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Resource Profile: US Core Patient Profile

Official URL: http://shinny.org/StructureDefinition/us-core-patient				Version: 0.2
Active as of 2022-09-30			Realm:	Computable Name: USCorePatientProfile
Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License

The US Core Patient Profile meets the U.S. Core Data for Interoperability (USCDI) v3 ‘Patient Demographics’ requirements. This profile sets minimum expectations for the Patient resource to record, search, and fetch basic demographics and other administrative information about an individual patient. It identifies which core elements, extensions, vocabularies, and value sets SHALL be present in the resource when using this profile to promote interoperability and adoption through common implementation. It identifies which core elements, extensions, vocabularies, and value sets SHALL be present in the resource when using this profile. It provides the floor for standards development for specific use cases.

Usage:

• Derived from this Resource Profile: SHINNY Patient Profile
• Refer to this Resource Profile: US Core CarePlan Profile, US Core CareTeam Profile, US Core Condition Encounter Diagnosis Profile, US Core Condition Problems and Health Concerns Profile... Show 8 more, US Core DocumentReference Profile, US Core Encounter Profile, US Core Laboratory Result Observation Profile, US Core Observation Screening Assessment Profile, US Core Procedure Profile, US Core RelatedPerson Profile, US Core ServiceRequest Profile and US Core Simple Observation Profile

Formal Views of Profile Content

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

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

This structure is derived from Patient

Name	Flags	Card.	Type	Description & Constraints
Patient		0..*	Patient	Information about an individual or animal receiving health care services
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
race		0..1	(Complex)	US Core Race Extension URL: http://shinny.org/StructureDefinition/us-core-race
ethnicity		0..1	(Complex)	US Core ethnicity Extension URL: http://shinny.org/StructureDefinition/us-core-ethnicity
tribalAffiliation		0..*	(Complex)	Tribal Affiliation Extension URL: http://shinny.org/StructureDefinition/us-core-tribal-affiliation
birthsex		0..1	code	US Core Birth Sex Extension URL: http://shinny.org/StructureDefinition/us-core-birthsex Binding: Birth Sex (required): Code for sex assigned at birth
sex-for-clinical-use		0..*	(Complex)	A context-specific sex for clinical use URL: http://shinny.org/StructureDefinition/us-core-sex-for-clinical-use
genderIdentity		0..*	CodeableConcept	US Core Gender Identity Extension URL: http://hl7.org/fhir/StructureDefinition/patient-genderIdentity profiled by http://shinny.org/StructureDefinition/us-core-genderIdentity Binding: Gender Identity (extensible)
identifier	S	1..*	Identifier	An identifier for this patient
system	S	1..1	uri	The namespace for the identifier value
value	S	1..1	string	The value that is unique within the system.
name	SC	0..*	HumanName	A name associated with the patient us-core-6: At least name.given and/or name.family are present or, if neither is available, the Data Absent Reason Extension is present.
family	SC	0..1	string	Family name (often called 'Surname')
given	SC	0..*	string	Given names (not always 'first'). Includes middle names
suffix		0..*	string	Parts that come after the name
period		0..1	Period	Time period when name was/is in use
telecom		0..*	ContactPoint	A contact detail for the individual
system	S	1..1	code	phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value	S	1..1	string	The actual contact point details
use	S	0..1	code	home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required)
gender	S	1..1	code	male | female | other | unknown Binding: AdministrativeGender (required)
birthDate	S	0..1	date	The date of birth for the individual
address	S	0..*	Address	An address for the individual
line	S	0..*	string	Street name, number, direction & P.O. Box etc.
city	S	0..1	string	Name of city, town etc.
state	S	0..1	string	Sub-unit of country (abbreviations ok) Binding: USPS Two Letter Alphabetic Codes (extensible): Two Letter USPS alphabetic codes.
postalCode	S	0..1	string	US Zip Codes
period	S	0..1	Period	Time period when address was/is in use
communication		0..*	BackboneElement	A language which may be used to communicate with the patient about his or her health
language	S	1..1	CodeableConcept	The language which can be used to communicate with the patient about his or her health Binding: Language codes with language and optionally a region modifier (extensible)
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Patient.telecom.system	required	ContactPointSystem
Patient.telecom.use	required	ContactPointUse
Patient.gender	required	AdministrativeGender
Patient.address.state	extensible	UspsTwoLetterAlphabeticCodes (a valid code from https://www.usps.com/)
Patient.communication.language	extensible	LanguageCodesWithLanguageAndOptionallyARegionModifier

