ACP Patient - Advance Care Planning (PZP) v1.0.0

Is Modifier true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

4. Patient.extension:nationality

Slice Name nationality

Definition

The nationality of the patient.

Short Nationality

Comments

Due to the nature of the nationality core extension (which allows for a period to be placed next to the nationality and thus allows for different nationalities over time), the cardinality of the extension is left at 0..* instead of the zib cardinality of 0..1.

Control 0..*
This element is affected by the following invariants: ele-1

Type Extension(Patient Nationality) (Complex Extension)

Is Modifier false

Alternate Names extensions, user content

6. Patient.extension:nationality.extension:code

Slice Name code

Definition

Code representing nationality of patient.

Short Nationality CodeAdditional content defined by implementations

Control 0..1*

Is Modifier false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())

8. Patient.extension:nationality.extension:code.extension

Definition

An Extension

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

Short ExtensionAdditional content defined by implementations

Comments

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

Control 0..0*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

10. Patient.extension:nationality.extension:code.url

Definition

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

Short identifies the meaning of the extension

Comments

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

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value code

12. Patient.extension:nationality.extension:code.value[x]

Definition

Indicates the country of citizenship.

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

Short NationalityValue of extension

Control 10..1

Binding Unless not suitable, these codes SHALL be taken from For codes, see NationaliteitCodelijst (2020-09-01T00:00:00)
(extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.7.6.3--20200901000000|2020-09-01T00:00:00)

Type CodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary false

Alternate Names Nationaliteit

14. Patient.extension:nationality.extension:period

Slice Name period

Definition

Period when nationality was effective.

Short Nationality PeriodAdditional content defined by implementations

Control 0..1*

Is Modifier false

Summary false

16. Patient.extension:nationality.extension:period.extension

Definition

An Extension

Short ExtensionAdditional content defined by implementations

Comments

Control 0..0*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

18. Patient.extension:nationality.extension:period.url

Definition

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

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value period

20. Patient.extension:nationality.extension:period.value[x]

Definition

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

Short Value of extension

Control 10..1

Type Period, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary false

22. Patient.extension:nationality.url

Definition

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

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://hl7.org/fhir/StructureDefinition/patient-nationality

24. Patient.extension:nationality.value[x]

Definition

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

Short Value of extension

Control 0..01

Type Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

26. Patient.modifierExtension

Definition

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

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

Short Extensions that cannot be ignored

Comments

Control 0..*

Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them

Summary false

Requirements

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

Alternate Names extensions, user content

28. Patient.identifier

Definition

The patient’s identification number. In transfer situations, use of the social security number (BSN) must comply with the Use of Social Security Numbers in Healthcare Act (Wbsn-z). In other situations, other number systems can be used, such as internal hospital patient numbers for example.

An identifier for this patient.

Short PatientIdentificationNumberAn identifier for this patient

Note This is a business identifier, not a resource identifier (see discussion)

Control 0..*

Identifier

Is Modifier false

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary true

Requirements

Patients are almost always assigned specific numerical identifiers.

Alternate Names Identificatienummer

This element introduces a set of slices on Patient.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ $this

30. Patient.identifier:bsn

Slice Name bsn

Definition

An identifier for this patient.

Short An identifier for this patient

Note This is a business identifier, not a resource identifier (see discussion)

Control 0..*

Identifier

Is Modifier false

Summary true

Requirements

Patients are almost always assigned specific numerical identifiers.

Pattern Value { "system" : "http://fhir.nl/fhir/NamingSystem/bsn" }

32. Patient.active

Definition

Whether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules.

It is often used to filter patient lists to exclude inactive patients

Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death.

Short Whether this patient's record is in active use

Comments

If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient.

Control 0..1

Is Modifier true because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

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

Meaning if Missing This resource is generally assumed to be active if no value is provided for the active element

34. Patient.name

Definition

Patient's full name.

A name associated with the individual.

Short NameInformation / PayerNameA name associated with the patient

Comments

A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.

Control 10..*

HumanName

Is Modifier false

Summary true

Requirements

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

Alternate Names Naamgegevens, BetalerNaam

This element introduces a set of slices on Patient.name. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ use

36. Patient.name:nameInformation

Slice Name nameInformation

Definition

This slice represents the person's official name information, including given names, last name and possibly the partner's last name.

A name associated with the individual.

Short NameInformationA name associated with the patient

Comments

This .name element accomodates the official parts of a Dutch name according to common international usage and optionally to the zib NameInformation v1.1 (2020). An official Dutch name is represented in FHIR as an ordinary international name, optionally augmented using extensions to specify how the last name is built up according to the Dutch rules if conformance to the zib is required. See the guidance on .family and on .extension:nameUsage for more information.

Systems that need to work in a Dutch context SHOULD support the extensions as specified in .given, .family and .extension:nameUsage. In addition, systems SHOULD use the core elements according to the FHIR specifications to provide compatibility outside Dutch contexts. This means that:

If parts of the name are specified using one or more of the structured elements, the .text element SHOULD be populated with a rendered version of the full name.
If parts of the family name are specified using the extensions in .family, the .family element SHOULD be populated with the full family name.

Note 1: The zib cannot be represented straightforward in FHIR. Especially note the guidance on .given on how to map the FirstNames and Initials concepts, and on .prefix/.suffix on how to map the Titles concept.

Note 2: This element should only contain a person's official names. The GivenName concept is represented in another .name element with .name.use = usual.

Note 3: The examples illustrate how the zib is mapped to FHIR.

A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.

Control 0..2*
This element is affected by the following invariants: ele-1

Type HumanName(nl core NameInformation)

Is Modifier false

Summary true

Requirements

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

Alternate Names Naamgegevens, nl-core-NameInformation

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
zib-NameInformation-1: If a prefix for a family name is specified, the family name is expected as well (family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-prefix').empty().not() implies family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-name').empty().not())
zib-NameInformation-2: If the prefix for a partner family name is specified, the partner family name is expected as well (family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix').empty().not() implies family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-name').empty().not())
nl-core-NameInformation-01: If parts of the name are specified using one or more of the structured elements, the `.text` element SHOULD be populated with a rendered version of the full name. This ensures compatibility with common FHIR usage. ((family.exists() or given.extension.where(url = 'http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier').where(value != 'IN').exists()) implies text.hasValue())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

38. Patient.name:nameInformation.extension:nameUsage

Slice Name nameUsage

Definition

A code that represents the preferred display order of the components of this human name.

Short Preferred display order of name parts

Comments

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(Assembly Order) (Extension Type: code)

Is Modifier false

Summary false

Alternate Names extensions, user content

40. Patient.name:nameInformation.extension:nameUsage.extension

Definition

An Extension

Short ExtensionAdditional content defined by implementations

Comments

Control 0..0*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.name.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

42. Patient.name:nameInformation.extension:nameUsage.url

Definition

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

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://hl7.org/fhir/StructureDefinition/humanname-assembly-order

44. Patient.name:nameInformation.extension:nameUsage.value[x]

Definition

This concept indicates the last name or order of last names with which the person is to be addressed.

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

Short NameUsageValue of extension

Control 10..1

The codes SHALL be taken from For codes, see HumanNameAssemblyOrder
(required to http://hl7.org/fhir/ValueSet/name-assembly-order|4.0.1)

Use ConceptMap NaamgebruikCodelijst-to-HumanNameAssemblyOrder to translate terminology from the functional model to profile terminology in ValueSet HumanNameAssemblyOrder.

Type code, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Alternate Names Naamgebruik

46. Patient.name:nameInformation.use

Definition

Identifies the purpose for this name.

Comments

Applications can assume that a name is current unless it explicitly says that it is temporary or old.

Control 10..1

The codes SHALL be taken from NameUsehttp://hl7.org/fhir/ValueSet/name-use|4.0.1
(required to http://hl7.org/fhir/ValueSet/name-use|4.0.1)

The use of a human name.

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary true

Requirements

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

Pattern Value official

48. Patient.name:nameInformation.family

Definition

The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.

Short Family name (often called 'Surname')

Comments

When implementing zib NameInformation, this representation should be constrcuted from the Prefix, LastName, PartnerPrefix and/or PartnerLastName concepts according to the NameUsage concept.

Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).

Control 0..1
This element is affected by the following invariants: nl-core-NameInformation-01

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Alternate Names surname

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
nl-core-NameInformation-02: If parts of the family name are specified using the extensions in .family, the .family element SHOULD be populated with the full family name as well. This ensures compatibility with common FHIR usage. ((extension('http://hl7.org/fhir/StructureDefinition/humanname-own-prefix').exists() or extension('http://hl7.org/fhir/StructureDefinition/humanname-own-name').exists() or extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix').exists() or extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-name').exists()) implies $this.hasValue())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

50. Patient.name:nameInformation.family.extension:prefix

Slice Name prefix

Definition

The prefix portion (e.g. voorvoegsel) of the family name that is derived from the person's own surname, as distinguished from any portion that is derived from the surname of the person's partner or spouse.

Short Voorvoegsel derived from person's own surname

Comments

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

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(Own Prefix) (Extension Type: string)

Is Modifier false

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary false

52. Patient.name:nameInformation.family.extension:prefix.extension

Definition

An Extension

Short ExtensionAdditional content defined by implementations

Comments

Control 0..0*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.name.family.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

54. Patient.name:nameInformation.family.extension:prefix.url

Definition

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

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://hl7.org/fhir/StructureDefinition/humanname-own-prefix

56. Patient.name:nameInformation.family.extension:prefix.value[x]

Definition

Prefix to the person’s own last name.

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

Short PrefixValue of extension

Control 10..1

Type string, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Alternate Names Voorvoegsels

58. Patient.name:nameInformation.family.extension:lastName

Slice Name lastName

Definition

The portion of the family name that is derived from the person's own surname, as distinguished from any portion that is derived from the surname of the person's partner or spouse.

Short Portion derived from person's own surname

Comments

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

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(Own Name) (Extension Type: string)

Is Modifier false

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary false

60. Patient.name:nameInformation.family.extension:lastName.extension

Definition

An Extension

Short ExtensionAdditional content defined by implementations

Comments

Control 0..0*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.name.family.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

62. Patient.name:nameInformation.family.extension:lastName.url

Definition

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

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://hl7.org/fhir/StructureDefinition/humanname-own-name

64. Patient.name:nameInformation.family.extension:lastName.value[x]

Definition

The person’s official last name

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

Short LastNameValue of extension

Control 10..1

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Alternate Names Achternaam

66. Patient.name:nameInformation.family.extension:partnerPrefix

Slice Name partnerPrefix

Definition

The prefix portion (e.g. voorvoegsel) of the family name that is derived from the person's partner's surname, as distinguished from any portion that is derived from the surname of the person's own.

Short Voorvoegsel derived from person's partner's surname

Comments

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

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(Partner Prefix) (Extension Type: string)

Is Modifier false

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary false

68. Patient.name:nameInformation.family.extension:partnerPrefix.extension

Definition

An Extension

Short ExtensionAdditional content defined by implementations

Comments

Control 0..0*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.name.family.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

70. Patient.name:nameInformation.family.extension:partnerPrefix.url

Definition

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

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix

72. Patient.name:nameInformation.family.extension:partnerPrefix.value[x]

Definition

Prefix to the partner’s last name.

