Version specific identifier
.... lastUpdated Σ 0..1 instant When the resource version last changed
.... source Σ 0..1 uri Identifies where the resource comes from
.... profile Σ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
.... Slices for security Σ 1..* Coding Security Labels applied to this resource
Slice: Unordered, Open by pattern:system
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
..... security:TransplantCenter SΣ 1..1 Coding Security Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Required Pattern: http://terminology.cibmtr.org/codesystem/transplant-center
...... version Σ 0..1 string Version of the system - if relevant
...... code ΣC 1..1 code Symbol in syntax defined by the system
Constraints: sec-rc
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... tag Σ 0..* Coding Tags applied to this resource
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:race C 0..1 (Complex) 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Race Extension. (multiple races are supported in the extension)
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-race
Constraints: us-core-23
.... extension:ethnicity 0..1 (Complex) 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core ethnicity Extension (multiple ethnicities are supported in the extension)
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity
.... extension:tribalAffiliation 0..* (Complex) 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Tribal Affiliation Extension
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-tribal-affiliation
.... extension:sex 0..1 Coding 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Sex Extension
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-sex
Binding: Federal Administrative Sex . (extensible): Federal Administrative Sex
.... extension:interpreterRequired 0..1 Coding 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Whether the patient needs an interpreter
URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-interpreter-needed
Binding: Answer Set with Yes No and Unknowns . (required): Answer Set with Yes No and Unknowns
.... extension:MaidenNameExt S 0..1 string Mother's Maiden name
URL: http://hl7.org/fhir/StructureDefinition/patient-mothersMaidenName
.... extension:PatBirthPlaceExt S 0..1 Address Place of Birth for patient
URL: http://hl7.org/fhir/StructureDefinition/patient-birthPlace
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... Slices for identifier SΣ 1..* Identifier An identifier for this patient
Slice: Unordered, Open by pattern:system
.... identifier:All Slices Content/Rules for all slices
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
..... system SΣ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value SΣ 1..1 string The value that is unique within the system.
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
.... identifier:CRID SΣ 0..1 Identifier An identifier for this patient
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
..... system SΣ 1..1 uri The namespace for the identifier value
Required Pattern: http://terminology.cibmtr.org/identifier/CRID
..... value SΣ 1..1 string The value that is unique within the system.
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
.... identifier:GRID SΣ 0..1 Identifier An identifier for this patient
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... coding Σ 0..* Coding Code defined by a terminology system
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 0..1 uri Identity of the terminology system
Required Pattern: https://www.hl7.org/fhir/v2/0203/index.html
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 0..1 code Symbol in syntax defined by the system
Required Pattern: DR
....... display Σ 0..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... system SΣ 1..1 uri The namespace for the identifier value
Required Pattern: http://www.isbt128.org/uri/GRID
..... value SΣ 1..1 string The value that is unique within the system.
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
.... identifier:NMDPRecipient SΣ 0..1 Identifier An identifier for this patient
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
..... system SΣ 1..1 uri The namespace for the identifier value
Required Pattern: http://terminology.nmdp.org/identifier/recipient
..... value SΣ 1..1 string The value that is unique within the system.
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
.... identifier:CIBMTR-non-NMDP-donor SΣ 0..1 Identifier An identifier for this patient
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
..... system SΣ 1..1 uri The namespace for the identifier value
Required Pattern: http://terminology.cibmtr.org/identifier/non-nmdp-donor
..... value SΣ 1..1 string The value that is unique within the system.
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
.... identifier:SSN SΣ 0..1 Identifier An identifier for this patient
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
..... system SΣ 1..1 uri The namespace for the identifier value
Required Pattern: http://hl7.org/fhir/sid/us-ssn
..... value SΣ 1..1 string The value that is unique within the system.
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... active ?!Σ 0..1 boolean Whether this patient's record is in active use
... name SΣC 1..* HumanName A name associated with the patient
Constraints: us-core-6
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: usual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required): The use of a human name.
.... text Σ 0..1 string Text representation of the full name
.... family SΣC 0..1 string Family name (often called 'Surname')
.... given SΣC 0..* string Given names (not always 'first'). Includes middle names
This repeating element order: Given Names appear in the correct order for presenting the name
.... prefix Σ 0..* string Parts that come before the name
This repeating element order: Prefixes appear in the correct order for presenting the name
.... suffix Σ 0..* string 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Parts that come after the name
This repeating element order: Suffixes appear in the correct order for presenting the name
.... period Σ 0..1 Period 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Time period when name was/is in use
... telecom Σ 0..* ContactPoint 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: A contact detail for the individual
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... system SΣC 1..1 code phone | fax | email | pager | url | sms | other
Binding: ContactPointSystem (required): Telecommunications form for contact point.
.... value SΣ 1..1 string The actual contact point details
.... use ?!SΣ 0..1 code home | work | temp | old | mobile - purpose of this contact point
Binding: ContactPointUse (required)
.... rank Σ 0..1 positiveInt Specify preferred order of use (1 = highest)
.... period Σ 0..1 Period Time period when the contact point was/is in use
... gender Σ 0..1 code male | female | other | unknown
Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
... birthDate SΣ 0..1 date The date of birth for the individual
... deceased[x] ?!Σ 0..1 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Indicates if the individual is deceased or not
.... deceasedBoolean boolean
.... deceasedDateTime dateTime
... address SΣ 0..* Address An address for the individual
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: home | work | temp | old | billing - purpose of this address
Binding: AddressUse (required): The use of an address.
Example General: home
.... type Σ 0..1 code postal | physical | both
Binding: AddressType (required): The type of an address (physical / postal).
Example General: both
.... text Σ 0..1 string Text representation of the address
Example General: 137 Nowhere Street, Erewhon 9132
.... line SΣ 0..* string Street name, number, direction & P.O. Box etc.
This repeating element order: The order in which lines should appear in an address label
Example General: 137 Nowhere Street
Example US Core: 49 MEADOW ST
.... city SΣ 0..1 string Name of city, town etc.
Example General: Erewhon
Example US Core: EVERYTOWN
.... district Σ 0..1 string District name (aka county)
Example General: Madison
.... state SΣ 0..1 string Sub-unit of country (abbreviations ok)
Binding: USPS Two Letter Alphabetic Codes (extensible): Two Letter USPS alphabetic codes.
Example US Core: OK
.... postalCode SΣ 0..1 string US Zip Codes
Example General: 9132
Example US Core: 74047
.... country Σ 0..1 string Country (e.g. can be ISO 3166 2 or 3 letter code)
.... period Σ 0..1 Period 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Time period when address was/is in use
Example General: {"start":"2010-03-23","end":"2010-07-01"}
... maritalStatus 0..1 CodeableConcept Marital (civil) status of a patient
Binding: Marital Status Codes (extensible): The domestic partnership status of a person.
... multipleBirth[x] 0..1 Whether patient is part of a multiple birth
.... multipleBirthBoolean boolean
.... multipleBirthInteger integer
... photo 0..* Attachment Image of the patient
... contact C 0..* BackboneElement A contact party (e.g. guardian, partner, friend) for the patient
Constraints: pat-1
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... relationship 0..* CodeableConcept The kind of relationship
Binding: PatientContactRelationship (extensible): The nature of the relationship between a patient and a contact person for that patient.
.... name 0..1 HumanName A name associated with the contact person
.... telecom 0..* ContactPoint A contact detail for the person
.... address 0..1 Address Address for the contact person
.... gender 0..1 code male | female | other | unknown
Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
.... organization C 0..1 Reference(Organization) Organization that is associated with the contact
.... period 0..1 Period The period during which this contact person or organization is valid to be contacted relating to this patient
... communication 0..* BackboneElement 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: A language which may be used to communicate with the patient about his or her health
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... language S 1..1 CodeableConcept The language which can be used to communicate with the patient about his or her health
Binding: Languages (extensible)
.... preferred 0..1 boolean Language preference indicator
... generalPractitioner 0..* Reference(Organization | Practitioner | PractitionerRole) Patient's nominated primary care provider
... managingOrganization Σ 0..1 Reference(Organization) Organization that is the custodian of the patient record
... link ?!Σ 0..* BackboneElement Link to another patient resource that concerns the same actual person
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... other Σ 1..1 Reference(Patient | RelatedPerson) The other patient or related person resource that the link refers to
.... type Σ 1..1 code replaced-by | replaces | refer | seealso
Binding: LinkType (required): The type of link between this patient resource and another patient resource.