Constraints

Id	Grade	Path(s)	Details	Requirements
us-core-6	error	Patient.name	At least name.given and/or name.family are present or, if neither is available, the Data Absent Reason Extension is present. : (family.exists() or given.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()

Name	Flags	Card.	Type	Description & Constraints
Patient		0..*	Patient	Information about an individual or animal receiving health care services
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
race		0..1	(Complex)	US Core Race Extension URL: http://shinny.org/StructureDefinition/us-core-race
ethnicity		0..1	(Complex)	US Core ethnicity Extension URL: http://shinny.org/StructureDefinition/us-core-ethnicity
tribalAffiliation		0..*	(Complex)	Tribal Affiliation Extension URL: http://shinny.org/StructureDefinition/us-core-tribal-affiliation
birthsex		0..1	code	US Core Birth Sex Extension URL: http://shinny.org/StructureDefinition/us-core-birthsex Binding: Birth Sex (required): Code for sex assigned at birth
sex-for-clinical-use		0..*	(Complex)	A context-specific sex for clinical use URL: http://shinny.org/StructureDefinition/us-core-sex-for-clinical-use
genderIdentity		0..*	CodeableConcept	US Core Gender Identity Extension URL: http://hl7.org/fhir/StructureDefinition/patient-genderIdentity profiled by http://shinny.org/StructureDefinition/us-core-genderIdentity Binding: Gender Identity (extensible)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..*	Identifier	An identifier for this patient
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique within the system. Example General: 123456
active	?!Σ	0..1	boolean	Whether this patient's record is in active use
name	SΣC	0..*	HumanName	A name associated with the patient us-core-6: At least name.given and/or name.family are present or, if neither is available, the Data Absent Reason Extension is present.
use	?!Σ	0..1	code	usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
family	SΣC	0..1	string	Family name (often called 'Surname')
given	SΣC	0..*	string	Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name
suffix	Σ	0..*	string	Parts that come after the name This repeating element order: Suffixes appear in the correct order for presenting the name
period	Σ	0..1	Period	Time period when name was/is in use
telecom	Σ	0..*	ContactPoint	A contact detail for the individual
system	SΣC	1..1	code	phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value	SΣ	1..1	string	The actual contact point details
use	?!SΣ	0..1	code	home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required)
gender	SΣ	1..1	code	male | female | other | unknown Binding: AdministrativeGender (required)
birthDate	SΣ	0..1	date	The date of birth for the individual
deceased[x]	?!Σ	0..1		Indicates if the individual is deceased or not
deceasedBoolean			boolean
deceasedDateTime			dateTime
address	SΣ	0..*	Address	An address for the individual
use	?!Σ	0..1	code	home | work | temp | old | billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
line	SΣ	0..*	string	Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label Example General: 137 Nowhere Street
city	SΣ	0..1	string	Name of city, town etc. Example General: Erewhon
state	SΣ	0..1	string	Sub-unit of country (abbreviations ok) Binding: USPS Two Letter Alphabetic Codes (extensible): Two Letter USPS alphabetic codes.
postalCode	SΣ	0..1	string	US Zip Codes Example General: 9132
period	SΣ	0..1	Period	Time period when address was/is in use Example General: {"start":"2010-03-23","end":"2010-07-01"}
communication		0..*	BackboneElement	A language which may be used to communicate with the patient about his or her health
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
language	S	1..1	CodeableConcept	The language which can be used to communicate with the patient about his or her health Binding: Language codes with language and optionally a region modifier (extensible)
link	?!Σ	0..*	BackboneElement	Link to another patient resource that concerns the same actual person
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
other	Σ	1..1	Reference(Patient | RelatedPerson)	The other patient or related person resource that the link refers to
type	Σ	1..1	code	replaced-by | replaces | refer | seealso Binding: LinkType (required): The type of link between this patient resource and another patient resource.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Patient.identifier.use	required	IdentifierUse
Patient.name.use	required	NameUse
Patient.telecom.system	required	ContactPointSystem
Patient.telecom.use	required	ContactPointUse
Patient.gender	required	AdministrativeGender
Patient.address.use	required	AddressUse
Patient.address.state	extensible	UspsTwoLetterAlphabeticCodes (a valid code from https://www.usps.com/)
Patient.communication.language	extensible	LanguageCodesWithLanguageAndOptionallyARegionModifier
Patient.link.type	required	LinkType