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

Short PartnerPrefixValue of extension

Control 10..1

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Alternate Names VoorvoegselsPartner

74. Patient.name:nameInformation.family.extension:partnerLastName

Slice Name partnerLastName

Definition

The portion of the family name that is derived from the person's partner's surname, as distinguished from any portion that is derived from the surname of the person's own name.

Short Portion derived from person's partner's surname

Comments

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(Partner Name) (Extension Type: string)

Is Modifier false

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary false

76. Patient.name:nameInformation.family.extension:partnerLastName.extension

Definition

An Extension

Short ExtensionAdditional content defined by implementations

Comments

Control 0..0*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.name.family.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

78. Patient.name:nameInformation.family.extension:partnerLastName.url

Definition

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

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://hl7.org/fhir/StructureDefinition/humanname-partner-name

80. Patient.name:nameInformation.family.extension:partnerLastName.value[x]

Definition

Partner’s official last name.

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

Short PartnerLastNameValue of extension

Control 10..1

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Alternate Names AchternaamPartner

82. Patient.name:nameInformation.given

Definition

One of a person’s official first names or the initial if the full name is not known.

Given name.

Short FirstName / InitialGiven names (not always 'first'). Includes middle names

Comments

This element can be used to represent full given names or initials. extension:givenOrInitial SHALL be used on each repretition to specifiy if it's a full name (BR) or an initial (IN).

Zib compatibility

Tthis element is used to represent the FirstNames and Initials concepts of zib NameInformation, but the FHIR implementation deviates from the zib model. The zib defines these concepts as a list of official first names (as a single string) and a list of initials (as a single string), both optional. They both represent the official name(s) of a person and thus represent the same concept. In FHIR however, each first name is either a complete name or an initial, but not both. In addition, each name may be defined separately.

Therefore, the zib concepts are implemented here in the following way:

Systems SHOULD use a .given element for each official first name that they know of (either as a full name or an initial), in order of appearance (as specified by FHIR).
Each of these elements:
- SHOULD be populated with the complete name if it is known, or with the initial if no more information is available.
- As noted, it SHALL be augmented with extension:givenOrInitial.

Initials should thus not be communicated for each complete first name that is known, in contrast to what is specified by the zib. Receiving systems can recreate initials from the full names if needed.

If a system does however only have a list of official first names and a separate list of official initials, without knowing the relationship between these two, only the full names SHOULD be communicated, while an additional .name instance MAY be used to communicate the initials. It is expected that the second instance just contains the initials and no other information from the zib. Receiving systems MAY ignore the second instance.

Note 1: The GivenName concept should not be included here but in a separate .name instance where .use = usual.

Note 2: As specified by FHIR, multiple official first names MAY be combined in a single .given element (separated by spaces), as long as the .given elements can be concatenated to form the full first name representation, and the 'extension:givenOrInitial` is used to mark the element as containing either full names or the initials. This pattern is strongly discouraged as it is hard to determine if the value pertains multiple names or a single combined name containing spaces.

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.

Control 0..*
This element is affected by the following invariants: nl-core-NameInformation-01

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary true

Alternate Names first name, middle name, Voornaam, Initiaal

84. Patient.name:nameInformation.given.extension

Definition

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

Short Additional content defined by implementations

Comments

Control 10..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.name.given.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

86. Patient.name:nameInformation.given.extension:givenOrInitial

Slice Name givenOrInitial

Definition

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

Short LS | AC | NB | PR | HON | BR | AD | SP | MID | CL | IN | VV

Comments

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

Control 1..*
This element is affected by the following invariants: ele-1

Type Extension(EN Qualifier) (Extension Type: code)

Is Modifier false

Summary false

Alternate Names extensions, user content

88. Patient.name:nameInformation.suffix

Definition

Noble and scientific titles. These can assist in formulating oral and formal addresing titles.

Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name.

Short TitlesParts that come after the name

Comments

The zib concept 'titles' is mapped to elements HumanName.prefix and HumanName.suffix. Semantically this mapping is not complete: the zib uses a single concept that contains all the required information about noble and scientific titles, while FHIR captures the same information in a structured way.

Export:

Systems are expected to transform as much as possible to the FHIR datamodel and thereby to be as explicit as possible. Note that in order to mark the type of a prefix, you can use the FHIR standard extension for ISO 21090 EN Qualifiers. Examples include the use of the qualifier HON to indicate honorific prefixes and AC for academic prefixes.

If it is not possible to breakup the zib concept titles to positioned prefixes and suffixes, the prefix element is used to store all information.

Import:

Systems need to expect and be resilient for a broader range of information stored in the prefix element than stated by it's definition.

Control 0..*

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary true

Alternate Names Titels

90. Patient.name:nameInformation-GivenName

Slice Name nameInformation-GivenName

Definition

This slice represents the name information normally used to address the person.

A name associated with the individual.

Short Name of a human - parts and usageA name associated with the patient

Comments

This .name element represents the Dutch given name ("roepnaam") according to the zib NameInformation v1.1 (2020).

Note 1: This element should only contain a person's unofficial name. The official names are represented in one or more other .name elements with .name.use = official.

Note 2: The examples illustrate how the zib is mapped to FHIR.

A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.

Control 0..*
This element is affected by the following invariants: ele-1

Type HumanName(nl core NameInformation.GivenName)

Is Modifier false

Summary true

Requirements

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

Alternate Names nl-core-NameInformation.GivenName

92. Patient.name:nameInformation-GivenName.use

Definition

Identifies the purpose for this name.

Comments

Applications can assume that a name is current unless it explicitly says that it is temporary or old.

Control 10..1

The codes SHALL be taken from NameUsehttp://hl7.org/fhir/ValueSet/name-use|4.0.1
(required to http://hl7.org/fhir/ValueSet/name-use|4.0.1)

The use of a human name.

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

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

Pattern Value usual

94. Patient.name:nameInformation-GivenName.family

Definition

The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.

Short Family name (often called 'Surname')

Comments

Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).

Control 0..01

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Alternate Names surname

96. Patient.name:nameInformation-GivenName.given

Definition

The name normally used to address the person.

Given name.

Short GivenNameGiven names (not always 'first'). Includes middle names

Comments

Control 10..*

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary true

Alternate Names first name, middle name, Roepnaam

98. Patient.name:nameInformation-GivenName.prefix

Definition

Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name.

Short Parts that come before the name

Control 0..0*

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

100. Patient.name:nameInformation-GivenName.suffix

Definition

Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name.

Short Parts that come after the name

Control 0..0*

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

102. Patient.telecom

Definition

Patient’s telephone number(s) or e-mail address(es).

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

Short ContactInformationA contact detail for the individual

Comments

The cardinality mismatch between the zib (0..1) and FHIR (0..*) is explained by the containers TelephoneNumbers (0..*) and EmailAddresses (0..*) inside the ContactInformation model. The FHIR datatype ContactPoint does not have these containers.

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).

Control 0..*

Is Modifier false

Summary true

Requirements

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

Alternate Names Contactgegevens

This element introduces a set of slices on Patient.telecom. The slices areUnordered and Open, and can be differentiated using the following discriminators:

profile @ $this

104. Patient.telecom:telephoneNumbers

Slice Name telephoneNumbers

Definition

Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc.

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

Short TelephoneNumbersA contact detail for the individual

Comments

Implementation of the "TelephoneNumbers" concept of zib ContactInformation.

Please note that, although the zib concepts TelecomType and NumberType are functionally equivalent to the FHIR concepts ContactPoint.system and ContactPoint.use respectively, a mismatch occurs on the concept of mobile phone numbers; the zib uses the first concept and FHIR the second. For this reason, the ValueSet on ContactPoint.system is too narrow and the zib code will need to be communicated using the ext-CodeSpecification extension.

Control 0..*
This element is affected by the following invariants: ele-1

Type ContactPoint(nl core ContactInformation TelephoneNumbers)

Is Modifier false

Summary true

Requirements

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

Alternate Names Telefoonnummers, nl-core-ContactInformation-TelephoneNumbers

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
cpt-2: A system is required if a value is provided. (value.empty() or system.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

106. Patient.telecom:telephoneNumbers.extension:comment

Slice Name comment

Definition

Optional Extension Element - found in all resources.

Short Optional Extensions Element

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(ext Comment) (Extension Type: string)

Is Modifier false

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary false

108. Patient.telecom:telephoneNumbers.extension:comment.url

Definition

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

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://nictiz.nl/fhir/StructureDefinition/ext-Comment

110. Patient.telecom:telephoneNumbers.system

Definition

The telecom or device type that the telephone number is connected to.

Telecommunications form for contact point - what communications system is required to make use of the contact.

Short TelecomTypephone | fax | email | pager | url | sms | other

Control 10..1
This element is affected by the following invariants: cpt-2

The codes SHALL be taken from ContactInformationTelephoneNumbersSystem (4.0.1)http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
(required to http://nictiz.nl/fhir/ValueSet/ContactInformation-TelephoneNumbersSystem|4.0.1)

Use ConceptMap TelecomType-to-ContactInformation-TelephoneNumbersSystem to translate terminology from the functional model to profile terminology in ValueSet ContactInformation-TelephoneNumbersSystem.

Telecommunications form for contact point.

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary true

Alternate Names TelecomType

112. Patient.telecom:telephoneNumbers.system.extension:telecomType

Slice Name telecomType

Definition

Optional Extension Element - found in all resources.

Short Optional Extensions Element

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(ext CodeSpecification) (Extension Type: CodeableConcept)

Is Modifier false

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary false

114. Patient.telecom:telephoneNumbers.system.extension:telecomType.url

Definition

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

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://nictiz.nl/fhir/StructureDefinition/ext-CodeSpecification

116. Patient.telecom:telephoneNumbers.system.extension:telecomType.value[x]

Definition

The telecom or device type that the telephone number is connected to.

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

Short TelecomTypeValue of extension

Control 0..1

Binding The codes SHALL be taken from For codes, see TelecomTypeCodelijst (2020-09-01T00:00:00)
(required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.20.6.1--20200901000000|2020-09-01T00:00:00)

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary false

Alternate Names TelecomType

118. Patient.telecom:telephoneNumbers.value

Definition

The person's telephone number.

The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

Short TelephoneNumberThe actual contact point details

Comments

Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary true

Requirements

Need to support legacy numbers that are not in a tightly controlled format.

Alternate Names Telefoonnummer

120. Patient.telecom:telephoneNumbers.use

Definition

NumberType indicates whether the number is a landline, temporary, work telephone number.

Identifies the purpose for the contact point.

Short NumberTypehome | work | temp | old | mobile - purpose of this contact point

Comments

Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

Control 0..1

The codes SHALL be taken from ContactInformationTelephoneNumbersUse (4.0.1)http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1
(required to http://nictiz.nl/fhir/ValueSet/ContactInformation-TelephoneNumbersUse|4.0.1)

Use ConceptMap NummerSoortCodelijst-to-ContactInformation-TelephoneNumbersUse to translate terminology from the functional model to profile terminology in ValueSet ContactInformation-TelephoneNumbersUse.