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Patient.meta.security Base extensible SecurityLabels 📍4.0.1 FHIR Std.
Patient.meta.security:TransplantCenter Base extensible SecurityLabels 📍4.0.1 FHIR Std.
Patient.meta.tag Base example Common Tags 📍4.0.1 FHIR Std.
Patient.language Base preferred Common Languages 📦4.0.1 FHIR Std.
Patient.identifier.use Base required IdentifierUse 📍4.0.1 FHIR Std.
Patient.identifier.type Base extensible IdentifierType 📦4.0.1 FHIR Std.
Patient.identifier:CRID.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
Patient.identifier:CRID.​type Base extensible IdentifierType 📦4.0.1 FHIR Std.
Patient.identifier:GRID.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
Patient.identifier:GRID.​type Base extensible IdentifierType 📦4.0.1 FHIR Std.
Patient.identifier:NMDPRecipient.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
Patient.identifier:NMDPRecipient.​type Base extensible IdentifierType 📦4.0.1 FHIR Std.
Patient.identifier:CIBMTR-non-NMDP-donor.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
Patient.identifier:CIBMTR-non-NMDP-donor.​type Base extensible IdentifierType 📦4.0.1 FHIR Std.
Patient.identifier:SSN.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
Patient.identifier:SSN.​type Base extensible IdentifierType 📦4.0.1 FHIR Std.
Patient.name.use Base required NameUse 📍4.0.1 FHIR Std.
Patient.telecom.system Base required ContactPointSystem 📦4.0.1 FHIR Std.
Patient.telecom.use Base required ContactPointUse 📦4.0.1 FHIR Std.
Patient.gender Base required AdministrativeGender 📍4.0.1 FHIR Std.
Patient.address.use Base required AddressUse 📍4.0.1 FHIR Std.
Patient.address.type Base required AddressType 📍4.0.1 FHIR Std.
Patient.address.state Base extensible USPS Two Letter Alphabetic Codes 📦2.0.0 THO v7.2
Patient.maritalStatus Base extensible MaritalStatus 📦4.0.1 FHIR Std.
Patient.contact.relationship Base extensible Patient Contact Relationship 📦4.0.1 FHIR Std.
Patient.contact.gender Base required AdministrativeGender 📍4.0.1 FHIR Std.
Patient.communication.​language Base extensible Languages 📦1.0.0 THO v7.2
Patient.link.type Base required LinkType 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Patient If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Patient If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Patient If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Patient If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Patient A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
pat-1 error Patient.contact SHALL at least contain a contact's details or a reference to an organization name.exists() or telecom.exists() or address.exists() or organization.exists()
sec-rc error Patient.meta.security:TransplantCenter.code Use transplant center identifier for security tag matches('^rc_[0-9]{5}$')
us-core-6 error Patient.name At least name.given and/or name.family are present or, if neither is available, the Data Absent Reason Extension is present. (family.exists() or given.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()
us-core-23 error Patient.extension:race If "ASKU" or "UNK" are present, then no other OMB race categories can be present. extension.where(url = 'ombCategory').value.where(code in 'ASKU'|'UNK').exists() implies extension.where(url = 'ombCategory').count() = 1