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Patient	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Patient	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Patient	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Patient	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Patient	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
us-core-6	error	Patient.name	At least name.given and/or name.family are present or, if neither is available, the Data Absent Reason Extension is present. : (family.exists() or given.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()

Name	Flags	Card.	Type	Description & Constraints
Patient		0..*	Patient	Information about an individual or animal receiving health care services
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
race		0..1	(Complex)	US Core Race Extension URL: http://shinny.org/StructureDefinition/us-core-race
ethnicity		0..1	(Complex)	US Core ethnicity Extension URL: http://shinny.org/StructureDefinition/us-core-ethnicity
tribalAffiliation		0..*	(Complex)	Tribal Affiliation Extension URL: http://shinny.org/StructureDefinition/us-core-tribal-affiliation
birthsex		0..1	code	US Core Birth Sex Extension URL: http://shinny.org/StructureDefinition/us-core-birthsex Binding: Birth Sex (required): Code for sex assigned at birth
sex-for-clinical-use		0..*	(Complex)	A context-specific sex for clinical use URL: http://shinny.org/StructureDefinition/us-core-sex-for-clinical-use
genderIdentity		0..*	CodeableConcept	US Core Gender Identity Extension URL: http://hl7.org/fhir/StructureDefinition/patient-genderIdentity profiled by http://shinny.org/StructureDefinition/us-core-genderIdentity Binding: Gender Identity (extensible)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..*	Identifier	An identifier for this patient
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique within the system. Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
active	?!Σ	0..1	boolean	Whether this patient's record is in active use
name	SΣC	0..*	HumanName	A name associated with the patient us-core-6: At least name.given and/or name.family are present or, if neither is available, the Data Absent Reason Extension is present.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
text	Σ	0..1	string	Text representation of the full name
family	SΣC	0..1	string	Family name (often called 'Surname')
given	SΣC	0..*	string	Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name
prefix	Σ	0..*	string	Parts that come before the name This repeating element order: Prefixes appear in the correct order for presenting the name
suffix	Σ	0..*	string	Parts that come after the name This repeating element order: Suffixes appear in the correct order for presenting the name
period	Σ	0..1	Period	Time period when name was/is in use
telecom	Σ	0..*	ContactPoint	A contact detail for the individual
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣC	1..1	code	phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value	SΣ	1..1	string	The actual contact point details
use	?!SΣ	0..1	code	home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required)
rank	Σ	0..1	positiveInt	Specify preferred order of use (1 = highest)
period	Σ	0..1	Period	Time period when the contact point was/is in use
gender	SΣ	1..1	code	male | female | other | unknown Binding: AdministrativeGender (required)
birthDate	SΣ	0..1	date	The date of birth for the individual
deceased[x]	?!Σ	0..1		Indicates if the individual is deceased or not
deceasedBoolean			boolean
deceasedDateTime			dateTime
address	SΣ	0..*	Address	An address for the individual
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	home | work | temp | old | billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
type	Σ	0..1	code	postal | physical | both Binding: AddressType (required): The type of an address (physical / postal). Example General: both
text	Σ	0..1	string	Text representation of the address Example General: 137 Nowhere Street, Erewhon 9132
line	SΣ	0..*	string	Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label Example General: 137 Nowhere Street
city	SΣ	0..1	string	Name of city, town etc. Example General: Erewhon