Use of contact point.

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary true

Requirements

Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

Alternate Names NummerSoort

122. Patient.telecom:emailAddresses

Slice Name emailAddresses

Definition

Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc.

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

Short EmailAddressesA contact detail for the individual

Comments

Implementation of the "EmailAddresses" concept of zib ContactInformation.

Control 0..*
This element is affected by the following invariants: ele-1

Type ContactPoint(nl core ContactInformation EmailAddresses)

Is Modifier false

Summary true

Requirements

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

Alternate Names EmailAdressen, nl-core-ContactInformation-EmailAddresses

124. Patient.telecom:emailAddresses.system

Definition

Telecommunications form for contact point - what communications system is required to make use of the contact.

Short emailphone | fax | email | pager | url | sms | other

Control 10..1
This element is affected by the following invariants: cpt-2

The codes SHALL be taken from ContactPointSystemhttp://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
(required to http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1)

Telecommunications form for contact point.

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary true

Pattern Value email

126. Patient.telecom:emailAddresses.value

Definition

The person's e-mail address

The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

Short EmailAddressThe actual contact point details

Comments

Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary true

Requirements

Need to support legacy numbers that are not in a tightly controlled format.

Alternate Names EmailAdres

128. Patient.telecom:emailAddresses.use

Definition

EmailAddressType indicates whether it is a private or business e-mail address.

Identifies the purpose for the contact point.

Short EmailAddressTypehome | work | temp | old | mobile - purpose of this contact point

Comments

Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

Control 0..1

The codes SHALL be taken from ContactInformationEmailAddressesUse (4.0.1)http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1
(required to http://nictiz.nl/fhir/ValueSet/ContactInformation-EmailAddressesUse|4.0.1)

Use ConceptMap EmailSoortCodelijst-to-ContactInformation-EmailAddressesUse to translate terminology from the functional model to profile terminology in ValueSet ContactInformation-EmailAddressesUse.

Use of contact point.

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

Alternate Names EmailSoort

130. Patient.gender

Definition

Patient’s administrative gender.

Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes.

Short Gendermale | female | other | unknown

Comments

The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex.

Control 0..1

The codes SHALL be taken from AdministrativeGenderhttp://hl7.org/fhir/ValueSet/administrative-gender|4.0.1
(required to http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1)

Use ConceptMap GeslachtCodelijst-to-AdministrativeGender to translate terminology from the functional model to profile terminology in ValueSet AdministrativeGender.

The gender of a person used for administrative purposes.

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary true

Requirements

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

Alternate Names Geslacht

132. Patient.gender.extension:genderCodelist

Slice Name genderCodelist

Definition

Optional Extension Element - found in all resources.

Short Optional Extensions Element

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(ext CodeSpecification) (Extension Type: CodeableConcept)

Is Modifier false

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary false

134. Patient.gender.extension:genderCodelist.url

Definition

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

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://nictiz.nl/fhir/StructureDefinition/ext-CodeSpecification

136. Patient.birthDate

Definition

Patient’s date of birth. The date of birth is mandatory for a patient. A vague date (such as only the year) is permitted.

The date of birth for the individual.

Short DateOfBirthThe date of birth for the individual

Comments

At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternity/infant care systems).

Control 0..1

date

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary true

Requirements

Age of the individual drives many clinical processes.

Alternate Names Geboortedatum

138. Patient.deceased[x]

Definition

Indicates if the individual is deceased or not.

Short Indicates if the individual is deceased or not

Comments

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

Control 0..1

Type Choice of: boolean, dateTime

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier true because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

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

This element introduces a set of slices on Patient.deceased[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:

type @ $this

140. Patient.deceased[x]:deceasedBoolean

Slice Name deceasedBoolean

Definition

An indication stating whether the patient has died.

Indicates if the individual is deceased or not.

Short DeathIndicatorIndicates if the individual is deceased or not

Comments

Control 0..1

Type boolean, dateTime

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier true because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

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

Alternate Names OverlijdensIndicator

142. Patient.deceased[x]:deceasedDateTime

Slice Name deceasedDateTime

Definition

The date on which the patient died. A ‘vague’ date, such as only the year, is permitted.

Indicates if the individual is deceased or not.

Short DateOfDeathIndicates if the individual is deceased or not

Comments

The zib recognizes both the DeathIndicator (boolean) and DateOfDeath (datetime) concepts, whereas in FHIR only one of these concepts may be present. Therefore, if deceasedDateTime is present and has a value, its value can be mapped to DateOfDeath and DeathIndicator is assumed to be true.

Control 0..1

Type dateTime, boolean

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier true because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

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

Alternate Names DatumOverlijden, OverlijdensIndicator

144. Patient.address

Definition

An address expressed using postal conventions (as opposed to GPS or other location definition formats). This data type may be used to convey addresses for use in delivering mail as well as for visiting locations which might not be valid for mail delivery. There are a variety of postal address formats defined around the world.

An address for the individual.

Short AddressInformationAn address for the individual

Comments

This datatype defines a common basis for expressing all addresses around the world, but adds extensions to express Dutch addresses specifically, according to the zib AddressInformation v1.1 (2020). A Dutch Address still is a proper FHIR Address, which means that systems that cannot interpret the extensions will still be able to render and work with this datatype.

To have true compatibility an implementer SHOULD use the core Address parts as intended. To have addresses work for Dutch context, the implementer SHOULD in addition use the extension elements.

Separate address parts

The first addition is that Dutch addresses make certain address parts separately communicable. These parts are required for use in true Dutch systems when dealing with Dutch addresses, but may not have value for international systems when information gets sent abroad.

Custom address types

The second addition is that the zib defines its own ValueSet for address types, which can only be partially expressed using the FHIR Address datatype and requires a mapping to multiple elements. The table below explains how the zib concepts are mapped to the various FHIR elements (see the ConceptMaps http://nictiz.nl/fhir/ConceptMap/AdresSoortCodelijst-to-AddressUse and http://nictiz.nl/fhir/ConceptMap/AdresSoortCodelijst-to-AddressType as well). The code from the zib should also be included using the extension on Address.extension:addressType.

zib

.ext:addressType

.use

.type

Postal Address/Postadres

PST

postal

Primary Home/Officieel adres

home

both

Visit Address/Woon-/verblijfadres

PHYS

home

physical

Temporary Address/Tijdelijk adres

TMP

temp

Work Place/Werkadres

work

Vacation Home/Vakantie adres

temp

If Address.type is both then this is to be understood as a dual purpose address (postal and physical), unless a specific postal type address is added. Systems that support importing it like this are encouraged to do so, otherwise they may need to import this as two separate addresses.

Note: FHIR core defines the AD-use extension to further specify the postal address type. However, the ValueSet used in that extension doesn't completely match the zib ValueSet. Therefore, a custom extension has been made. This doesn't preclude the use of the AD-use extension.

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

Control 0..*
This element is affected by the following invariants: ele-1

Type Address(nl core AddressInformation)

Is Modifier false

Summary true

Requirements

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

Alternate Names Adresgegevens, nl-core-AddressInformation

146. Patient.address.extension:addressType

Slice Name addressType

Definition

Optional Extension Element - found in all resources.

Short Optional Extensions Element

Comments

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(ext AddressInformation.AddressType) (Extension Type: CodeableConcept)

Is Modifier false

Standard Status Normative (from Normative)

Summary false

Alternate Names extensions, user content

148. Patient.address.use

Definition

The type of address in question, such as a home address or mailing address.

The purpose of this address.

Short AddressTypehome | work | temp | old | billing - purpose of this address

Comments

Applications can assume that an address is current unless it explicitly says that it is temporary or old.

Control 0..1

The codes SHALL be taken from AddressUsehttp://hl7.org/fhir/ValueSet/address-use|4.0.1
(required to http://hl7.org/fhir/ValueSet/address-use|4.0.1)

Use ConceptMap AdresSoortCodelijst-to-AddressUse to translate terminology from the functional model to profile terminology in ValueSet AddressUse.

The use of an address.

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary true

Requirements

Allows an appropriate address to be chosen from a list of many.

Alternate Names AdresSoort

Example General: home

150. Patient.address.type

Definition

The type of address in question, such as a home address or mailing address.

Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both.

Short AddressTypepostal | physical | both

Comments

The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource).

Control 0..1

The codes SHALL be taken from AddressTypehttp://hl7.org/fhir/ValueSet/address-type|4.0.1
(required to http://hl7.org/fhir/ValueSet/address-type|4.0.1)

Use ConceptMap AdresSoortCodelijst-to-AddressType to translate terminology from the functional model to profile terminology in ValueSet AddressType.

The type of an address (physical / postal).

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary true

Alternate Names AdresSoort

Example General: both

152. Patient.address.line

Definition

This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.

Short Street name, number, direction & P.O. Box etc.

Comments

The mapping of zib AddressInformation on the FHIR Address datatype is the result of compatibility with HL7v3, which is the format that a lot of healthcare data in the Netherlands is stored in.

The elements of Address stored in the address-part extensions will be ignored by applications that do not support them, so any information in them should also be duplicated in the Address.line to which they are attached. The value of Address.line should be populated with a complete string representation of all the separate extension values, like: "[Street] [HouseNumberIndication] [HouseNumber] [HouseNumberLetter] [HouseNumberAddition]".

Control 0..*

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Example General: 137 Nowhere Street

154. Patient.address.line.extension:streetName

Slice Name streetName

Definition

streetName.

Short streetName

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(ADXP Street Name) (Extension Type: string)

Is Modifier false

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary false

156. Patient.address.line.extension:streetName.extension

Definition

An Extension

Short ExtensionAdditional content defined by implementations

Comments

Control 0..0*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.address.line.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

158. Patient.address.line.extension:streetName.url

Definition

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

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName

160. Patient.address.line.extension:streetName.value[x]

Definition

Street name of the address.

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

Short StreetValue of extension

Control 10..1

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Alternate Names Straat

162. Patient.address.line.extension:houseNumber

Slice Name houseNumber

Definition

The number of a building, house or lot alongside the street. Also known as "primary street number". This does not number the street but rather the building.

Short houseNumber

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(ADXP House Number) (Extension Type: string)

Is Modifier false

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary false

164. Patient.address.line.extension:houseNumber.extension

Definition

An Extension

Short ExtensionAdditional content defined by implementations

Comments

Control 0..0*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.address.line.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

166. Patient.address.line.extension:houseNumber.url

Definition

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

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber

168. Patient.address.line.extension:houseNumber.value[x]

Definition

House number of the address.

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

Short HouseNumberValue of extension

Control 10..1

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Alternate Names Huisnummer

170. Patient.address.line.extension:houseNumberLetter-houseNumberAddition

Slice Name houseNumberLetter-houseNumberAddition

Definition

Any alphabetic character, fraction or other text that may appear after the numeric portion of a building number.