This structure is derived from USCorePatientProfile

Summary

Mandatory: 0 element(4 nested mandatory elements)
Must-Support: 7 elements

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Patient.meta.security
  • The element 1 is sliced based on the value of Patient.identifier

 

Other representations of profile: CSV, Excel, Schematron

Notes:

This section describes how client systems should search for and (if needed) create a Patient on the CIBMTR FHIR server before submitting other resources that reference the Patient as subject.

Patient Resources (CIBMTR Server Workflow)

A FHIR Patient resource with an identifier containing the CRID must exist on the CIBMTR FHIR server to be used as a subject reference in Observation or other resources. To prevent multiple identical Patient resources from being created, the client must first check to see if it already exists.

To search for Patient resource with a specific CRID, use this GET request (all one line)

GET <base URL>/r4/Patient?
    _security=http://cibmtr.org/codesystem/transplant-center|rc_<CCN>
    &identifier=http://cibmtr.org/identifier/CRID|<CRID>

If the response shows a searchset result with a total of 0, then a Patient resource with that CRID has not been created, and a new Patient resource must be created. In this case, proceed to Submit Patient FHIR Resource.

If the response shows a total of one or more, then at least one Patient with that CRID already exists. In this case, skip Step 3, and go on to Step 4. If more than one Patient was found, then it suggests that someone created a Patient without checking to see if it first exists.

A note about special characters: The FHIR search parameters sometime include special characters such as the pipe character ("|"). Often, these need to be replaced with url-encoded character strings. In this case, "|" is replaced by "%7C" in the values for the keys.

The response below shows one Patient resource, and that resource has an id of 46986.

Figure 5
Figure 5: Example of response of Patient search

The 'id' should be used in all subject.references for all subsequent Observations that are submitted for this Patient. This would have the form of:

"subject": {
    "reference": "Patient/<id>"
    }

Replace <id> with the Patient.id found in the search.

To drive home the point, the

  • Patient.id is a local server id, and is used as a subject.reference in other FHIR resources.
  • Patient.identifier is a business identifier and the where the CRID is located.
Submit Patient FHIR Resource

If the Patient FHIR resource doesn't already exist, it must be created before any other FHIR resources. The Patient FHIR resource ID is part of the response to the Patient POST request. The resource ID is unique to the CIBMTR FHIR server and is used to reference the Patient subject on all subsequently submitted FHIR resources. The resource ID is assigned by the FHIR server and is different from the Patient.identifier section of the FHIR resource. The Patient ID is NOT a Patient CRID.