district	Σ	0..1	string	District name (aka county) Example General: Madison
state	SΣ	0..1	string	Sub-unit of country (abbreviations ok) Binding: USPS Two Letter Alphabetic Codes (extensible): Two Letter USPS alphabetic codes.
postalCode	SΣ	0..1	string	US Zip Codes Example General: 9132
country	Σ	0..1	string	Country (e.g. can be ISO 3166 2 or 3 letter code)
period	SΣ	0..1	Period	Time period when address was/is in use Example General: {"start":"2010-03-23","end":"2010-07-01"}
maritalStatus		0..1	CodeableConcept	Marital (civil) status of a patient Binding: Marital Status Codes (extensible): The domestic partnership status of a person.
multipleBirth[x]		0..1		Whether patient is part of a multiple birth
multipleBirthBoolean			boolean
multipleBirthInteger			integer
photo		0..*	Attachment	Image of the patient
contact	C	0..*	BackboneElement	A contact party (e.g. guardian, partner, friend) for the patient
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
relationship		0..*	CodeableConcept	The kind of relationship Binding: PatientContactRelationship (extensible): The nature of the relationship between a patient and a contact person for that patient.
name		0..1	HumanName	A name associated with the contact person
telecom		0..*	ContactPoint	A contact detail for the person
address		0..1	Address	Address for the contact person
gender		0..1	code	male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
organization	C	0..1	Reference(Organization)	Organization that is associated with the contact
period		0..1	Period	The period during which this contact person or organization is valid to be contacted relating to this patient
communication		0..*	BackboneElement	A language which may be used to communicate with the patient about his or her health
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
language	S	1..1	CodeableConcept	The language which can be used to communicate with the patient about his or her health Binding: Language codes with language and optionally a region modifier (extensible)
preferred		0..1	boolean	Language preference indicator
generalPractitioner		0..*	Reference(Organization | Practitioner | PractitionerRole)	Patient's nominated primary care provider
managingOrganization	Σ	0..1	Reference(Organization)	Organization that is the custodian of the patient record
link	?!Σ	0..*	BackboneElement	Link to another patient resource that concerns the same actual person
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
other	Σ	1..1	Reference(Patient | RelatedPerson)	The other patient or related person resource that the link refers to
type	Σ	1..1	code	replaced-by | replaces | refer | seealso Binding: LinkType (required): The type of link between this patient resource and another patient resource.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Patient.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Patient.identifier.use	required	IdentifierUse
Patient.identifier.type	extensible	Identifier Type Codes
Patient.name.use	required	NameUse
Patient.telecom.system	required	ContactPointSystem
Patient.telecom.use	required	ContactPointUse
Patient.gender	required	AdministrativeGender
Patient.address.use	required	AddressUse
Patient.address.type	required	AddressType
Patient.address.state	extensible	UspsTwoLetterAlphabeticCodes (a valid code from https://www.usps.com/)
Patient.maritalStatus	extensible	Marital Status Codes
Patient.contact.relationship	extensible	PatientContactRelationship
Patient.contact.gender	required	AdministrativeGender
Patient.communication.language	extensible	LanguageCodesWithLanguageAndOptionallyARegionModifier
Patient.link.type	required	LinkType

Constraints

Id	Grade	Path(s)	Details	Requirements
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
pat-1	error	Patient.contact	SHALL at least contain a contact's details or a reference to an organization : name.exists() or telecom.exists() or address.exists() or organization.exists()
us-core-6	error	Patient.name	At least name.given and/or name.family are present or, if neither is available, the Data Absent Reason Extension is present. : (family.exists() or given.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()