Short buildingNumberSuffix

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(ADXP Building Number Suffix) (Extension Type: string)

Is Modifier false

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary false

172. Patient.address.line.extension:houseNumberLetter-houseNumberAddition.extension

Definition

An Extension

Short ExtensionAdditional content defined by implementations

Comments

Control 0..0*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.address.line.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

174. Patient.address.line.extension:houseNumberLetter-houseNumberAddition.url

Definition

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

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-buildingNumberSuffix

176. Patient.address.line.extension:houseNumberLetter-houseNumberAddition.value[x]

Definition

Export:

If a HouseNumberLetter as well as a HouseNumberAddition is known: HouseNumberLetter first, followed by a space and finally the HouseNumberAddition.
If only a HouseNumberLetter is known, send just that. No trailing space is required.
If only a HouseNumberAddition is known, communicate that with a leading space.

Import

If the value of buildingNumberSuffix contains no space, then the whole value is considered to be the HouseNumberLetter.
If the value of buildingNumberSuffix contains a space, then everything before the first space is considered to be the HouseNumberLetter, and the everything trailing the first space is considered to be the HouseNumberAddition.

Note: While a leading space is allowed in string values in FHIR, the parsing of such space cannot be guaranteed in XML representations. Although aware of this issue, this mapping is not changed because of compatibility reasons. If an implementer cannot parse a leading space, the practical risk of mapping a HouseNumberIndication to a HouseNumberAddition is deemed insignificant.

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

Short HouseNumberLetter / HouseNumberAdditionValue of extension

Control 10..1

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Alternate Names Huisnummerletter, Huisnummertoevoeging

178. Patient.address.line.extension:houseNumberIndication

Slice Name houseNumberIndication

Definition

This can be a unit designator, such as apartment number, suite number, or floor. There may be several unit designators in an address (e.g., "3rd floor, Appt. 342"). This can also be a designator pointing away from the location, rather than specifying a smaller location within some larger one (e.g., Dutch "t.o." means "opposite to" for house boats located across the street facing houses).

Short additionalLocator

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(ADXP Additional Locator) (Extension Type: string)

Is Modifier false

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary false

180. Patient.address.line.extension:houseNumberIndication.extension

Definition

An Extension

Short ExtensionAdditional content defined by implementations

Comments

Control 0..0*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.address.line.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

182. Patient.address.line.extension:houseNumberIndication.url

Definition

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

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator

184. Patient.address.line.extension:houseNumberIndication.value[x]

Definition

The indication used for addresses which do not consist of the usual street name and house number.

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

Short HouseNumberIndicationValue of extension

Comments

The mapping of zib AddressInformation on the FHIR Address datatype is the result of compatibility with HL7v3, which is the format that a lot of healthcare data in the Netherlands is stored in. As a result of this, the coded zib HouseNumberIndication concept (CD datatype) is mapped to a FHIR string datatype with a constraint added (the value can only be 'by' or 'to').

Control 10..1

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Alternate Names AanduidingBijNummer

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
houseNumberIndication: Must have value 'by' or 'to' ($this in ('by' | 'to'))
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

186. Patient.address.line.extension:additionalInformation

Slice Name additionalInformation

Definition

The number or name of a specific unit contained within a building or complex, as assigned by that building or complex.

Short unitID

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(ADXP Unit ID) (Extension Type: string)

Is Modifier false

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary false

188. Patient.address.line.extension:additionalInformation.extension

Definition

An Extension

Short ExtensionAdditional content defined by implementations

Comments

Control 0..0*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.address.line.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

190. Patient.address.line.extension:additionalInformation.url

Definition

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

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-unitID

192. Patient.address.line.extension:additionalInformation.value[x]

Definition

Extra information such as the building name, building number, entrance, route number.

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

Short AdditionalInformationValue of extension

Control 10..1

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Alternate Names AdditioneleInformatie

194. Patient.address.city

Definition

A geographically determined area which forms part of the municipal area. For Dutch places of residence, preferably use the name from the GBA, table 33 (OID: 2.16.840.1.113883.2.4.6.14).

The name of the city, town, suburb, village or other community or delivery center.

Short PlaceOfResidenceName of city, town etc.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary true

Alternate Names Municpality, Woonplaats

Example General: Erewhon

196. Patient.address.district

Definition

Municipality of residence. For Dutch municipalities, preferably use the name from the GBA, table 33 (OID: 2.16.840.1.113883.2.4.6.14).

The name of the administrative area (county).

Short MunicipalityDistrict name (aka county)

Comments

District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary true

Alternate Names County, Gemeente

Example General: Madison

198. Patient.address.postalCode

Definition

Postcode of the address. In Dutch addresses, preferably use the postcode from the Postcode table (OID: 2.16.840.1.113883.2.4.4.15).

A postal code designating a region defined by the postal service.

Short PostcodePostal code for area

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary true

Alternate Names Zip, Postcode

Example General: 9132

200. Patient.address.country

Definition

Country - a nation as commonly understood or generally accepted.

Short Country (e.g. can be ISO 3166 2 or 3 letter code)

Comments

The FHIR datatype does not properly support coding the country using a CodeableConcept or Coding datatype. If the sender supports coded countries, it SHALL send the coded value using the ext-CodeSpecification extension under Address.country.extension:countryCode.

ISO 3166 3 letter codes can be used in place of a human readable country name.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

202. Patient.address.country.extension:countryCode

Slice Name countryCode

Definition

Optional Extension Element - found in all resources.

Short Optional Extensions Element

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(ext CodeSpecification) (Extension Type: CodeableConcept)

Is Modifier false

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary false

204. Patient.address.country.extension:countryCode.url

Definition

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

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://nictiz.nl/fhir/StructureDefinition/ext-CodeSpecification

206. Patient.multipleBirth[x]

Definition

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

Short Whether patient is part of a multiple birth

Comments

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

Control 0..1

Type Choice of: boolean, integer

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Requirements

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

This element introduces a set of slices on Patient.multipleBirth[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:

type @ $this

208. Patient.multipleBirth[x]:multipleBirthBoolean

Slice Name multipleBirthBoolean

Definition

An indication stating whether the patient is of a multiple birth.

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

Short MultipleBirthIndicatorWhether patient is part of a multiple birth

Comments

Control 0..1

Type boolean, integer

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Requirements

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

Alternate Names MeerlingIndicator

210. Patient.contact

Definition

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

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

Comments

Whereas the zib ContactPerson includes all (non-healthcare professional) persons that are involved in the care for a patient, FHIR distinguishes two use cases for these persons:

The RelatedPerson resource is used to capture information about any person that is related to the patient, using the profile http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactPerson.
Information about persons that should be contacted regarding the care for the patient is captured using the Patient.contact resource.

If a person is both a related person and a contact person, then some data duplication is inevitable. The nl-core-ContactPerson can be referenced using the extension in contact:contactPerson.

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.

Control 0..*

Is Modifier false

Summary false

Requirements

Need to track people you can contact about the patient.

Alternate Names Contactpersoon

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
pat-1: SHALL at least contain a contact's details or a reference to an organization (name.exists() or telecom.exists() or address.exists() or organization.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
pat-1: SHALL at least contain a contact's details or a reference to an organization (name.exists() or telecom.exists() or address.exists() or organization.exists())

212. Patient.contact.extension:contactPerson

Slice Name contactPerson

Definition

In some cases a Patient.contact will also be populated as a RelatedPerson resource. This linkage permits the linkage between the 2 resources to be able to accurately indicate a representation of the same individual, and updating details between could be appropriate.

Short This contact may have further details in this RelatedPerson

Comments

All information regarding the patient's contact persons should preferably be stored in the RelatedPerson resource, and optionally in Patient.contact. The http://hl7.org/fhir/StructureDefinition/patient-relatedPerson extension is used to link the contact person to the Patient and to emphasize that the related person is also a contact person of the patient.

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(Patient Related Person) (Extension Type: Reference(RelatedPerson))

Is Modifier false

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary false

214. Patient.contact.extension:contactPerson.extension

Definition

An Extension

Short ExtensionAdditional content defined by implementations

Comments

Control 0..0*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.contact.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

216. Patient.contact.extension:contactPerson.url

Definition

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

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://hl7.org/fhir/StructureDefinition/patient-relatedPerson

218. Patient.contact.extension:contactPerson.value[x]

Definition

Reference to an nl-core-ContactPerson instance containing the full details for the current contact.

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

Short ContactValue of extension

Control 10..1

Type Reference(ACP ContactPerson), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary false

Alternate Names Contactpersoon

220. Patient.contact.modifierExtension

Definition

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

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

Short Extensions that cannot be ignored even if unrecognized

Comments

Control 0..*

Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

Summary true

Requirements

Alternate Names extensions, user content, modifiers

222. Patient.contact.relationship

Definition

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

Short The kind of relationship

Control 0..*

Unless not suitable, these codes SHALL be taken from PatientContactRelationshiphttp://hl7.org/fhir/ValueSet/patient-contactrelationship|4.0.1
(extensible to http://hl7.org/fhir/ValueSet/patient-contactrelationship|4.0.1)

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

Is Modifier false

Summary false

Requirements

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

This element introduces a set of slices on Patient.contact.relationship. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ $this

224. Patient.contact.relationship:role

Slice Name role

Definition

Defines the role of the contact in relation to the patient.

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

Short RoleThe kind of relationship

Control 0..*

The codes SHALL be taken from Unless not suitable, these codes SHALL be taken from RolCodelijst (2020-09-01T00:00:00)http://hl7.org/fhir/ValueSet/patient-contactrelationship|4.0.1
(required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.3.1.2--20200901000000|2020-09-01T00:00:00)

RolCodelijst

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

Is Modifier false

Summary false

Requirements

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

Alternate Names Rol

226. Patient.contact.relationship:relationship

Slice Name relationship

Definition

Defines the contact’s familial relationship to the patient.

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

Short RelationshipThe kind of relationship

Control 0..*

The codes SHALL be taken from Unless not suitable, these codes SHALL be taken from RelatieCodelijst (2020-09-01T00:00:00)http://hl7.org/fhir/ValueSet/patient-contactrelationship|4.0.1
(required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.3.1.1--20200901000000|2020-09-01T00:00:00)

RelatieCodelijst

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

Is Modifier false

Summary false

Requirements

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

Alternate Names Relatie

228. Patient.contact.telecom

Definition

The contact’s telephone number and/or e-mail address.

A contact detail for the person, e.g. a telephone number or an email address.

Short ContactInformationA contact detail for the person

Comments

Contact may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification.

Control 0..*

Is Modifier false

Summary false

Requirements

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

Alternate Names Contactgegevens

This element introduces a set of slices on Patient.contact.telecom. The slices areUnordered and Open, and can be differentiated using the following discriminators:

profile @ $this

230. Patient.contact.telecom:telephoneNumbers

Slice Name telephoneNumbers

Definition

Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc.

A contact detail for the person, e.g. a telephone number or an email address.

Short TelephoneNumbersA contact detail for the person

Comments

Implementation of the "TelephoneNumbers" concept of zib ContactInformation.

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.

Control 0..*
This element is affected by the following invariants: ele-1

Type ContactPoint(nl core ContactInformation TelephoneNumbers)

Is Modifier false

Standard Status Normative (from Normative)

Summary false

Requirements

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

Alternate Names Telefoonnummers, nl-core-ContactInformation-TelephoneNumbers

232. Patient.contact.telecom:emailAddresses

Slice Name emailAddresses

Definition

Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc.

A contact detail for the person, e.g. a telephone number or an email address.