The Direct FHIR Service API uses a POST request to submit a Patient resource at the following case-sensitive endpoint URLs:

POST    <base URL>/r4/Patient

The authorization key and bearer token must be included in the request as mentioned in the previous section. FHIR JSON submissions should also include a content-type key in the header with value: application/fhir+json.

Minimum Patient Resource Example

The Patient FHIR resource usually contains the demographics data for the patient, however, since the demographics data is already submitted during the CRID registration process, there are only three primary components necessary in the Patient FHIR resource:

  1. A security label (describe above) within the meta section of the Patient resource must contain the CIBMTR Center Number (CCN) prepended with rc_ and associated with the codesystem as shown in Figure 6.
  2. A text.status section that should have the narrative code of empty if no text narrative is provided. An example is shown in Figure 6.
  3. A CRID identifier reference within the identifier section of the Patient resource as shown in Figure 6.
Figure 6
Figure 6: Example POST request to submit a Patient FHIR resource and the required FHIR sections in the body of the request

PII information should be avoided as part of the Patient resource. However, the Direct FHIR service API will remove PII information, including any that might be contained in text.div or other sections of the resource before storing it on the FHIR server.

The response after submitting a Patient resource request, includes the Patient resource ID in the header of the response (see Figure 7). The Location section of the response header includes a URL reference for the Patient resource on the CIBMTR FHIR server and the Patient resource ID is in the URL (circled in red in Figure 7). The Patient resource ID is necessary for submitting other FHIR resources to the Direct FHIR service API, but if the ID for a Patient resource previously submitted is not known, the following GET request can be submitted to the API to retrieve the Patient resource for a given CRID:

Figure 7
Figure 7: Example FHIR Patient submission response with the Patient resource ID found in the response header Location

Preferred Patient resource While including the CRID identifier, meta.security tag, and empty text element is the bare minimum for creating a Patient resource, we prefer to have some additional data present to help with resource management. These include date of birth, gender, and race & ethnicity information. Race and ethnicity must be reported as described in the FHIR US-Core Implementation Guide:

  • https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-race.html
  • https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-ethnicity.html

See the following for an example that using these elements with data as found for registering for the CRID above.

{
    "resourceType": "Patient",
    "meta": {"security": [
        {
            "system": "http://cibmtr.org/codesystem/transplant-center",
            "code": "rc_12002"
        }
    ]},
    "text": {"status": "empty"},
    "identifier": [
        {
            "use": "official",
            "system": "http://cibmtr.org/identifier/CRID",
            "value": "4598886"
        }
    ],
    "gender": "male",
    "birthDate": "1925-07-04",
    "extension": [
        {
            "extension": [
                {
                    "url": "ombCategory",
                    "valueCoding": {
                        "system": "urn:oid:2.16.840.1.113883.6.238",
                        "code": "2106-3",
                        "display": "White"
                    }
                },
                {
                    "url": "text",
                    "valueString": "White"
                }
            ],
            "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"
        }
    ]
}

Note that ethnicity is not included in the above example. This is because valueset for the US-Core Ethnicity Extension does not include Unknown which was submitted to the CRID service. To be conformant to the FHIR US-Core Implementation Guide, it must be either "Hispanic or Latino" or "Non Hispanic or Latino." Please contact us if you have any questions on how to implement these extensions.

Here's an example with ethnicity included:

{
    "resourceType": "Patient",
    "meta": {"security": [
        {
            "system": "http://cibmtr.org/codesystem/transplant-center",
            "code": "rc_12002"
        }
    ]},
    "text": {"status": "empty"},
    "identifier": [
        {
            "use": "official",
            "system": "http://cibmtr.org/identifier/CRID",
            "value": "4598886"
        }
    ],
    "gender": "male",
    "birthDate": "1925-07-04",
    "extension": [
        {
            "extension": [
                {
                    "url": "ombCategory",
                    "valueCoding": {
                        "system": "urn:oid:2.16.840.1.113883.6.238",
                        "code": "2106-3",
                        "display": "White"
                    }
                },
                {
                    "url": "text",
                    "valueString": "White"
                }
            ],
            "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"
        },
        {
            "extension": [
                {
                    "url": "ombCategory",
                    "valueCoding": {
                        "system": "urn:oid:2.16.840.1.113883.6.238",
                        "code": "2135-2",
                        "display": "Hispanic or Latino"
                    }
                },
                {
                    "url": "detailed",
                    "valueCoding": {
                        "system": "urn:oid:2.16.840.1.113883.6.238",
                        "code": "2184-0",
                        "display": "Dominican"
                    }
                },
                {
                    "url": "text",
                    "valueString": "Hispanic or Latino"
                }
            ],
            "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity"
        }
    ]
}