This structure is derived from Patient

Summary

Mandatory: 4 elements (2 nested mandatory elements)
Must-Support: 18 elements

Extensions

This structure refers to these extensions:

• http://shinny.org/StructureDefinition/us-core-race
• http://shinny.org/StructureDefinition/us-core-ethnicity
• http://shinny.org/StructureDefinition/us-core-tribal-affiliation
• http://shinny.org/StructureDefinition/us-core-birthsex
• http://shinny.org/StructureDefinition/us-core-sex-for-clinical-use
• http://shinny.org/StructureDefinition/us-core-genderIdentity

Differential View

This structure is derived from Patient

Name	Flags	Card.	Type	Description & Constraints
Patient		0..*	Patient	Information about an individual or animal receiving health care services
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
race		0..1	(Complex)	US Core Race Extension URL: http://shinny.org/StructureDefinition/us-core-race
ethnicity		0..1	(Complex)	US Core ethnicity Extension URL: http://shinny.org/StructureDefinition/us-core-ethnicity
tribalAffiliation		0..*	(Complex)	Tribal Affiliation Extension URL: http://shinny.org/StructureDefinition/us-core-tribal-affiliation
birthsex		0..1	code	US Core Birth Sex Extension URL: http://shinny.org/StructureDefinition/us-core-birthsex Binding: Birth Sex (required): Code for sex assigned at birth
sex-for-clinical-use		0..*	(Complex)	A context-specific sex for clinical use URL: http://shinny.org/StructureDefinition/us-core-sex-for-clinical-use
genderIdentity		0..*	CodeableConcept	US Core Gender Identity Extension URL: http://hl7.org/fhir/StructureDefinition/patient-genderIdentity profiled by http://shinny.org/StructureDefinition/us-core-genderIdentity Binding: Gender Identity (extensible)
identifier	S	1..*	Identifier	An identifier for this patient
system	S	1..1	uri	The namespace for the identifier value
value	S	1..1	string	The value that is unique within the system.
name	SC	0..*	HumanName	A name associated with the patient us-core-6: At least name.given and/or name.family are present or, if neither is available, the Data Absent Reason Extension is present.
family	SC	0..1	string	Family name (often called 'Surname')
given	SC	0..*	string	Given names (not always 'first'). Includes middle names
suffix		0..*	string	Parts that come after the name
period		0..1	Period	Time period when name was/is in use
telecom		0..*	ContactPoint	A contact detail for the individual
system	S	1..1	code	phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value	S	1..1	string	The actual contact point details
use	S	0..1	code	home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required)
gender	S	1..1	code	male | female | other | unknown Binding: AdministrativeGender (required)
birthDate	S	0..1	date	The date of birth for the individual
address	S	0..*	Address	An address for the individual
line	S	0..*	string	Street name, number, direction & P.O. Box etc.
city	S	0..1	string	Name of city, town etc.
state	S	0..1	string	Sub-unit of country (abbreviations ok) Binding: USPS Two Letter Alphabetic Codes (extensible): Two Letter USPS alphabetic codes.
postalCode	S	0..1	string	US Zip Codes
period	S	0..1	Period	Time period when address was/is in use
communication		0..*	BackboneElement	A language which may be used to communicate with the patient about his or her health
language	S	1..1	CodeableConcept	The language which can be used to communicate with the patient about his or her health Binding: Language codes with language and optionally a region modifier (extensible)
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Patient.telecom.system	required	ContactPointSystem
Patient.telecom.use	required	ContactPointUse
Patient.gender	required	AdministrativeGender
Patient.address.state	extensible	UspsTwoLetterAlphabeticCodes (a valid code from https://www.usps.com/)
Patient.communication.language	extensible	LanguageCodesWithLanguageAndOptionallyARegionModifier