Short EmailAddressesA contact detail for the person

Comments

Implementation of the "EmailAddresses" concept of zib ContactInformation.

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.

Control 0..*
This element is affected by the following invariants: ele-1

Type ContactPoint(nl core ContactInformation EmailAddresses)

Is Modifier false

Standard Status Normative (from Normative)

Summary false

Requirements

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

Alternate Names EmailAdressen, nl-core-ContactInformation-EmailAddresses

234. Patient.link

Definition

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

Short Link to another patient resource that concerns the same actual person

Comments

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

Control 0..*

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

Summary true

Requirements

There are multiple use cases:

Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and
Distribution of patient information across multiple servers.

236. Patient.link.modifierExtension

Definition

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

Short Extensions that cannot be ignored even if unrecognized

Comments

Control 0..*

Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

Summary true

Requirements

Alternate Names extensions, user content, modifiers

238. Patient.link.other

Definition

The other patient resource that the link refers to.

Short The other patient or related person resource that the link refers to

Comments

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

Control 1..1

Type Reference(Patient, RelatedPerson)

Is Modifier false

Summary true

240. Patient.link.type

Definition

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

Short replaced-by | replaces | refer | seealso

Control 1..1

The codes SHALL be taken from LinkTypehttp://hl7.org/fhir/ValueSet/link-type|4.0.1
(required to http://hl7.org/fhir/ValueSet/link-type|4.0.1)

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

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

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

0. Patient

2. Patient.identifier

Note This is a business identifier, not a resource identifier (see discussion)

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

4. Patient.name

Control 1..?

6. Patient.name:nameInformation

Slice Name nameInformation

8. Patient.name:nameInformation.use

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

10. Patient.name:nameInformation.family

12. Patient.name:nameInformation.family.extension:prefix

Slice Name prefix

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

14. Patient.name:nameInformation.family.extension:lastName

Slice Name lastName

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

16. Patient.name:nameInformation.family.extension:partnerPrefix

Slice Name partnerPrefix

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

18. Patient.name:nameInformation.family.extension:partnerLastName

Slice Name partnerLastName

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

20. Patient.name:nameInformation.given

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

22. Patient.name:nameInformation.suffix

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

24. Patient.name:nameInformation-GivenName

Slice Name nameInformation-GivenName

26. Patient.name:nameInformation-GivenName.given

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

28. Patient.telecom

30. Patient.telecom:telephoneNumbers

Slice Name telephoneNumbers

32. Patient.telecom:telephoneNumbers.extension:comment

Slice Name comment

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

34. Patient.telecom:telephoneNumbers.system

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

36. Patient.telecom:telephoneNumbers.system.extension:telecomType

Slice Name telecomType

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

38. Patient.telecom:telephoneNumbers.system.extension:telecomType.value[x]

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

40. Patient.telecom:telephoneNumbers.value

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

42. Patient.telecom:telephoneNumbers.use

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

44. Patient.telecom:emailAddresses

Slice Name emailAddresses

46. Patient.telecom:emailAddresses.system

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

48. Patient.telecom:emailAddresses.value

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

50. Patient.gender

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

52. Patient.gender.extension:genderCodelist

Slice Name genderCodelist

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

54. Patient.birthDate

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

56. Patient.address

58. Patient.address.use

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

60. Patient.address.type

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

62. Patient.address.line

64. Patient.address.line.extension:streetName

Slice Name streetName

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

66. Patient.address.line.extension:houseNumber

Slice Name houseNumber

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

68. Patient.address.line.extension:houseNumberLetter-houseNumberAddition

Slice Name houseNumberLetter-houseNumberAddition

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

70. Patient.address.line.extension:houseNumberIndication

Slice Name houseNumberIndication

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

72. Patient.address.line.extension:additionalInformation

Slice Name additionalInformation

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

74. Patient.address.city

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

76. Patient.address.district

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

78. Patient.address.postalCode

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

80. Patient.address.country

82. Patient.address.country.extension:countryCode

Slice Name countryCode

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

84. Patient.contact

86. Patient.contact.extension:contactPerson

Slice Name contactPerson

Comments

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

88. Patient.contact.extension:contactPerson.value[x]

Type Reference(ACP ContactPerson)

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

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

0. Patient

Definition

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

Short Patient

Control 0..*

Is Modifier false

Summary false

Alternate Names SubjectOfCare Client Resident, Patient, nl-core-Patient

2. Patient.id

Definition

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

Short Logical id of this artifact

Comments

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

Control 0..1

Is Modifier false

Summary true

4. Patient.meta

Definition

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

Short Metadata about the resource

Control 0..1

Zib compatibility

Therefore, the zib concepts are implemented here in the following way:

Systems SHOULD use a .given element for each official first name that they know of (either as a full name or an initial), in order of appearance (as specified by FHIR).
Each of these elements:
- SHOULD be populated with the complete name if it is known, or with the initial if no more information is available.
- As noted, it SHALL be augmented with extension:givenOrInitial.

Note 1: The GivenName concept should not be included here but in a separate .name instance where .use = usual.

Control 0..*
This element is affected by the following invariants: nl-core-NameInformation-01

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary true

Alternate Names first name, middle name, Voornaam, Initiaal

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

126. Patient.name:nameInformation.given.id

Definition

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

Short xml:id (or equivalent in JSON)

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

128. Patient.name:nameInformation.given.extension

Definition

Short Additional content defined by implementations

Comments

Control 1..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.name.given.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

130. Patient.name:nameInformation.given.extension:givenOrInitial

Slice Name givenOrInitial

Definition

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

Short LS | AC | NB | PR | HON | BR | AD | SP | MID | CL | IN | VV

Comments

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

Control 1..*
This element is affected by the following invariants: ele-1

Type Extension(EN Qualifier) (Extension Type: code)

Is Modifier false

Summary false

Alternate Names extensions, user content

132. Patient.name:nameInformation.given.value

Definition

The actual value

Short Primitive value for string

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Max Length: 1048576

134. Patient.name:nameInformation.prefix

Definition

Noble and scientific titles. These can assist in formulating oral and formal addresing titles.

Short Titles

Comments

Export:

If it is not possible to breakup the zib concept titles to positioned prefixes and suffixes, the prefix element is used to store all information.

Import:

Systems need to expect and be resilient for a broader range of information stored in the prefix element than stated by it's definition.

Control 0..*

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Alternate Names Titels

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

136. Patient.name:nameInformation.suffix

Definition

Noble and scientific titles. These can assist in formulating oral and formal addresing titles.

Short Titles

Comments

Export:

If it is not possible to breakup the zib concept titles to positioned prefixes and suffixes, the prefix element is used to store all information.

Import:

Systems need to expect and be resilient for a broader range of information stored in the prefix element than stated by it's definition.

Control 0..*

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary true

Alternate Names Titels

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

138. Patient.name:nameInformation.period

Definition

Indicates the period of time when this name was valid for the named person.

Short Time period when name was/is in use

Control 0..1

Is Modifier false

Summary true

Requirements

Allows names to be placed in historical context.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

140. Patient.name:nameInformation-GivenName

Slice Name nameInformation-GivenName

Definition

This slice represents the name information normally used to address the person.

Short Name of a human - parts and usage

Comments

This .name element represents the Dutch given name ("roepnaam") according to the zib NameInformation v1.1 (2020).

Note 1: This element should only contain a person's unofficial name. The official names are represented in one or more other .name elements with .name.use = official.

Note 2: The examples illustrate how the zib is mapped to FHIR.

Control 0..*
This element is affected by the following invariants: ele-1

Type HumanName(nl core NameInformation.GivenName)

Is Modifier false

Summary true

Requirements

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

Alternate Names nl-core-NameInformation.GivenName

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

142. Patient.name:nameInformation-GivenName.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

144. Patient.name:nameInformation-GivenName.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.name.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

146. Patient.name:nameInformation-GivenName.use

Definition

Identifies the purpose for this name.

Comments

Applications can assume that a name is current unless it explicitly says that it is temporary or old.

Control 1..1

The codes SHALL be taken from NameUse
(required to http://hl7.org/fhir/ValueSet/name-use|4.0.1)

The use of a human name.

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

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

Pattern Value usual

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

148. Patient.name:nameInformation-GivenName.text

Definition

Specifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts.

Short Text representation of the full name

Comments

Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

A renderable, unencoded form.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

150. Patient.name:nameInformation-GivenName.family

Definition

The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.

Short Family name (often called 'Surname')

Comments

Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).

Control 0..0

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Alternate Names surname

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

152. Patient.name:nameInformation-GivenName.given

Definition

The name normally used to address the person.

Short GivenName

Comments

Control 1..*

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary true

Alternate Names first name, middle name, Roepnaam

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

154. Patient.name:nameInformation-GivenName.prefix

Definition

Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name.

Short Parts that come before the name

Control 0..0

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

156. Patient.name:nameInformation-GivenName.suffix

Definition

Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name.

Short Parts that come after the name

Control 0..0

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

158. Patient.name:nameInformation-GivenName.period

Definition

Indicates the period of time when this name was valid for the named person.

Short Time period when name was/is in use

Control 0..1

Is Modifier false

Summary true

Requirements

Allows names to be placed in historical context.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

160. Patient.telecom

Definition

Patient’s telephone number(s) or e-mail address(es).

Short ContactInformation

Comments

Control 0..*

Is Modifier false

Summary true

Requirements

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

Alternate Names Contactgegevens

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

This element introduces a set of slices on Patient.telecom. The slices areUnordered and Open, and can be differentiated using the following discriminators:

profile @ $this

162. Patient.telecom:telephoneNumbers

Slice Name telephoneNumbers

Definition

Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc.

Short TelephoneNumbers

Comments

Implementation of the "TelephoneNumbers" concept of zib ContactInformation.

Control 0..*
This element is affected by the following invariants: ele-1

Type ContactPoint(nl core ContactInformation TelephoneNumbers)

Is Modifier false

Summary true

Requirements

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

Alternate Names Telefoonnummers, nl-core-ContactInformation-TelephoneNumbers

164. Patient.telecom:telephoneNumbers.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

166. Patient.telecom:telephoneNumbers.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.telecom.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

168. Patient.telecom:telephoneNumbers.extension:comment

Slice Name comment

Definition

Optional Extension Element - found in all resources.

Short Optional Extensions Element

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(ext Comment) (Extension Type: string)

Is Modifier false

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary false

170. Patient.telecom:telephoneNumbers.extension:comment.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

172. Patient.telecom:telephoneNumbers.extension:comment.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.telecom.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

174. Patient.telecom:telephoneNumbers.extension:comment.url

Definition

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

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://nictiz.nl/fhir/StructureDefinition/ext-Comment

176. Patient.telecom:telephoneNumbers.extension:comment.value[x]

Definition

Explanation about the telephone number and how to use it. It can be indicated, for example, that it is a department number (for healthcare professionnels) or that availability by phone is only possible during a specified part of the day.

Short Comment

Control 0..1

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Alternate Names Toelichting

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

178. Patient.telecom:telephoneNumbers.system

Definition

The telecom or device type that the telephone number is connected to.

Short TelecomType

Control 1..1
This element is affected by the following invariants: cpt-2

The codes SHALL be taken from ContactInformationTelephoneNumbersSystem (4.0.1)
(required to http://nictiz.nl/fhir/ValueSet/ContactInformation-TelephoneNumbersSystem|4.0.1)

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary true

Alternate Names TelecomType

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

180. Patient.telecom:telephoneNumbers.system.id

Definition

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

Short xml:id (or equivalent in JSON)

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

182. Patient.telecom:telephoneNumbers.system.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.telecom.system.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

184. Patient.telecom:telephoneNumbers.system.extension:telecomType

Slice Name telecomType

Definition

Optional Extension Element - found in all resources.

Short Optional Extensions Element

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(ext CodeSpecification) (Extension Type: CodeableConcept)

Is Modifier false

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary false

186. Patient.telecom:telephoneNumbers.system.extension:telecomType.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

188. Patient.telecom:telephoneNumbers.system.extension:telecomType.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.telecom.system.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

190. Patient.telecom:telephoneNumbers.system.extension:telecomType.url

Definition

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

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://nictiz.nl/fhir/StructureDefinition/ext-CodeSpecification

192. Patient.telecom:telephoneNumbers.system.extension:telecomType.value[x]

Definition

The telecom or device type that the telephone number is connected to.

Short TelecomType

Control 0..1

Binding The codes SHALL be taken from TelecomTypeCodelijst (2020-09-01T00:00:00)
(required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.20.6.1--20200901000000|2020-09-01T00:00:00)

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary false

Alternate Names TelecomType

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

194. Patient.telecom:telephoneNumbers.system.value

Definition

Primitive value for code

Short Primitive value for code

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

196. Patient.telecom:telephoneNumbers.value

Definition

The person's telephone number.

Short TelephoneNumber

Comments

Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary true

Requirements

Need to support legacy numbers that are not in a tightly controlled format.

Alternate Names Telefoonnummer

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

198. Patient.telecom:telephoneNumbers.use

Definition

NumberType indicates whether the number is a landline, temporary, work telephone number.

Short NumberType

Comments

Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

Control 0..1

The codes SHALL be taken from ContactInformationTelephoneNumbersUse (4.0.1)
(required to http://nictiz.nl/fhir/ValueSet/ContactInformation-TelephoneNumbersUse|4.0.1)

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary true

Requirements

Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

Alternate Names NummerSoort

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

200. Patient.telecom:telephoneNumbers.rank

Definition

Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.

Short Specify preferred order of use (1 = highest)

Comments

Note that rank does not necessarily follow the order in which the contacts are represented in the instance.

Control 0..1

positiveInt

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

202. Patient.telecom:telephoneNumbers.period

Definition

Time period when the contact point was/is in use.

Short Time period when the contact point was/is in use

Control 0..1

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

204. Patient.telecom:emailAddresses

Slice Name emailAddresses

Definition

Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc.

Short EmailAddresses

Comments

Implementation of the "EmailAddresses" concept of zib ContactInformation.

Control 0..*
This element is affected by the following invariants: ele-1

Type ContactPoint(nl core ContactInformation EmailAddresses)

Is Modifier false

Summary true

Requirements

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

Alternate Names EmailAdressen, nl-core-ContactInformation-EmailAddresses

206. Patient.telecom:emailAddresses.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

208. Patient.telecom:emailAddresses.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.telecom.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

210. Patient.telecom:emailAddresses.system

Definition

Telecommunications form for contact point - what communications system is required to make use of the contact.

Short email

Control 1..1
This element is affected by the following invariants: cpt-2

The codes SHALL be taken from ContactPointSystem
(required to http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1)

Telecommunications form for contact point.

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary true

Pattern Value email

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

212. Patient.telecom:emailAddresses.value

Definition

The person's e-mail address

Short EmailAddress

Comments

Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary true

Requirements

Need to support legacy numbers that are not in a tightly controlled format.

Alternate Names EmailAdres

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

214. Patient.telecom:emailAddresses.use

Definition

EmailAddressType indicates whether it is a private or business e-mail address.

Short EmailAddressType

Comments

Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

Control 0..1

The codes SHALL be taken from ContactInformationEmailAddressesUse (4.0.1)
(required to http://nictiz.nl/fhir/ValueSet/ContactInformation-EmailAddressesUse|4.0.1)

Use ConceptMap EmailSoortCodelijst-to-ContactInformation-EmailAddressesUse to translate terminology from the functional model to profile terminology in ValueSet ContactInformation-EmailAddressesUse.

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

Alternate Names EmailSoort

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

216. Patient.telecom:emailAddresses.rank

Definition

Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.

Short Specify preferred order of use (1 = highest)

Comments

Note that rank does not necessarily follow the order in which the contacts are represented in the instance.

Control 0..1

positiveInt

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

218. Patient.telecom:emailAddresses.period

Definition

Time period when the contact point was/is in use.

Short Time period when the contact point was/is in use

Control 0..1

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

220. Patient.gender

Definition

Patient’s administrative gender.

Short Gender

Comments

Control 0..1

The codes SHALL be taken from AdministrativeGender
(required to http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1)

Use ConceptMap GeslachtCodelijst-to-AdministrativeGender to translate terminology from the functional model to profile terminology in ValueSet AdministrativeGender.

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary true

Requirements

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

Alternate Names Geslacht

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

222. Patient.gender.id

Definition

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

Short xml:id (or equivalent in JSON)

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

224. Patient.gender.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.gender.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

226. Patient.gender.extension:genderCodelist

Slice Name genderCodelist

Definition

Optional Extension Element - found in all resources.

Short Optional Extensions Element

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(ext CodeSpecification) (Extension Type: CodeableConcept)

Is Modifier false

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary false

228. Patient.gender.extension:genderCodelist.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

230. Patient.gender.extension:genderCodelist.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.gender.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

232. Patient.gender.extension:genderCodelist.url

Definition

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

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://nictiz.nl/fhir/StructureDefinition/ext-CodeSpecification

234. Patient.gender.extension:genderCodelist.value[x]

Definition

Patient’s administrative gender.

Short Gender

Control 0..1

The codes SHALL be taken from GeslachtCodelijst (2020-09-01T00:00:00)
(required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.0.1.1--20200901000000|2020-09-01T00:00:00)

GeslachtCodelijst

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary false

Alternate Names Geslacht

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

236. Patient.gender.value

Definition

Primitive value for code

Short Primitive value for code

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

238. Patient.birthDate

Definition

Patient’s date of birth. The date of birth is mandatory for a patient. A vague date (such as only the year) is permitted.

Short DateOfBirth

Comments

Control 0..1

date

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary true

Requirements

Age of the individual drives many clinical processes.

Alternate Names Geboortedatum

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

240. Patient.deceased[x]

Definition

Indicates if the individual is deceased or not.

Short Indicates if the individual is deceased or not

Comments

Control 0..1

Type Choice of: boolean, dateTime

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier true because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

This element introduces a set of slices on Patient.deceased[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:

type @ $this

242. Patient.deceased[x]:deceasedBoolean

Slice Name deceasedBoolean

Definition

An indication stating whether the patient has died.

Short DeathIndicator

Comments

Control 0..1

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier true because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

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

Alternate Names OverlijdensIndicator

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

244. Patient.deceased[x]:deceasedDateTime

Slice Name deceasedDateTime

Definition

The date on which the patient died. A ‘vague’ date, such as only the year, is permitted.

Short DateOfDeath

Comments

Control 0..1

dateTime

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier true because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

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

Alternate Names DatumOverlijden, OverlijdensIndicator

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

246. Patient.address

Definition

Short AddressInformation

Comments

To have true compatibility an implementer SHOULD use the core Address parts as intended. To have addresses work for Dutch context, the implementer SHOULD in addition use the extension elements.

Separate address parts

Custom address types

zib

.ext:addressType

.use

.type

Postal Address/Postadres

PST

postal

Primary Home/Officieel adres

home

both

Visit Address/Woon-/verblijfadres

PHYS

home

physical

Temporary Address/Tijdelijk adres

TMP

temp

Work Place/Werkadres

work

Vacation Home/Vakantie adres

temp

Control 0..*
This element is affected by the following invariants: ele-1

Type Address(nl core AddressInformation)

Is Modifier false

Summary true

Requirements

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

Alternate Names Adresgegevens, nl-core-AddressInformation

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

248. Patient.address.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

250. Patient.address.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.address.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

252. Patient.address.extension:addressType

Slice Name addressType

Definition

Optional Extension Element - found in all resources.

Short Optional Extensions Element

Comments

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(ext AddressInformation.AddressType) (Extension Type: CodeableConcept)

Is Modifier false

Standard Status Normative (from Normative)

Summary false

Alternate Names extensions, user content

254. Patient.address.use

Definition

The type of address in question, such as a home address or mailing address.

Short AddressType

Comments

Applications can assume that an address is current unless it explicitly says that it is temporary or old.

Control 0..1

The codes SHALL be taken from AddressUse
(required to http://hl7.org/fhir/ValueSet/address-use|4.0.1)

Use ConceptMap AdresSoortCodelijst-to-AddressUse to translate terminology from the functional model to profile terminology in ValueSet AddressUse.

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary true

Requirements

Allows an appropriate address to be chosen from a list of many.

Alternate Names AdresSoort

Example General: home

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

256. Patient.address.type

Definition

The type of address in question, such as a home address or mailing address.

Short AddressType

Comments

Control 0..1

The codes SHALL be taken from AddressType
(required to http://hl7.org/fhir/ValueSet/address-type|4.0.1)

Use ConceptMap AdresSoortCodelijst-to-AddressType to translate terminology from the functional model to profile terminology in ValueSet AddressType.

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary true

Alternate Names AdresSoort

Example General: both

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

258. Patient.address.text

Definition

Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts.

Short Text representation of the address

Comments

Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

A renderable, unencoded form.

Example General: 137 Nowhere Street, Erewhon 9132

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

260. Patient.address.line

Definition

This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.

Short Street name, number, direction & P.O. Box etc.

Comments

The mapping of zib AddressInformation on the FHIR Address datatype is the result of compatibility with HL7v3, which is the format that a lot of healthcare data in the Netherlands is stored in.

Control 0..*

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Example General: 137 Nowhere Street

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

262. Patient.address.line.id

Definition

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

Short xml:id (or equivalent in JSON)

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

264. Patient.address.line.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.address.line.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

266. Patient.address.line.extension:streetName

Slice Name streetName

Definition

streetName.

Short streetName

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(ADXP Street Name) (Extension Type: string)

Is Modifier false

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary false

268. Patient.address.line.extension:streetName.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

270. Patient.address.line.extension:streetName.extension

Definition

An Extension

Short Extension

Control 0..0

Is Modifier false

Summary false

This element introduces a set of slices on Patient.address.line.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

272. Patient.address.line.extension:streetName.url

Definition

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

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName

274. Patient.address.line.extension:streetName.value[x]

Definition

Street name of the address.

Short Street

Control 1..1

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Alternate Names Straat

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

276. Patient.address.line.extension:houseNumber

Slice Name houseNumber

Definition

The number of a building, house or lot alongside the street. Also known as "primary street number". This does not number the street but rather the building.