Constraints

Id	Grade	Path(s)	Details	Requirements
us-core-6	error	Patient.name	At least name.given and/or name.family are present or, if neither is available, the Data Absent Reason Extension is present. : (family.exists() or given.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Patient		0..*	Patient	Information about an individual or animal receiving health care services
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
race		0..1	(Complex)	US Core Race Extension URL: http://shinny.org/StructureDefinition/us-core-race
ethnicity		0..1	(Complex)	US Core ethnicity Extension URL: http://shinny.org/StructureDefinition/us-core-ethnicity
tribalAffiliation		0..*	(Complex)	Tribal Affiliation Extension URL: http://shinny.org/StructureDefinition/us-core-tribal-affiliation
birthsex		0..1	code	US Core Birth Sex Extension URL: http://shinny.org/StructureDefinition/us-core-birthsex Binding: Birth Sex (required): Code for sex assigned at birth
sex-for-clinical-use		0..*	(Complex)	A context-specific sex for clinical use URL: http://shinny.org/StructureDefinition/us-core-sex-for-clinical-use
genderIdentity		0..*	CodeableConcept	US Core Gender Identity Extension URL: http://hl7.org/fhir/StructureDefinition/patient-genderIdentity profiled by http://shinny.org/StructureDefinition/us-core-genderIdentity Binding: Gender Identity (extensible)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..*	Identifier	An identifier for this patient
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique within the system. Example General: 123456
active	?!Σ	0..1	boolean	Whether this patient's record is in active use
name	SΣC	0..*	HumanName	A name associated with the patient us-core-6: At least name.given and/or name.family are present or, if neither is available, the Data Absent Reason Extension is present.
use	?!Σ	0..1	code	usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
family	SΣC	0..1	string	Family name (often called 'Surname')
given	SΣC	0..*	string	Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name
suffix	Σ	0..*	string	Parts that come after the name This repeating element order: Suffixes appear in the correct order for presenting the name
period	Σ	0..1	Period	Time period when name was/is in use
telecom	Σ	0..*	ContactPoint	A contact detail for the individual
system	SΣC	1..1	code	phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value	SΣ	1..1	string	The actual contact point details
use	?!SΣ	0..1	code	home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required)
gender	SΣ	1..1	code	male | female | other | unknown Binding: AdministrativeGender (required)
birthDate	SΣ	0..1	date	The date of birth for the individual
deceased[x]	?!Σ	0..1		Indicates if the individual is deceased or not
deceasedBoolean			boolean
deceasedDateTime			dateTime
address	SΣ	0..*	Address	An address for the individual
use	?!Σ	0..1	code	home | work | temp | old | billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
line	SΣ	0..*	string	Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label Example General: 137 Nowhere Street
city	SΣ	0..1	string	Name of city, town etc. Example General: Erewhon
state	SΣ	0..1	string	Sub-unit of country (abbreviations ok) Binding: USPS Two Letter Alphabetic Codes (extensible): Two Letter USPS alphabetic codes.
postalCode	SΣ	0..1	string	US Zip Codes Example General: 9132
period	SΣ	0..1	Period	Time period when address was/is in use Example General: {"start":"2010-03-23","end":"2010-07-01"}
communication		0..*	BackboneElement	A language which may be used to communicate with the patient about his or her health
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
language	S	1..1	CodeableConcept	The language which can be used to communicate with the patient about his or her health Binding: Language codes with language and optionally a region modifier (extensible)
link	?!Σ	0..*	BackboneElement	Link to another patient resource that concerns the same actual person
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
other	Σ	1..1	Reference(Patient | RelatedPerson)	The other patient or related person resource that the link refers to
type	Σ	1..1	code	replaced-by | replaces | refer | seealso Binding: LinkType (required): The type of link between this patient resource and another patient resource.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Patient.identifier.use	required	IdentifierUse
Patient.name.use	required	NameUse
Patient.telecom.system	required	ContactPointSystem
Patient.telecom.use	required	ContactPointUse
Patient.gender	required	AdministrativeGender
Patient.address.use	required	AddressUse
Patient.address.state	extensible	UspsTwoLetterAlphabeticCodes (a valid code from https://www.usps.com/)
Patient.communication.language	extensible	LanguageCodesWithLanguageAndOptionallyARegionModifier
Patient.link.type	required	LinkType

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Patient	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Patient	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Patient	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Patient	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Patient	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
us-core-6	error	Patient.name	At least name.given and/or name.family are present or, if neither is available, the Data Absent Reason Extension is present. : (family.exists() or given.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Patient		0..*	Patient	Information about an individual or animal receiving health care services
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
race		0..1	(Complex)	US Core Race Extension URL: http://shinny.org/StructureDefinition/us-core-race
ethnicity		0..1	(Complex)	US Core ethnicity Extension URL: http://shinny.org/StructureDefinition/us-core-ethnicity
tribalAffiliation		0..*	(Complex)	Tribal Affiliation Extension URL: http://shinny.org/StructureDefinition/us-core-tribal-affiliation
birthsex		0..1	code	US Core Birth Sex Extension URL: http://shinny.org/StructureDefinition/us-core-birthsex Binding: Birth Sex (required): Code for sex assigned at birth
sex-for-clinical-use		0..*	(Complex)	A context-specific sex for clinical use URL: http://shinny.org/StructureDefinition/us-core-sex-for-clinical-use
genderIdentity		0..*	CodeableConcept	US Core Gender Identity Extension URL: http://hl7.org/fhir/StructureDefinition/patient-genderIdentity profiled by http://shinny.org/StructureDefinition/us-core-genderIdentity Binding: Gender Identity (extensible)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..*	Identifier	An identifier for this patient
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique within the system. Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
active	?!Σ	0..1	boolean	Whether this patient's record is in active use
name	SΣC	0..*	HumanName	A name associated with the patient us-core-6: At least name.given and/or name.family are present or, if neither is available, the Data Absent Reason Extension is present.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
text	Σ	0..1	string	Text representation of the full name
family	SΣC	0..1	string	Family name (often called 'Surname')
given	SΣC	0..*	string	Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name
prefix	Σ	0..*	string	Parts that come before the name This repeating element order: Prefixes appear in the correct order for presenting the name
suffix	Σ	0..*	string	Parts that come after the name This repeating element order: Suffixes appear in the correct order for presenting the name
period	Σ	0..1	Period	Time period when name was/is in use
telecom	Σ	0..*	ContactPoint	A contact detail for the individual
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣC	1..1	code	phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value	SΣ	1..1	string	The actual contact point details
use	?!SΣ	0..1	code	home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required)
rank	Σ	0..1	positiveInt	Specify preferred order of use (1 = highest)
period	Σ	0..1	Period	Time period when the contact point was/is in use
gender	SΣ	1..1	code	male | female | other | unknown Binding: AdministrativeGender (required)
birthDate	SΣ	0..1	date	The date of birth for the individual
deceased[x]	?!Σ	0..1		Indicates if the individual is deceased or not
deceasedBoolean			boolean
deceasedDateTime			dateTime
address	SΣ	0..*	Address	An address for the individual
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	home | work | temp | old | billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
type	Σ	0..1	code	postal | physical | both Binding: AddressType (required): The type of an address (physical / postal). Example General: both
text	Σ	0..1	string	Text representation of the address Example General: 137 Nowhere Street, Erewhon 9132
line	SΣ	0..*	string	Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label Example General: 137 Nowhere Street
city	SΣ	0..1	string	Name of city, town etc. Example General: Erewhon
district	Σ	0..1	string	District name (aka county) Example General: Madison
state	SΣ	0..1	string	Sub-unit of country (abbreviations ok) Binding: USPS Two Letter Alphabetic Codes (extensible): Two Letter USPS alphabetic codes.
postalCode	SΣ	0..1	string	US Zip Codes Example General: 9132
country	Σ	0..1	string	Country (e.g. can be ISO 3166 2 or 3 letter code)