Short houseNumber

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(ADXP House Number) (Extension Type: string)

Is Modifier false

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary false

278. Patient.address.line.extension:houseNumber.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

280. Patient.address.line.extension:houseNumber.extension

Definition

An Extension

Short Extension

Control 0..0

Is Modifier false

Summary false

This element introduces a set of slices on Patient.address.line.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

282. Patient.address.line.extension:houseNumber.url

Definition

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

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber

284. Patient.address.line.extension:houseNumber.value[x]

Definition

House number of the address.

Short HouseNumber

Control 1..1

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Alternate Names Huisnummer

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

286. Patient.address.line.extension:houseNumberLetter-houseNumberAddition

Slice Name houseNumberLetter-houseNumberAddition

Definition

Any alphabetic character, fraction or other text that may appear after the numeric portion of a building number.

Short buildingNumberSuffix

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(ADXP Building Number Suffix) (Extension Type: string)

Is Modifier false

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary false

288. Patient.address.line.extension:houseNumberLetter-houseNumberAddition.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

290. Patient.address.line.extension:houseNumberLetter-houseNumberAddition.extension

Definition

An Extension

Short Extension

Control 0..0

Is Modifier false

Summary false

This element introduces a set of slices on Patient.address.line.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

292. Patient.address.line.extension:houseNumberLetter-houseNumberAddition.url

Definition

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

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-buildingNumberSuffix

294. Patient.address.line.extension:houseNumberLetter-houseNumberAddition.value[x]

Definition

Export:

If a HouseNumberLetter as well as a HouseNumberAddition is known: HouseNumberLetter first, followed by a space and finally the HouseNumberAddition.
If only a HouseNumberLetter is known, send just that. No trailing space is required.
If only a HouseNumberAddition is known, communicate that with a leading space.

Import

If the value of buildingNumberSuffix contains no space, then the whole value is considered to be the HouseNumberLetter.
If the value of buildingNumberSuffix contains a space, then everything before the first space is considered to be the HouseNumberLetter, and the everything trailing the first space is considered to be the HouseNumberAddition.

Short HouseNumberLetter / HouseNumberAddition

Control 1..1

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Alternate Names Huisnummerletter, Huisnummertoevoeging

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

296. Patient.address.line.extension:houseNumberIndication

Slice Name houseNumberIndication

Definition

Short additionalLocator

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(ADXP Additional Locator) (Extension Type: string)

Is Modifier false

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary false

298. Patient.address.line.extension:houseNumberIndication.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

300. Patient.address.line.extension:houseNumberIndication.extension

Definition

An Extension

Short Extension

Control 0..0

Is Modifier false

Summary false

This element introduces a set of slices on Patient.address.line.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

302. Patient.address.line.extension:houseNumberIndication.url

Definition

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

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator

304. Patient.address.line.extension:houseNumberIndication.value[x]

Definition

The indication used for addresses which do not consist of the usual street name and house number.

Short HouseNumberIndication

Comments

Control 1..1

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Alternate Names AanduidingBijNummer

306. Patient.address.line.extension:additionalInformation

Slice Name additionalInformation

Definition

The number or name of a specific unit contained within a building or complex, as assigned by that building or complex.

Short unitID

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(ADXP Unit ID) (Extension Type: string)

Is Modifier false

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary false

308. Patient.address.line.extension:additionalInformation.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

310. Patient.address.line.extension:additionalInformation.extension

Definition

An Extension

Short Extension

Control 0..0

Is Modifier false

Summary false

This element introduces a set of slices on Patient.address.line.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

312. Patient.address.line.extension:additionalInformation.url

Definition

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

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-unitID

314. Patient.address.line.extension:additionalInformation.value[x]

Definition

Extra information such as the building name, building number, entrance, route number.

Short AdditionalInformation

Control 1..1

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Alternate Names AdditioneleInformatie

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

316. Patient.address.line.value

Definition

The actual value

Short Primitive value for string

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Max Length: 1048576

318. Patient.address.city

Definition

A geographically determined area which forms part of the municipal area. For Dutch places of residence, preferably use the name from the GBA, table 33 (OID: 2.16.840.1.113883.2.4.6.14).

Short PlaceOfResidence

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary true

Alternate Names Municpality, Woonplaats

Example General: Erewhon

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

320. Patient.address.district

Definition

Municipality of residence. For Dutch municipalities, preferably use the name from the GBA, table 33 (OID: 2.16.840.1.113883.2.4.6.14).

Short Municipality

Comments

District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary true

Alternate Names County, Gemeente

Example General: Madison

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

322. Patient.address.state

Definition

Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes).

Short Sub-unit of country (abbreviations ok)

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Alternate Names Province, Territory

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

324. Patient.address.postalCode

Definition

Postcode of the address. In Dutch addresses, preferably use the postcode from the Postcode table (OID: 2.16.840.1.113883.2.4.4.15).

Short Postcode

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary true

Alternate Names Zip, Postcode

Example General: 9132

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

326. Patient.address.country

Definition

Country - a nation as commonly understood or generally accepted.

Short Country (e.g. can be ISO 3166 2 or 3 letter code)

Comments

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

328. Patient.address.country.id

Definition

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

Short xml:id (or equivalent in JSON)

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

330. Patient.address.country.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.address.country.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

332. Patient.address.country.extension:countryCode

Slice Name countryCode

Definition

Optional Extension Element - found in all resources.

Short Optional Extensions Element

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(ext CodeSpecification) (Extension Type: CodeableConcept)

Is Modifier false

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary false

334. Patient.address.country.extension:countryCode.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

336. Patient.address.country.extension:countryCode.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.address.country.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

338. Patient.address.country.extension:countryCode.url

Definition

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

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://nictiz.nl/fhir/StructureDefinition/ext-CodeSpecification

340. Patient.address.country.extension:countryCode.value[x]

Definition

Country in which the address is located.

Short Country

Control 0..1

Binding The codes SHALL be taken from LandCodelijsten (2020-09-01T00:00:00)
(required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.121.11.10--20200901000000|2020-09-01T00:00:00)

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary false

Alternate Names Land

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

342. Patient.address.country.value

Definition

The actual value

Short Primitive value for string

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Max Length: 1048576

344. Patient.address.period

Definition

Time period when address was/is in use.

Short Time period when address was/is in use

Control 0..1

Is Modifier false

Summary true

Requirements

Allows addresses to be placed in historical context.

Example General: { "start" : "2010-03-23", "end" : "2010-07-01" }

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

346. Patient.maritalStatus

Definition

A person’s marital status according to the terms and definition in the Dutch civil code.

Short MaritalStatus

Control 0..1

The codes SHALL be taken from BurgerlijkeStaatCodelijst (2020-09-01T00:00:00)
(required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.7.9.1--20200901000000|2020-09-01T00:00:00)

BurgerlijkeStaatCodelijst

Is Modifier false

Summary false

Requirements

Most, if not all systems capture it.

Alternate Names BurgerlijkeStaat

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

348. Patient.multipleBirth[x]

Definition

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

Short Whether patient is part of a multiple birth

Comments

Control 0..1

Type Choice of: boolean, integer

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

This element introduces a set of slices on Patient.multipleBirth[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:

type @ $this

350. Patient.multipleBirth[x]:multipleBirthBoolean

Slice Name multipleBirthBoolean

Definition

An indication stating whether the patient is of a multiple birth.

Short MultipleBirthIndicator

Comments

Control 0..1

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Requirements

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

Alternate Names MeerlingIndicator

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

352. Patient.photo

Definition

Image of the patient.

Short Image of the patient

Comments

Guidelines:

Use id photos, not clinical photos.
Limit dimensions to thumbnail.
Keep byte count low to ease resource updates.

Control 0..*

Attachment

Is Modifier false

Summary false

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

354. Patient.contact

Definition

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

Short Contact

Comments

Whereas the zib ContactPerson includes all (non-healthcare professional) persons that are involved in the care for a patient, FHIR distinguishes two use cases for these persons:

The RelatedPerson resource is used to capture information about any person that is related to the patient, using the profile http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactPerson.
Information about persons that should be contacted regarding the care for the patient is captured using the Patient.contact resource.

If a person is both a related person and a contact person, then some data duplication is inevitable. The nl-core-ContactPerson can be referenced using the extension in contact:contactPerson.

Control 0..*

Is Modifier false

Summary false

Requirements

Need to track people you can contact about the patient.

Alternate Names Contactpersoon

356. Patient.contact.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

358. Patient.contact.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.contact.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

360. Patient.contact.extension:contactPerson

Slice Name contactPerson

Definition

Short This contact may have further details in this RelatedPerson

Comments

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(Patient Related Person) (Extension Type: Reference(RelatedPerson))

Is Modifier false

Must Support true

Obligations

Obligations

Actor

SHALL:populate-if-known

SHALL:no-error

Summary false

362. Patient.contact.extension:contactPerson.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

364. Patient.contact.extension:contactPerson.extension

Definition

An Extension

Short Extension

Control 0..0

Is Modifier false

Summary false

This element introduces a set of slices on Patient.contact.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

366. Patient.contact.extension:contactPerson.url

Definition

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

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://hl7.org/fhir/StructureDefinition/patient-relatedPerson

368. Patient.contact.extension:contactPerson.value[x]

Definition

Reference to an nl-core-ContactPerson instance containing the full details for the current contact.

Short Contact

Control 1..1

Type Reference(ACP ContactPerson)

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary false

Alternate Names Contactpersoon

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

370. Patient.contact.modifierExtension

Definition

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

Short Extensions that cannot be ignored even if unrecognized

Comments

Control 0..*

Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

Summary true

Requirements

Alternate Names extensions, user content, modifiers

372. Patient.contact.relationship

Definition

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

Short The kind of relationship

Control 0..*

Unless not suitable, these codes SHALL be taken from PatientContactRelationship
(extensible to http://hl7.org/fhir/ValueSet/patient-contactrelationship|4.0.1)

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

Is Modifier false

Summary false

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

This element introduces a set of slices on Patient.contact.relationship. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ $this

374. Patient.contact.relationship:role

Slice Name role

Definition

Defines the role of the contact in relation to the patient.

Short Role

Control 0..*

The codes SHALL be taken from RolCodelijst (2020-09-01T00:00:00)
(required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.3.1.2--20200901000000|2020-09-01T00:00:00)

RolCodelijst

Is Modifier false

Summary false

Requirements

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

Alternate Names Rol

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

376. Patient.contact.relationship:relationship

Slice Name relationship

Definition

Defines the contact’s familial relationship to the patient.

Short Relationship

Control 0..*

The codes SHALL be taken from RelatieCodelijst (2020-09-01T00:00:00)
(required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.3.1.1--20200901000000|2020-09-01T00:00:00)

RelatieCodelijst

Is Modifier false

Summary false

Requirements

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

Alternate Names Relatie

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

378. Patient.contact.name

Definition

This slice represents the person's official name information, including given names, last name and possibly the partner's last name.

Short NameInformation

Comments

If parts of the name are specified using one or more of the structured elements, the .text element SHOULD be populated with a rendered version of the full name.
If parts of the family name are specified using the extensions in .family, the .family element SHOULD be populated with the full family name.

Note 2: This element should only contain a person's official names. The GivenName concept is represented in another .name element with .name.use = usual.

Note 3: The examples illustrate how the zib is mapped to FHIR.

Control 0..1
This element is affected by the following invariants: ele-1

Type HumanName(nl core NameInformation)

Is Modifier false

Summary false

Requirements

Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person.

Alternate Names Naamgegevens, nl-core-NameInformation

380. Patient.contact.telecom

Definition

The contact’s telephone number and/or e-mail address.

Short ContactInformation

Comments

Control 0..*

Is Modifier false

Summary false

Requirements

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

Alternate Names Contactgegevens

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

This element introduces a set of slices on Patient.contact.telecom. The slices areUnordered and Open, and can be differentiated using the following discriminators:

profile @ $this

382. Patient.contact.telecom:telephoneNumbers

Slice Name telephoneNumbers

Definition

Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc.

Short TelephoneNumbers

Comments

Implementation of the "TelephoneNumbers" concept of zib ContactInformation.

Control 0..*
This element is affected by the following invariants: ele-1

Type ContactPoint(nl core ContactInformation TelephoneNumbers)

Is Modifier false

Standard Status Normative (from Normative)

Summary false

Requirements

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

Alternate Names Telefoonnummers, nl-core-ContactInformation-TelephoneNumbers

384. Patient.contact.telecom:emailAddresses

Slice Name emailAddresses

Definition

Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc.

Short EmailAddresses

Comments

Implementation of the "EmailAddresses" concept of zib ContactInformation.

Control 0..*
This element is affected by the following invariants: ele-1

Type ContactPoint(nl core ContactInformation EmailAddresses)

Is Modifier false

Standard Status Normative (from Normative)

Summary false

Requirements

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

Alternate Names EmailAdressen, nl-core-ContactInformation-EmailAddresses

386. Patient.contact.address

Definition

Short AddressInformation

Comments

This element can and should not completely capture the AddressInformation concept from zib ContactPerson; it should just be used for the information that is needed for contacting the person in relation to care of the patient. The full address information should instead be captured using an instance of nl-core-ContactPerson, which can then be referenced from this resource. See the comment on Patient.contact for more information.

Control 0..1
This element is affected by the following invariants: ele-1

Type Address(nl core AddressInformation)

Is Modifier false

Summary false

Requirements

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

Alternate Names Adresgegevens, nl-core-AddressInformation

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

388. Patient.contact.gender

Definition

Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes.

Short male | female | other | unknown

Control 0..1

The codes SHALL be taken from AdministrativeGender
(required to http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1)

The gender of a person used for administrative purposes.

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Requirements

Needed to address the person correctly.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

390. Patient.contact.organization

Definition

Organization on behalf of which the contact is acting or for which the contact is working.

Short Organization that is associated with the contact

Control 0..1
This element is affected by the following invariants: pat-1

Type Reference(Organization)

Is Modifier false

Summary false

Requirements

For guardians or business related contacts, the organization is relevant.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

392. Patient.contact.period

Definition

The period during which this contact person or organization is valid to be contacted relating to this patient.

Short The period during which this contact person or organization is valid to be contacted relating to this patient

Control 0..1

Is Modifier false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

394. Patient.communication

Definition

A language which may be used to communicate with the patient about his or her health.

Short LanguageProficiency

Comments

If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.

Control 0..*

Is Modifier false

Summary false

Requirements

If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest.

Alternate Names Taalvaardigheid

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

396. Patient.communication.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

398. Patient.communication.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.communication.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

400. Patient.communication.extension:languageControl

Slice Name languageControl

Definition

The ability to understand spoken text in the language in question. The ability to express oneself in spoken language. The ability to understand written text in he language in question.

Short LanguageControlListening / LanguageControlSpeaking / LanguageControlReading

Comments

The zib concepts LanguageControlListening, LanguageControlReading, LanguageControlSpeaking are captured using a core extension from the R4 FHIR specification. Each of these three concepts is encoded as a copy of the extension, typed using the code in the type slice according to the following mapping:

LanguageControlListening maps to code 'RSP' (Received spoken)
LanguageControlReading maps to code 'RWR' (Received written)
LanguageControlSpeaking maps to code 'ESP' (Expressed spoken)

Control 0..*
This element is affected by the following invariants: ele-1

Type Extension(Patient Proficiency) (Complex Extension)

Is Modifier false

Alternate Names extensions, user content, TaalvaardigheidBegrijpen, TaalvaardigheidSpreken, TaalvaardigheidLezen

402. Patient.communication.extension:languageControl.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

404. Patient.communication.extension:languageControl.extension

Definition

Short Additional content defined by implementations

Comments

Control 2..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.communication.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

406. Patient.communication.extension:languageControl.extension:level

Slice Name level

Definition

How well the patient can communicate this communication (good, poor, etc.).

Short The proficiency level of the communication

Control 1..1

Is Modifier false

Summary false

408. Patient.communication.extension:languageControl.extension:level.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

410. Patient.communication.extension:languageControl.extension:level.extension

Definition

An Extension

Short Extension

Control 0..0

Is Modifier false

Summary false

This element introduces a set of slices on Patient.communication.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

412. Patient.communication.extension:languageControl.extension:level.url

Definition

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

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value level

414. Patient.communication.extension:languageControl.extension:level.value[x]

Definition

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

Short Value of extension

Comments

The zib ValueSets TaalvaardigheidBegrijpenCodelijst, TaalvaardigheidSprekenCodelijst and TaalvaardigheidLezenCodelijst are equal to the default FHIR ValueSet.

Control 1..1

The codes SHALL be taken from LanguageAbilityProficiency (3.0.0)
(required to http://terminology.hl7.org/ValueSet/v3-LanguageAbilityProficiency|3.0.0)

The proficiency level for the communication.

Coding

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

416. Patient.communication.extension:languageControl.extension:type

Slice Name type

Definition

What type of communication for the proficiency (spoken, written, etc.).

Short The proficiency type of the communication

Control 1..1

Is Modifier false

Summary false

418. Patient.communication.extension:languageControl.extension:type.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

420. Patient.communication.extension:languageControl.extension:type.extension

Definition

An Extension

Short Extension

Control 0..0

Is Modifier false

Summary false

This element introduces a set of slices on Patient.communication.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

422. Patient.communication.extension:languageControl.extension:type.url

Definition

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

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value type

424. Patient.communication.extension:languageControl.extension:type.value[x]

Definition

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

Short Value of extension

Control 1..1

The codes SHOULD be taken from LanguageAbilityMode (3.0.0)
(preferred to http://terminology.hl7.org/ValueSet/v3-LanguageAbilityMode|3.0.0)

The proficiency type for the communication.

Coding

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

426. Patient.communication.extension:languageControl.url

Definition

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

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://hl7.org/fhir/StructureDefinition/patient-proficiency

428. Patient.communication.extension:languageControl.value[x]

Definition

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

Short Value of extension

Control 0..0

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

430. Patient.communication.extension:communicationDetails

Slice Name communicationDetails

Definition

Optional Extension Element - found in all resources.

Short Optional Extensions Element

Comments

Control 0..*
This element is affected by the following invariants: ele-1

Type Extension(ext LanguageProficiency.CommunicationDetails) (Extension Type: CodeableConcept)

Is Modifier false

Standard Status Normative (from Normative)

Summary false

Alternate Names extensions, user content

432. Patient.communication.extension:comment

Slice Name comment

Definition

Optional Extension Element - found in all resources.

Short Optional Extensions Element

Comments

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(ext Comment) (Extension Type: string)

Is Modifier false

Standard Status Normative (from Normative)

Summary false

Alternate Names extensions, user content

434. Patient.communication.extension:comment.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

436. Patient.communication.extension:comment.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.communication.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

438. Patient.communication.extension:comment.url

Definition

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

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://nictiz.nl/fhir/StructureDefinition/ext-Comment

440. Patient.communication.extension:comment.value[x]

Definition

A comment on the linguistic proficiency. When using sign language, this field can be used to clarify, for example, which sign language is used. This can be informative, as there is not always a one-to-one relationship between the spoken language and sign language.

Short Comment

Control 0..1

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Alternate Names Toelichting

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

442. Patient.communication.modifierExtension

Definition

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

Short Extensions that cannot be ignored even if unrecognized

Comments

Control 0..*

Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

Summary true

Requirements

Alternate Names extensions, user content, modifiers

444. Patient.communication.language

Definition

The language of communication.

Short CommunicationLanguage

Comments

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

Control 1..1

The codes SHALL be taken from CommunicatieTaalCodelijst (2020-09-01T00:00:00)
(required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.7.12.2--20200901000000|2020-09-01T00:00:00)

CommunicatieTaalCodelijst

Additional Bindings

Purpose

Is Modifier false

Summary false

Requirements

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

Alternate Names CommunicatieTaal

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

446. Patient.communication.preferred

Definition

Indicates whether or not the patient prefers this language (over other languages he masters up a certain level).

Short Language preference indicator

Comments

This language is specifically identified for communicating healthcare information.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Requirements

People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

448. Patient.generalPractitioner

Definition

Patient's nominated care provider.

Short Patient's nominated primary care provider

Comments

Each occurrence of the zib HealthProfessional is normally represented by two FHIR resources: a PractitionerRole resource (instance of nl-core-HealthProfessional-PractitionerRole) and a Practitioner resource (instance of nl-core-HealthProfessional-Practitioner). The Practitioner resource is referenced from the PractitionerRole instance. For this reason, sending systems should fill the reference to the PractitionerRole instance here, and not the Practitioner resource. Receiving systems can then retrieve the reference to the Practitioner resource from that PractitionerRole instance.

In rare circumstances, there is only a Practitioner instance, in which case it is that instance which will be referenced here. However, since this should be the exception, the nl-core-HealthProfessional-Practitioner profile is not explicitly mentioned as a target profile.

Control 0..*

Type Reference(Organization, Practitioner, PractitionerRole, nl core HealthProfessional PractitionerRole)

Is Modifier false

Summary false

Alternate Names careProvider

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

450. Patient.managingOrganization

Definition

Organization that is the custodian of the patient record.

Short Organization that is the custodian of the patient record

Comments

There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association).

Control 0..1

Type Reference(Organization)

Is Modifier false

Summary true

Requirements

Need to know who recognizes this patient record, manages and updates it.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

452. Patient.link

Definition

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

Short Link to another patient resource that concerns the same actual person

Comments

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

Control 0..*

Summary true

Requirements

There are multiple use cases:

Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and
Distribution of patient information across multiple servers.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

454. Patient.link.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

456. Patient.link.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

458. Patient.link.modifierExtension

Definition

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

Short Extensions that cannot be ignored even if unrecognized

Comments

Control 0..*

Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

Summary true

Requirements

Alternate Names extensions, user content, modifiers

460. Patient.link.other

Definition

The other patient resource that the link refers to.

Short The other patient or related person resource that the link refers to

Comments

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

Control 1..1

Type Reference(Patient, RelatedPerson)

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

462. Patient.link.type

Definition

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

Short replaced-by | replaces | refer | seealso

Control 1..1

The codes SHALL be taken from LinkType
(required to http://hl7.org/fhir/ValueSet/link-type|4.0.1)

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