period	SΣ	0..1	Period	Time period when address was/is in use Example General: {"start":"2010-03-23","end":"2010-07-01"}
maritalStatus		0..1	CodeableConcept	Marital (civil) status of a patient Binding: Marital Status Codes (extensible): The domestic partnership status of a person.
multipleBirth[x]		0..1		Whether patient is part of a multiple birth
multipleBirthBoolean			boolean
multipleBirthInteger			integer
photo		0..*	Attachment	Image of the patient
contact	C	0..*	BackboneElement	A contact party (e.g. guardian, partner, friend) for the patient
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
relationship		0..*	CodeableConcept	The kind of relationship Binding: PatientContactRelationship (extensible): The nature of the relationship between a patient and a contact person for that patient.
name		0..1	HumanName	A name associated with the contact person
telecom		0..*	ContactPoint	A contact detail for the person
address		0..1	Address	Address for the contact person
gender		0..1	code	male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
organization	C	0..1	Reference(Organization)	Organization that is associated with the contact
period		0..1	Period	The period during which this contact person or organization is valid to be contacted relating to this patient
communication		0..*	BackboneElement	A language which may be used to communicate with the patient about his or her health
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
language	S	1..1	CodeableConcept	The language which can be used to communicate with the patient about his or her health Binding: Language codes with language and optionally a region modifier (extensible)
preferred		0..1	boolean	Language preference indicator
generalPractitioner		0..*	Reference(Organization | Practitioner | PractitionerRole)	Patient's nominated primary care provider
managingOrganization	Σ	0..1	Reference(Organization)	Organization that is the custodian of the patient record
link	?!Σ	0..*	BackboneElement	Link to another patient resource that concerns the same actual person
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
other	Σ	1..1	Reference(Patient | RelatedPerson)	The other patient or related person resource that the link refers to
type	Σ	1..1	code	replaced-by | replaces | refer | seealso Binding: LinkType (required): The type of link between this patient resource and another patient resource.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Patient.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Patient.identifier.use	required	IdentifierUse
Patient.identifier.type	extensible	Identifier Type Codes
Patient.name.use	required	NameUse
Patient.telecom.system	required	ContactPointSystem
Patient.telecom.use	required	ContactPointUse
Patient.gender	required	AdministrativeGender
Patient.address.use	required	AddressUse
Patient.address.type	required	AddressType
Patient.address.state	extensible	UspsTwoLetterAlphabeticCodes (a valid code from https://www.usps.com/)
Patient.maritalStatus	extensible	Marital Status Codes
Patient.contact.relationship	extensible	PatientContactRelationship
Patient.contact.gender	required	AdministrativeGender
Patient.communication.language	extensible	LanguageCodesWithLanguageAndOptionallyARegionModifier
Patient.link.type	required	LinkType

Constraints

Id	Grade	Path(s)	Details	Requirements
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
pat-1	error	Patient.contact	SHALL at least contain a contact's details or a reference to an organization : name.exists() or telecom.exists() or address.exists() or organization.exists()
us-core-6	error	Patient.name	At least name.given and/or name.family are present or, if neither is available, the Data Absent Reason Extension is present. : (family.exists() or given.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()

This structure is derived from Patient

Summary

Mandatory: 4 elements (2 nested mandatory elements)
Must-Support: 18 elements

Extensions

This structure refers to these extensions:

• http://shinny.org/StructureDefinition/us-core-race
• http://shinny.org/StructureDefinition/us-core-ethnicity
• http://shinny.org/StructureDefinition/us-core-tribal-affiliation
• http://shinny.org/StructureDefinition/us-core-birthsex
• http://shinny.org/StructureDefinition/us-core-sex-for-clinical-use
• http://shinny.org/StructureDefinition/us-core-genderIdentity

Other representations of profile: CSV, Excel, Schematron